Kalil Hussein Khalil1, Michel Pompeu B O Sá2,3, Dominique Vervoort4, Leonardo Roever5, Marcos Alfredo de Andrade Pires1, Jaqueline Maria de Oliveira Lima1, Felipe Borsu de Salles6, Giovana Munhoz Khalil1, Pedro Felipe Gomes Nicz7, Omar Asdrúbal Vilca Mejía7, Arnaldo Akio Okino1, Ricardo de Carvalho Lima2,3. 1. Department of Cardiovascular Surgery, Hospital Norte Paranaense, Arapongas, Paraná, Brazil. 2. Department of Cardiovascular Surgery, PROCAPE, University of Pernambuco, Recife, Brazil. 3. Nucleus of Postgraduate and Research in Health Sciences, Faculty of Medical Sciences and Biological Sciences Institute-(FCM/ICB), Recife, Pernambuco, Brazil. 4. Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA. 5. Department of Cardiovascular Surgery, Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil. 6. Department of Cardiovascular Surgery, Institute of Cardiology, Fundação Universitária de Cardiologia, Porto Alegre, Rio Grande do Sul, Brazil. 7. Department of Cardiology, Heart Institute - INCOR-HCFM-USP, São Paulo, São Paulo, Brazil.
Abstract
BACKGROUND: Brazil is an upper middle-income country in South America with the world's sixth largest population. Despite great advances in health-care services and cardiac surgical care in both its public and private health systems, little is known on the volume, outcomes, and trends of coronary artery bypass grafting (CABG) in Brazil's public health system. OBJECTIVE: The aim of this study was to evaluate the outcome of CABG on the public health system from January 2008 to December 2017 through the database DATASUS. METHODS: This study is based on publicly available material obtained from DATASUS, the Brazilian Ministry of Health's data processing system, on numbers of surgical procedures, death rates, length of stay, and costs. Only isolated CABG procedures were included in our study. We used the TabNet software from the DATASUS website to generate reports. The χ2 test was used to compare death rates. A p < .05 was considered statistically significant. RESULTS: We identified 226,697 CABG procedures performed from January 2008 to December 2017. The overall in-hospital mortality over the 10-year period was 5.7%. We observed statistically significant differences in death rates between the five Brazilian macro-regions. Death rates by state ranged from 2.6% to 13.1%. The national average mortality rate remained stable over the course of time. CONCLUSION: Over 10 years, a high volume of CABG was performed in the Brazilian Public Health System, with significant differences in mortality, number of procedures, and distribution of surgeries by region. Future databases involving all centers that perform CABG and carry out risk-adjusted analysis will help improve Brazilian results and enable policymakers to adopt appropriate health-care policies for greater transparency and accountability.
BACKGROUND: Brazil is an upper middle-income country in South America with the world's sixth largest population. Despite great advances in health-care services and cardiac surgical care in both its public and private health systems, little is known on the volume, outcomes, and trends of coronary artery bypass grafting (CABG) in Brazil's public health system. OBJECTIVE: The aim of this study was to evaluate the outcome of CABG on the public health system from January 2008 to December 2017 through the database DATASUS. METHODS: This study is based on publicly available material obtained from DATASUS, the Brazilian Ministry of Health's data processing system, on numbers of surgical procedures, death rates, length of stay, and costs. Only isolated CABG procedures were included in our study. We used the TabNet software from the DATASUS website to generate reports. The χ2 test was used to compare death rates. A p < .05 was considered statistically significant. RESULTS: We identified 226,697 CABG procedures performed from January 2008 to December 2017. The overall in-hospital mortality over the 10-year period was 5.7%. We observed statistically significant differences in death rates between the five Brazilian macro-regions. Death rates by state ranged from 2.6% to 13.1%. The national average mortality rate remained stable over the course of time. CONCLUSION: Over 10 years, a high volume of CABG was performed in the Brazilian Public Health System, with significant differences in mortality, number of procedures, and distribution of surgeries by region. Future databases involving all centers that perform CABG and carry out risk-adjusted analysis will help improve Brazilian results and enable policymakers to adopt appropriate health-care policies for greater transparency and accountability.
Authors: Salil V Deo; Yakov Elgudin; A Laurie W Shroyer; Salah Altarabsheh; Vikas Sharma; Joseph Rubelowsky; Lorraine Cornwell; Piroze Davierwala; Danny Chu; Brian Cmolik Journal: J Am Heart Assoc Date: 2022-03-01 Impact factor: 6.106