Hussein Khalil Kalil, B O Sá Michel Pompeu, Vervoort Dominique, Roever Leonardo, de Andrade Pires Marcos Alfredo, de Oliveira Lima Jaqueline Maria, de Salles Felipe Borsu, Munhoz Khalil Giovana, Gomes Nicz Pedro Felipe, Vilca Mejía Omar Asdrúbal, Akio Okino Arnaldo, de Carvalho Lima Ricardo
Department of Cardiovascular Surgery, Hospital Norte Paranaense, Arapongas, Paraná, Brazil.
Department of Cardiovascular Surgery, PROCAPE, University of Pernambuco, Recife, Brazil.
J Card Surg. 2021 Mar;36(3):913-920. doi: 10.1111/jocs.15328. Epub 2021 Jan 19.
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.
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.
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 χ test was used to compare death rates. A p < .05 was considered statistically significant.
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.
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.
巴西是南美洲的一个上中等收入国家，人口居世界第六。尽管其公共和私人卫生系统在医疗服务和心脏外科护理方面取得了巨大进展，但对于巴西公共卫生系统中冠状动脉旁路移植术（CABG）的手术量、结果和趋势却知之甚少。
本研究的目的是通过数据库DATASUS评估2008年1月至2017年12月期间巴西公共卫生系统中CABG的结果。
本研究基于从巴西卫生部数据处理系统DATASUS获取的公开资料，包括手术数量、死亡率、住院时间和费用。我们的研究仅纳入单纯CABG手术。我们使用DATASUS网站的TabNet软件生成报告。采用χ检验比较死亡率。p < 0.05被认为具有统计学意义。
我们确定在2008年1月至2017年12月期间共进行了226,697例CABG手术。10年期间的总体住院死亡率为5.7%。我们观察到巴西五个大区域之间的死亡率存在统计学显著差异。各州的死亡率从2.6%到13.1%不等。全国平均死亡率在这期间保持稳定。
在10年期间，巴西公共卫生系统中进行了大量的CABG手术，在死亡率、手术数量和各地区手术分布方面存在显著差异。未来涉及所有进行CABG手术的中心并开展风险调整分析的数据库，将有助于改善巴西的手术结果，并使政策制定者能够采取适当的医疗政策，以提高透明度和问责制。
