Lower Limb Revascularization for Peripheral Arterial Disease in 10,951 Procedures over 11 years in a Public Health System: A Descriptive Analysis of the Largest Brazilian City.


Journal

Annals of vascular surgery
ISSN: 1615-5947
Titre abrégé: Ann Vasc Surg
Pays: Netherlands
ID NLM: 8703941

Informations de publication

Date de publication:
Jan 2021
Historique:
received: 18 06 2020
revised: 12 07 2020
accepted: 13 07 2020
pubmed: 12 8 2020
medline: 20 1 2021
entrez: 12 8 2020
Statut: ppublish

Résumé

Worldwide, peripheral arterial disease (PAD) is a disease with high morbidity, affecting more than 200 million people. Our objective was to analyze the surgical treatment for PAD performed in the Unified Health System of the city of São Paulo during the last 11 years based on publicly available data. The study was conducted with data analysis available on the TabNet platform, belonging to the DATASUS. Public data (government health system) from procedures performed in São Paulo between 2008 and 2018 were extracted. Sex, age, municipality of residence, operative technique, number of surgeries (total and per hospital), mortality during hospitalization, mean length of stay in the intensive care unit and amount paid by the government system were analyzed. A total of 10,951 procedures were analyzed (either for claudicants or critical ischemia-proportion unknown); 55.4% of the procedures were performed on males, and in 50.60%, the patient was older than 65 years. Approximately two-thirds of the patients undergoing these procedures had residential addresses in São Paulo. There were 363 in-hospital deaths (mortality of 3.31%). The hospital with the highest number of surgeries (n = 2,777) had lower in-hospital mortality (1.51%) than the other hospitals. A total of $20,655,272.70 was paid for all revascularizations. Revascularization for PAD treatment has cost the government system more than $20 million over 11 years. Endovascular surgeries were performed more often than open surgeries and resulted in shorter hospital stays and lower perioperative mortality rates.

Sections du résumé

BACKGROUND BACKGROUND
Worldwide, peripheral arterial disease (PAD) is a disease with high morbidity, affecting more than 200 million people. Our objective was to analyze the surgical treatment for PAD performed in the Unified Health System of the city of São Paulo during the last 11 years based on publicly available data.
METHODS METHODS
The study was conducted with data analysis available on the TabNet platform, belonging to the DATASUS. Public data (government health system) from procedures performed in São Paulo between 2008 and 2018 were extracted. Sex, age, municipality of residence, operative technique, number of surgeries (total and per hospital), mortality during hospitalization, mean length of stay in the intensive care unit and amount paid by the government system were analyzed.
RESULTS RESULTS
A total of 10,951 procedures were analyzed (either for claudicants or critical ischemia-proportion unknown); 55.4% of the procedures were performed on males, and in 50.60%, the patient was older than 65 years. Approximately two-thirds of the patients undergoing these procedures had residential addresses in São Paulo. There were 363 in-hospital deaths (mortality of 3.31%). The hospital with the highest number of surgeries (n = 2,777) had lower in-hospital mortality (1.51%) than the other hospitals. A total of $20,655,272.70 was paid for all revascularizations.
CONCLUSIONS CONCLUSIONS
Revascularization for PAD treatment has cost the government system more than $20 million over 11 years. Endovascular surgeries were performed more often than open surgeries and resulted in shorter hospital stays and lower perioperative mortality rates.

Identifiants

pubmed: 32781262
pii: S0890-5096(20)30618-X
doi: 10.1016/j.avsg.2020.07.026
pii:
doi:

Types de publication

Comparative Study Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

223-229

Informations de copyright

Copyright © 2020 Elsevier Inc. All rights reserved.

Auteurs

Nelson Wolosker (N)

Hospital Israelita Albert Einstein, São Paulo - SP, Brazil; Faculdade Israelita de Ciências da Saúde Albert Einstein (FICSAE), Hospital Israelita Albert Einstein, São Paulo - SP, Brazil.

Marcelo Fiorelli Alexandrino da Silva (MFA)

Hospital Israelita Albert Einstein, São Paulo - SP, Brazil. Electronic address: marcelo.fiorelli96@gmail.com.

Dafne Braga Diamante Leiderman (DBD)

Hospital Israelita Albert Einstein, São Paulo - SP, Brazil.

Nickolas Stabellini (N)

Faculdade Israelita de Ciências da Saúde Albert Einstein (FICSAE), Hospital Israelita Albert Einstein, São Paulo - SP, Brazil.

Wellington Araujo Nogueira (WA)

Hospital Israelita Albert Einstein, São Paulo - SP, Brazil.

Claudia Szlejf (C)

Hospital Israelita Albert Einstein, São Paulo - SP, Brazil.

Edson Amaro (E)

Hospital Israelita Albert Einstein, São Paulo - SP, Brazil.

Marcelo Passos Teivelis (MP)

Hospital Israelita Albert Einstein, São Paulo - SP, Brazil; Faculdade Israelita de Ciências da Saúde Albert Einstein (FICSAE), Hospital Israelita Albert Einstein, São Paulo - SP, Brazil.

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Classifications MeSH