Myocardial revascularization surgery (MRS): results from national health system (SUS)

Myocardial revascularization surgery (MRS) is the most common surgery in this country, with most being performed through the National Health System(SUS).

To assess MRS results when not associated to other procedures.

The information from the Hospital Information System (SIH/DATASUS) made available online was submitted to analysis. The data include information on gender, age, hospital stay period, hospital admission authorization (AIH) costs, number of surgeries at each hospital, and in-hospital mortality rate. Only MRS with no associated procedures were analyzed.

A total of 63,529 surgeries were performed in the period between 2005 and 2007 at 191 hospitals. Sixteen hospitals reporting very low surgery volume were excluded. The remaining total number of surgeries came down to 63,272 for the final analysis. In-hospital mortality rate was 6.22%, with small surgery volume hospitals reporting higher rate than high volume hospitals (>or=300 surgeries in the time period under study), 7.29% versus 5.77% (p<0.001). Average hospital stay time length was 12 days, with no difference having been reported between low (12.08+/-5.52) and high volume (12.15+/-7.70) hospitals. Males reported lower mortality rate than females - 5.20% versus 8.25% (p<0.001), similarly to younger individuals when compared to the elderly (>or= 65 years of age), 4.21% versus 9.36% (p<0.001). A slight variation was observed in AIH values between the Southern Region (R$ 7.214,63 - approximately US$ 3,600.00) and the Northeastern Region (R$ 6.572,03 - approximately US$ 3,280.00) (p<0.01). Regional distribution of surgeries was not comparable in all regions in the country, with Southern and Southeastern Regions having reported 77% of them.

MRS performed by SUS has reported high mortality rate in low volume hospitals, among women, and among the elderly. Future prospective studies are deemed to be necessary.