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Hospital admissions for treatment of ruptured and unruptured cerebral aneurysms within the Brazilian National Health

Rossana Machado Sarmento1, Roger Dos Santos Rosa2

  • 1Universidade Federal do Rio Grande do Sul, Programa de Pós-Graduação em Saúde Coletiva, Porto Alegre, RS, Brasil.

Epidemiologia E Servicos De Saude : Revista Do Sistema Unico De Saude Do Brasil
|October 5, 2022
PubMed

Insights

Embolization for cerebral aneurysms in Brazil

Area of Science:

  • Neurosurgery
  • Interventional Neuroradiology
  • Public Health Policy

Background:

  • Cerebral aneurysms pose significant health risks, necessitating effective treatment strategies.
  • The Brazilian National Health System (SUS) provides care for a large population, making its treatment data crucial.
  • Comparing endovascular embolization and open microsurgery is vital for optimizing patient outcomes and resource allocation.

Purpose of the Study:

  • To analyze and compare hospital admissions for cerebral aneurysm treatment using embolization versus microsurgery within the SUS.
  • To evaluate key metrics including length of stay, intensive care unit (ICU) utilization, case fatality rates, and expenditures.
  • To provide data-driven insights for healthcare decision-making regarding aneurysm treatment in Brazil.

Main Methods:

  • A descriptive epidemiological study utilizing data from the SUS Hospital Information System (2009-2018).
  • Analysis of hospital admission frequencies, treatment procedures (embolization vs. microsurgery), ICU admission rates, case fatality ratios, and total expenditures.
  • Statistical comparison of outcomes between the two primary treatment modalities.

Main Results:

  • Over 43,000 admissions were analyzed; 51.5% underwent microsurgery.
  • Embolization was associated with shorter hospital stays (7.7 days vs. 16.2 days), lower ICU admission rates (58.6% vs. 85.3%), and reduced case fatality (5.9% vs. 10.9%) compared to microsurgery.
  • Despite better clinical outcomes, embolization accounted for a higher proportion of total expenditure (66.3% of USD 240 million).

Conclusions:

  • Cerebral aneurysm embolization within the SUS demonstrates favorable clinical outcomes, including shorter hospital stays, reduced ICU needs, and lower mortality rates compared to microsurgery.
  • However, embolization incurs higher overall healthcare expenditures.
  • These findings highlight a trade-off between clinical efficiency and cost in the management of cerebral aneurysms within the Brazilian public healthcare system.
Abstract

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