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Hospitalization and surgery rates in patients with inflammatory bowel disease in Brazil: a time-trend analysis

Authors
  • Palacio, Flávia Gonçalves Musauer1
  • de Souza, Lucila Marieta Perrotta1
  • Moreira, Jéssica Pronestino de Lima2
  • Luiz, Ronir Raggio2
  • de Souza, Heitor Siffert Pereira1, 3
  • Zaltman, Cyrla1
  • 1 Hospital Universitário, Universidade Federal Do Rio de Janeiro, Rua Prof. Rodolpho Paulo Rocco 255, Ilha Do Fundão, Rio de Janeiro, RJ, 21941-913, Brazil , Rio de Janeiro (Brazil)
  • 2 Universidade Federal Do Rio de Janeiro, Rio de Janeiro, 21944-970, Brazil , Rio de Janeiro (Brazil)
  • 3 D’Or Institute for Research and Education (IDOR), Rua Diniz Cordeiro 30, Botafogo, Rio de Janeiro, RJ, 22281-100, Brazil , Rio de Janeiro (Brazil)
Type
Published Article
Journal
BMC Gastroenterology
Publisher
Springer (Biomed Central Ltd.)
Publication Date
Apr 27, 2021
Volume
21
Issue
1
Identifiers
DOI: 10.1186/s12876-021-01781-x
Source
Springer Nature
Keywords
License
Green

Abstract

BackgroundThe prevalence of inflammatory bowel disease (IBD) is increasing globally, and the disease is frequently managed surgically. The aim of this study was to investigate the time trends and geographic distribution of IBD hospitalizations, surgeries and surgical-associated lethality.MethodsData from the Brazilian Health Public System were retrospectively collected regarding hospitalizations, in-hospital deaths, IBD-related surgical procedures and lethality from 2005 to 2015.ResultsThis eleven-year period revealed decreases in the rates of hospitalization (24%), IBD-related surgeries (35%), and IBD-related surgical lethality (46%). Most surgeries were performed in Crohn’s disease patients, and the predominant procedure was small bowel resection, mostly in young adults. A higher prevalence of ulcerative was observed throughout the country. The highest hospitalization and surgical rates were observed in the more industrialized regions of the South and the Southeast and in the municipalities integrated with metropolitan regions (MRs). The highest surgical-related lethality rates were seen in the less-developed regions and in municipalities not integrated with MRs. The length of hospital stay showed a slight increase throughout the period.ConclusionsBrazil follows the global trend of decreases in hospitalizations, lethality, surgeries, and surgical lethality associated with IBD. The unequal distribution of hospitalizations and surgeries, concentrated in the industrialized areas, but with a shift towards the Northeast and from urbanized to rural areas, indicates ongoing changes within the country. Reductions in the rates of IBD-related hospitalizations, surgeries and lethality suggest the effectiveness of decentralization and improvements in the quality of public health services and the advances in medical therapy during the study period.

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