Heart failure quantified by underlying cause and multiple cause of death in Brazil between 2006 and 2016.

BACKGROUND: The Global Burden of Disease (GBD) does not produce estimates of heart failure (HF) since this condition is considered the common end to several diseases (i.e., garbage code). This study aims to analyze the interactions between underlying and multiple causes of death related to HF in Brazil and its geographic regions, by sex, from 2006 to 2016. METHODS: Descriptive study of a historical series of death certificates (DCs) related to deaths that occurred in Brazil between 2006 and 2016, including both sexes and all age groups. To identify HF as the underlying cause of death or as a multiple cause of death, we considered the International Classification of Diseases (ICD) code I50 followed by any digit. We evaluated the deaths and constructed graphs by geographic region to compare with national data. RESULTS: We included 1,074,038 DCs issued between 2006 and 2016 that included code I50 in Parts I or II of the certificate. The frequency of HF as the multiple cause of death in both sexes was nearly three times higher than the frequency of HF as an underlying cause of death; this observation remained consistent over the years. The Southeast region had the highest number of deaths in all years (about 40,000 records) and approximately double the number in the Northeast region and more than four times the number in the North region. Codes of diseases clinically unrelated to HF, such as diabetes mellitus, chronic obstructive pulmonary disease, and stroke, were mentioned in 3.11, 2.62, and 1.49% of the DCs, respectively. CONCLUSIONS: When we consider HF as the underlying cause of death, we observed an important underestimation of its impact on mortality, since when analyzed as a multiple cause of death, HF is present in almost three times more deaths recorded in Brazil from 2006 to 2016. The mentioning of conditions with little association with HF at the time of the death highlights the importance of HF as a complex syndrome with multiple components that must be considered in the analysis of mortality trends for implementation of public health management programs.

Mortalidade por Insuficiência Cardíaca e Desenvolvimento Socioeconômico no Brasil, 1980 a 2018 / Mortality Due to Heart Failure and Socioeconomic Development in Brazil between 1980 and 2018

Resumo Fundamento Estudos sobre mortalidade por Insuficiência Cardíaca (IC) no Brasil e Regiões Geográficas (RG) são escassos. Objetivo Analisar a evolução temporal das taxas de mortalidade por IC por sexo e faixa etária no Brasil, RG e Unidades da Federação (UF), de 1980 a 2018, e associações com o Índice de Desenvolvimento Humano Municipal (IDHM). Métodos Estudo de séries temporais dos óbitos por IC, por sexo e faixas etárias, no Brasil, RG e UF, de 1980 a 2018. Os óbitos e a população foram retirados do DATASUS para estimar taxas de mortalidade por 100.000 habitantes, brutas e padronizadas (método direto, população brasileira do ano 2000). Foram calculadas médias móveis de três anos das taxas padronizadas. Os IDHM das UF de 1991 e 2010 foram obtidos do Atlas Brasil. Empregou-se o coeficiente de correlação de Pearson, com 5% de significância. Resultados A mortalidade por IC diminuiu no Brasil a partir de 2008, atingindo ao final de 2018 patamar semelhante nas RG e UF, sendo maior nos homens durante quase todos os períodos e faixas etárias, exceto naqueles acima de 60 anos, a partir de 1995, na região Sul. Observou-se relação inversa entre o IDHM e a redução das taxas de mortalidade (0,73). Conclusão Houve redução das taxas de mortalidade por IC no Brasil progressivamente de 2008 até 2018, com patamares semelhantes em 2018 nas RG e UF, com maiores taxas no sexo masculino. Essas reduções parecem relacionadas com o IDHM em 2010, mais do que o aumento percentual ao longo do tempo.

Abstract Background Studies on mortality from heart failure (HF) in Brazil and in the country's Geographic Regions (GRs) are scarce. Objective To analyze the temporal progression of HF mortality rates by sex and age group in Brazil and its GRs and Federative Units (FUs) from 1980 to 2018, and the associations between mortality rates at each FU and the Municipal Human Development Index (MHDI). Methods Time series analysis of deaths due to HF categorized by sex and age groups in Brazil and Brazilian GRs and FUs from 1980 to 2018. Death and population data were obtained from the DATASUS for estimation of crude and standardized mortality rates per 100,000 inhabitants (direct method, Brazilian population in the year 2000). We calculated the 3-year moving averages of the standardized rates. The MHDIs of the FUs in 1991 and 2010 were obtained from Atlas Brasil and were correlated with mortality rates using Pearson's correlation at a 5% significance level. Results Mortality due to HF decreased in Brazil after 2008, reaching a similar level at the end of 2018 in the GRs and FUs, and was higher in men during almost all periods and age groups, except for those over the age of 60 years after 1995 in the South region. There was an inverse relationship between MHDI and reduction in mortality rates (0.73). Conclusion There was a progressive reduction in mortality rates due to HF in Brazil from 2008 to 2018, with similar levels in 2018 in the GRs and FUs and higher rates in men. These reductions appear to be related more to the 2010 MHDI than the percentage increase over time.

Mortality Due to Heart Failure and Socioeconomic Development in Brazil between 1980 and 2018. / Mortalidade por Insuficiência Cardíaca e Desenvolvimento Socioeconômico no Brasil, 1980 a 2018.

BACKGROUND: Studies on mortality from heart failure (HF) in Brazil and in the country's Geographic Regions (GRs) are scarce. OBJECTIVE: To analyze the temporal progression of HF mortality rates by sex and age group in Brazil and its GRs and Federative Units (FUs) from 1980 to 2018, and the associations between mortality rates at each FU and the Municipal Human Development Index (MHDI). METHODS: Time series analysis of deaths due to HF categorized by sex and age groups in Brazil and Brazilian GRs and FUs from 1980 to 2018. Death and population data were obtained from the DATASUS for estimation of crude and standardized mortality rates per 100,000 inhabitants (direct method, Brazilian population in the year 2000). We calculated the 3-year moving averages of the standardized rates. The MHDIs of the FUs in 1991 and 2010 were obtained from Atlas Brasil and were correlated with mortality rates using Pearson's correlation at a 5% significance level. RESULTS: Mortality due to HF decreased in Brazil after 2008, reaching a similar level at the end of 2018 in the GRs and FUs, and was higher in men during almost all periods and age groups, except for those over the age of 60 years after 1995 in the South region. There was an inverse relationship between MHDI and reduction in mortality rates (0.73). CONCLUSION: There was a progressive reduction in mortality rates due to HF in Brazil from 2008 to 2018, with similar levels in 2018 in the GRs and FUs and higher rates in men. These reductions appear to be related more to the 2010 MHDI than the percentage increase over time.

FUNDAMENTO: Estudos sobre mortalidade por Insuficiência Cardíaca (IC) no Brasil e Regiões Geográficas (RG) são escassos. OBJETIVO: Analisar a evolução temporal das taxas de mortalidade por IC por sexo e faixa etária no Brasil, RG e Unidades da Federação (UF), de 1980 a 2018, e associações com o Índice de Desenvolvimento Humano Municipal (IDHM). MÉTODOS: Estudo de séries temporais dos óbitos por IC, por sexo e faixas etárias, no Brasil, RG e UF, de 1980 a 2018. Os óbitos e a população foram retirados do DATASUS para estimar taxas de mortalidade por 100.000 habitantes, brutas e padronizadas (método direto, população brasileira do ano 2000). Foram calculadas médias móveis de três anos das taxas padronizadas. Os IDHM das UF de 1991 e 2010 foram obtidos do Atlas Brasil. Empregou-se o coeficiente de correlação de Pearson, com 5% de significância. RESULTADOS: A mortalidade por IC diminuiu no Brasil a partir de 2008, atingindo ao final de 2018 patamar semelhante nas RG e UF, sendo maior nos homens durante quase todos os períodos e faixas etárias, exceto naqueles acima de 60 anos, a partir de 1995, na região Sul. Observou-se relação inversa entre o IDHM e a redução das taxas de mortalidade (0,73). CONCLUSÃO: Houve redução das taxas de mortalidade por IC no Brasil progressivamente de 2008 até 2018, com patamares semelhantes em 2018 nas RG e UF, com maiores taxas no sexo masculino. Essas reduções parecem relacionadas com o IDHM em 2010, mais do que o aumento percentual ao longo do tempo.

Principais necessidades humanas básicas afetadas em pacientes com câncer e tromboembolismo venoso: revisão integrativa / Main basic human needs affected in patients with cancer and venous thromboembolism: integrative review

Objetiva-se identificar as principais necessidades humanas básicas afetadas em pacientes com câncer e tromboembolismo venoso baseando-se nas evidências de problemas de enfermagem identificadas na literatura científica, segundo o referencial conceitual de Wanda Horta. Revisão integrativa de literatura para identificação de problemas de enfermagem para pacientes com câncer e tromboembolismo venoso. A análise dos dados foi feita através da seleção e agrupamento de evidências empíricas conforme a Necessidade Humana Básica afetada. 151 evidências empíricas foram identificadas, relacionadas à 18 diferentes Necessidades Humanas Básicas, sendo 11 necessidades psicobiológicas e 07 psicossociais. Conclui-se que os problemas de enfermagem identificados distribuem-se em necessidades psicobiológicas e psicossociais. Dentre as necessidades mais afetadas destacam-se: regulação vascular, percepção dolorosa, oxigenação e integridade cutâneo-mucosa/integridade física. Sugere-se a produção de outros trabalhos que tratem do processo de enfermagem, com consequente elaboração de diagnósticos e de intervenções de enfermagem para pacientes com câncer e tromboembolismo venoso, com posterior validação dos mesmos

The aim is to identify the main basic human needs affected in patients with cancer and venous thromboembolism, based on the evidence of nursing problems identified in the scientific literature, according to the conceptual framework of Wanda Horta. Integrative review of literature to identify nursing problems for patients with cancer and venous thromboembolism. Data analysis was done through the selection and grouping of empirical evidence according to the Basic Human Needs affected. 151 empirical evidences were identified, related to 18 different Basic Human Needs, with 11 psychobiological needs and 07 psychosocial needs. It concludes that the nursing problems identified are distributed in psychobiological and psychosocial needs. Among the most affected needs are: vascular regulation, painful perception, oxygenation and cutaneous-mucosal integrity/physical integrity. It is suggested the production of other works that deal with the nursing process, with consequent elaboration of diagnoses and nursing interventions for patients with cancer and venous thromboembolism, with subsequent validation of the same