Avaliação Temporal dos Procedimentos de Revascularização Coronariana pelo Sistema Único de Saúde (SUS) no Brasil: Um Panorama de 20 Anos / Temporal Evaluation of Coronary Revascularization Procedures Performed through the Unified Health System (SUS) in Brazil: a 20-year overview

Fundamento: As taxas de mortalidade relacionadas à doença aterosclerótica coronariana (DAC) vêm reduzindo nas últimas décadas devido, em parte, aos avanços nas técnicas de revascularização. Objetivos: O objetivo deste estudo foi apresentar um visão dos últimos 20 anos do tratamento da DAC pelo Sistema Único de Saúde (SUS) no Brasil. Métodos:Os dados foram obtidos através dos sistemas TABNET e SIGTAP do SUS e através do IBGE. Os procedimentos foram agrupados nas categorias de revascularização percutânea, cirúrgica e percutânea primária. Foram analisados o número de autorizações de internação hospitalar (AIH), duração média de permanência hospitalar, mortalidade hospitalar, valor do repasse total por procedimento e valores médios da AIH e dos serviços profissional e hospitalar. Resultados:Entre 1995 e 2015, houve aumento no número de revascularizações cirúrgicas (de 13.198 a 22.559) e percutâneas (de 10.522 a 66.345). De modo semelhante, o número de angioplastias primárias apresentaram aumento entre 2004 e 2015 (de 1.901 a 8.524). Houve uma queda no tempo médio de permanência hospitalar (de 14,4 a 12,8 dias) e da mortalidade hospitalar (de 7,6% a 5,9%) nas revascularizações cirúrgicas e queda da permanência hospitalar (de 5,3 dias a 3,7 dias) mas manutenção da taxa de mortalidade (2,2%) nas revascularizações percutâneas. Nas angioplastias primárias, o tempo médio de permanência hospitalar variou de 5,3 a 5,6 dias e a taxa de mortalidade variou de 7,94% a 7,43% entre 2004 e 2015, respectivamente. O valor médio do repasse total para as revascularização cirúrgicas variou de R$ 4.327,57 para R$ 12.839,13 e para as revascularizações percutâneas de R$ 2.615,81 a R$ 6.187,87 entre 1995 e 2015, respectivamente. Os valores equivalentes para as angioplastias primárias foram de R$ 5.415,58 em 2004 a R$ 6.581,51 em 2015. Conclusões: O número de procedimentos de revascularização aumentou no Brasil nos últimos 20 anos, juntamente com uma melhora nas taxas de mortalidade e redução no tempo de permanência hospitalar. Observou-se importante defasagem de valores financeiros em relação à inflação acumulada neste período

Introduction: The mortality rates associated with coronary atherosclerotic disease (CAD) have been declining over the past decades driven, in part, by advances in revascularization techniques. Objective: The aim of this study was to provide an overview of the past 20 years in the treatment of CAD delivered by the Brazilian Unified Health Care System (SUS). Methods:The data were obtained from SUS's TABNET and SIGTAP systems and IBGE. The procedures were grouped into the categories percutaneous, surgical, and primary percutaneous revascularizations. The analysis included the number of hospital admission authorizations (AIH), mean length of hospital stay, in-hospital mortality, mean total amount paid by procedure, and mean values paid per AIH and for professional and hospital services. Results: Between 1995 and 2015, there were increases in the number of surgical revascularizations (from 13,198 to 22,559) and percutaneous revascularizations (from 10,522 to 66,345). Similarly, the number of primary angioplasties increased between 2004 and 2015 (from 1,901 to 8,524). There was a decrease in the mean length of hospital stay (from 14.4 to 12.8 days) and hospital mortality (from 7.6% to 5.9%) for surgical revascularizations, and decrease in mean length of hospital stay (from 5.3 days to 3.7 days) but maintenance of the mortality rates (2.2%) for percutaneous revascularizations. In primary angioplasties, the mean length of hospital stay varied from 5.3 to 5.6 days and the mortality rate varied from 7.94% to 7.43% between 2004 and 2015, respectively. The mean total amount paid for surgical revascularization varied from R$ 4,327.57 to $12,839.13 and for percutaneous revascularizations from R$ 2,615.81 to $6,187.87 between 1995 and 2015, respectively. Corresponding values for primary angioplasties were R$ 5,415.58 in 2004 to R$ 6,581.51 in 2015. Conclusions: The number of revascularization procedures increased in Brazil over the past 20 years, with an improvement in mortality rates and decrease in length of hospital stay. There was a substantial lag in economic values relative to the inflation accumulated during the period

Perfil epidemiológico dos acidentes de trânsito em Marília, São Paulo, 2012 / Epidemiological profile of traffic accidents in Marília, São Paulo State, Brazil, 2012 / El perfil epidemiológico de los accidentes de tráfico en Marília, São Paulo, Brasil, 2012

OBJETIVO: descrever o perfil das vítimas de acidentes e óbitos relacionados ao trânsito em Marília-SP, Brasil. MÉTODOS: estudo descritivo, com dados de Boletins de Ocorrência (BO) e Declarações de Óbito (DO) referentes a 2012. RESULTADOS: foram obtidos 1.537 BO; dos 3.257 indivíduos envolvidos em acidentes, 67,3% eram homens e 53,3% encontravam-se na faixa etária de 20-39 anos; os acidentes foram mais frequentes nos cruzamentos de vias (35,2%), às 8 (6,8%), 13 (7,2%) e 19 (8,1%) horas; a motocicleta foi o veículo mais utilizado no momento do acidente (47,6%); entre os 78 óbitos, 61 eram homens, 31 contavam mais de 50 anos de idade e 23 eram motociclistas; 32 acidentes fatais ocorreram em rodovias. CONCLUSÃO: indivíduos do sexo masculino e motociclistas foram os principais envolvidos em acidentes de trânsito e vítimas fatais; os acidentes fatais ocorreram principalmente em rodovias, tendo como principais vítimas os maiores de 50 anos.

OBJECTIVE: to describe the profile of victims of traffic accidents and traffic-related deaths in Marília-SP, Brazil. METHODS: this is a descriptive study, based on data from police reports (PR) and Death Certificates (DC), in 2012. RESULTS: 1,537 PR were gathered; among the 3,257 individuals involved in traffic accidents, 67.3% were men, and 53.3% were between 20-39 years of age; most accidents occurred on road intersections (35.2%), at 8 a.m. (6.8%), 1 p.m. (7.2%) and 7 p.m. (8.1%); motorcycle was the most involved vehicle in the accidents (47.6%); among the 78 deaths reported, 61 were men, 31 were over 50 years old, and 23 were motorcyclists; 32 fatal accidents occurred on highways. Conclusion: the main victims and fatal victims of traffic accidents were male motorcyclists; fatal accidents occurred mainly on highways, and the main victims were over 50 years old.

OBJETIVO: describir el perfil de las víctimas de accidentes y muertes relacionadas al tráfico, en Marília-SP, Brasil. MÉTODOS: estudio descriptivo, con datos de informes de la policía y certificados de defunción referentes al año 2012. RESULTADOS: se obtuvo 1.537 certificados de defunción; entre los 3.257 individuos involucrados, 67,3% eran hombres y 53,3% tenían entre 20 y 39 años; los accidentes prevalecen en las intersecciones (35,2%), con mayor incidencia a las 8 (6,8%), 13 (7,2%) y 19 (8,1%) horas; la motocicleta fue el vehículo más utilizado en el momento del accidente (47,6%); entre los 78 óbitos, 61 eran hombres, 31 mayores de 50 años de edad y 23 motociclistas; 32 accidentes fatales ocurrieron en carreteras. CONCLUSIÓN: las principales víctimas de los accidentes de tráfico y víctimas mortales fueron motociclistas hombres; las carreteras fueron los principales locales de accidentes fatales y sus principales víctimas tenían más de 50 años de edad.

[Epidemiological profile of traffic accidents in Marília, São Paulo State, Brazil, 2012]. / Perfil epidemiológico dos acidentes de trânsito em Marília, São Paulo, 2012.

OBJECTIVE: to describe the profile of victims of traffic accidents and traffic-related deaths in Marília-SP, Brazil. METHODS: this is a descriptive study, based on data from police reports (PR) and Death Certificates (DC), in 2012. RESULTS: 1,537 PR were gathered; among the 3,257 individuals involved in traffic accidents, 67.3% were men, and 53.3% were between 20-39 years of age; most accidents occurred on road intersections (35.2%), at 8 a.m. (6.8%), 1 p.m. (7.2%) and 7 p.m. (8.1%); motorcycle was the most involved vehicle in the accidents (47.6%); among the 78 deaths reported, 61 were men, 31 were over 50 years old, and 23 were motorcyclists; 32 fatal accidents occurred on highways. Conclusion: the main victims and fatal victims of traffic accidents were male motorcyclists; fatal accidents occurred mainly on highways, and the main victims were over 50 years old.