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Endovascular correction of isolated descending thoracic aortic disease: a descriptive analysis of 1, 344 procedures over 10 years in the public health system of São Paulo
Portugal, Maria Fernanda Cassino; Teivelis, Marcelo Passos; Silva, Marcelo Fiorelli Alexandrino da; Stabellini, Nickolas; Fioranelli, Alexandre; Szlejf, Claudia; Amaro Junior, Edson; Wolosker, Nelson.
Afiliação
  • Portugal, Maria Fernanda Cassino; Hospital Israelita Albert Einstein. Sao Paulo. BR
  • Teivelis, Marcelo Passos; Hospital Israelita Albert Einstein. Sao Paulo. BR
  • Silva, Marcelo Fiorelli Alexandrino da; Hospital Israelita Albert Einstein. Sao Paulo. BR
  • Stabellini, Nickolas; Faculdade Israelita de Ciencias da Saude Albert Einstein. Sao Paulo. BR
  • Fioranelli, Alexandre; Hospital Israelita Albert Einstein. Sao Paulo. BR
  • Szlejf, Claudia; Hospital Israelita Albert Einstein. Sao Paulo. BR
  • Amaro Junior, Edson; Hospital Israelita Albert Einstein. Sao Paulo. BR
  • Wolosker, Nelson; Hospital Israelita Albert Einstein. Sao Paulo. BR
Clinics ; 76: e2332, 2021. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1153976
Biblioteca responsável: BR1.1
ABSTRACT

OBJECTIVES:

In Brazil, descending thoracic aorta disease (TAD), including aneurysms and dissection, are preferentially managed by endovascular treatment (TEVAR) due to the feasibility and good results of this technique. In this study, we analyzed endovascular treatment of isolated TAD (ITAD) in the public health system over a 10-year period in São Paulo, a municipality in Brazil in which more than 5 million inhabitants depend on the governmental health system.

METHODS:

Public data from procedures performed between 2008 and 2019 were extracted using web scraping techniques. The following types of data were analyzed demographic data, operative technique, elective or urgent status, number of surgeries, in-hospital mortality, length of hospital stay, mean length of stay in the intensive care unit, and reimbursement values paid by the government. Trauma cases and congenital diseases were excluded.

RESULTS:

A total of 1,344 procedures were analyzed; most patients were male and aged ≥65 years. Most individuals had a residential address registered in the city. Approximately one-third of all surgeries were urgent cases. There were 128 in-hospital deaths (9.52%), and in-hospital mortality was lower for elective than for urgent surgeries (7.29% vs. 14.31%, p=0.031). A total of R$ 24.766.008,61 was paid; an average of R$ 17.222,98 per elective procedure and R$ 18.558,68 per urgent procedure. Urgent procedures were significantly more expensive than elective surgeries (p=0.029).

CONCLUSION:

Over a 10-year period, the total cost of ITAD interventions was R$ 24.766.008,61, which was paid from the governmental system. Elective procedures were associated with lower mortality and lower investment from the health system when compared to those performed in an urgent scenario.
Assuntos


Texto completo: Disponível Coleções: Bases de dados internacionais Contexto em Saúde: ODS3 - Meta 3.4 Reduzir as mortes prematuras devido doenças não transmissíveis Problema de saúde: Doença Cardiovascular Base de dados: LILACS Assunto principal: Aneurisma da Aorta Torácica / Implante de Prótese Vascular / Procedimentos Endovasculares Tipo de estudo: Estudo de etiologia / Estudo observacional / Fatores de risco Limite: Idoso / Feminino / Humanos / Masculino País/Região como assunto: América do Sul / Brasil Idioma: Inglês Revista: Clinics Assunto da revista: Medicina Ano de publicação: 2021 Tipo de documento: Artigo País de afiliação: Brasil Instituição/País de afiliação: Faculdade Israelita de Ciencias da Saude Albert Einstein/BR / Hospital Israelita Albert Einstein/BR

Texto completo: Disponível Coleções: Bases de dados internacionais Contexto em Saúde: ODS3 - Meta 3.4 Reduzir as mortes prematuras devido doenças não transmissíveis Problema de saúde: Doença Cardiovascular Base de dados: LILACS Assunto principal: Aneurisma da Aorta Torácica / Implante de Prótese Vascular / Procedimentos Endovasculares Tipo de estudo: Estudo de etiologia / Estudo observacional / Fatores de risco Limite: Idoso / Feminino / Humanos / Masculino País/Região como assunto: América do Sul / Brasil Idioma: Inglês Revista: Clinics Assunto da revista: Medicina Ano de publicação: 2021 Tipo de documento: Artigo País de afiliação: Brasil Instituição/País de afiliação: Faculdade Israelita de Ciencias da Saude Albert Einstein/BR / Hospital Israelita Albert Einstein/BR
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