scholarly journals Conservative treatment of cerebral hemorrhage: an analysis of the State of São Paulo

2021 ◽  
Author(s):  
Paulo Roberto Hernandes Júnior ◽  
Juliana de Souza Rosa ◽  
Patrick de Abreu Cunha Lopes ◽  
Bárbara Tisse da Silva ◽  
Heloá Santos Faria da Silva ◽  
...  

Background: Cerebral hemorrhage represents 10% to 15% of all strokes, with the worst prognosis and the highest rate of morbimortality. Objectives: To analyze the panorama of conservative treatment procedures for cerebral hemorrhage in the State of São Paulo and correlate it with the current epidemiology. Methods: observational, descriptive and cross-sectional collection of conservative treatment data for cerebral hemorrhage, available at DATASUS website, from January 2008 up to December 2020 - evaluating the number of hospitalizations, public spending, complexity, mortality rate, deaths, permanence and character of care. Results: 15,327 hospitalizations were observed for such procedures in this period, representing a total expenditure of R$ 30,258,539.39. 2008 was the year with the highest number of hospitalizations (1,373), and 2020 was the year with the greatest expenditure (R$ 3,008,526.38). 552 of the were elective and 14,606 were urgent, with 4,102 occurring in the public sector and 4,510 in private one. All 15,327 considered to be of medium complexity. The mortality rate was 29.68, corresponding to 4,549 deaths, 2009 was the year with the highest mortality, 33.33 and 2008 the lowest, 24.33. Mortality rate was lower in elective procedures (15.40 versus 30.48 in urgent ones) and when carried out in public sector (27.16 versus 30.07 in private care). The hospital stay was 11.0 days, with a cost of R$ 1,974.20. Conclusion: The conservative treatment of cerebral hemorrhage represents a procedure of medium complexity with a long period of hospital stay. Higher mortality was observed in emergency care and the private sector.

2021 ◽  
Author(s):  
Paulo Roberto Hernandes Júnior ◽  
Juliana de Souza Rosa ◽  
Patrick de Abreu Cunha Lopes ◽  
Bárbara Tisse da Silva ◽  
Heloá Santos Faria da Silva ◽  
...  

Background: Cerebral hemorrhage represents 10% to 15% of all strokes, with the worst prognosis and the highest rate of morbimortality. Objectives: To analyze the panorama of conservative treatment procedures for cerebral hemorrhage in the State of São Paulo and correlate it with the current epidemiology. Methods: observational, descriptive and cross-sectional collection of conservative treatment data for cerebral hemorrhage, available at DATASUS website, from January 2008 up to December 2020 - evaluating the number of hospitalizations, public spending, complexity, mortality rate, deaths, permanence and character of care. Results: 15,327 hospitalizations were observed for such procedures in this period, representing a total expenditure of R$ 30,258,539.39. 2008 was the year with the highest number of hospitalizations (1,373), and 2020 was the year with the greatest expenditure (R$ 3,008,526.38). 552 of the were elective and 14,606 were urgent, with 4,102 occurring in the public sector and 4,510 in private one. All 15,327 considered to be of medium complexity. The mortality rate was 29.68, corresponding to 4,549 deaths, 2009 was the year with the highest mortality, 33.33 and 2008 the lowest, 24.33. Mortality rate was lower in elective procedures (15.40 versus 30.48 in urgent ones) and when carried out in public sector (27.16 versus 30.07 in private care). The hospital stay was 11.0 days, with a cost of R$ 1,974.20. Conclusion: The conservative treatment of cerebral hemorrhage represents a procedure of medium complexity with a long period of hospital stay. Higher mortality was observed in emergency care and the private sector.


2021 ◽  
Author(s):  
Paulo Roberto Hernandes Júnior ◽  
Bruno Carvalho Brandão ◽  
Juliana de Souza Rosa ◽  
Heloá Santos Faria da Silva ◽  
Patrick de Abreu Cunha Lopes ◽  
...  

Background: extradural hematoma (EDM) is one the most lethal traumatic brain injury, being due to the rupture of middle meningeal artery and resulting in intracranial hypertension and brain damage. Objectives: to describe the overview of surgical procedures for the treatment of EDM in the state of São Paulo, correlating it with current epidemiology. Methods: observational, descriptive, and transversal data collect on surgical procedures for the treatment of EDM, available on DATASUS website, from January 2008 up to December 2020, taking in account: number of hospitalizations, public health expenditures, complexity, mortality rate, deaths, hospital stay, and service character. Results: there were 10,210 hospitalizations for such procedures in this period, accounting for R$39,342,868.41, with 2010 the year with the greatest number of hospitalizations (1,074) and 2011 with the greatest expenditure (R$3,772,361.55). 849 of them were elective, while 7,279 were urgent. 4,459 were carried out in public care and 2,671 in private one. All of them were considered medium complexity. Mortality rate was 11.29%, corresponding to 1,153 deaths, with 2015 the year with the greatest mortality (14.20%) and 2020 the lowest (9.93%). Mortality rate was lower in elective procedures (10.60 versus 11.46 in urgent ones) and when carried out in public sector (10.88 versus 11.49 in private care). Average stay was 10.9 days and average cost per hospital stay was R$3,853.37. Conclusion: surgical procedures for the treatment of EDM are considered medium complexity, most of which being carried out in public care. Higher mortality rate was observed in urgent cases and private care.


2021 ◽  
Author(s):  
Paulo Roberto Hernandes Júnior ◽  
Bruno Carvalho Brandão ◽  
Juliana de Souza Rosa ◽  
Heloá Santos Faria da Silva ◽  
Patrick de Abreu Cunha Lopes ◽  
...  

Background: epileptic seizures are treated with antiepileptics; nevertheless, about 30% of these patients do not present complete control with only drug therapy. Objectives: to describe the overview of treatment procedures for uncontrolled epileptic seizures in the state of São Paulo, correlating it with current epidemiology. Methods: observational, descriptive, and transversal data collect on treatment procedures for uncontrolled epileptic seizures, available on DATASUS website, from January 2008 up to December 2020, taking in account: number of hospitalizations, public health expenditures, complexity, mortality rate, deaths, hospital stay, and service character. Results: there were 131,397 hospitalizations for treatment procedures in this period, accounting for R$97,412,992.73, with 2008 the year with the greatest number of hospitalizations (12,041) and 2020 with the greatest expenditure (R$10,065,826.67). 7,091 of them were elective, while 124,290 were urgent. 45,307 were carried out in public care and 38,154 in private one. All of them were considered medium complexity. Mortality rate was 2.76%, corresponding to 3,621 deaths, with 2020 the year with the greatest mortality (3.67%) and 2008 with the lowest (2.21%). Mortality rate was lower in elective procedures (0.83 versus 2.87 in urgent ones) and when carried out in public sector (2.40 versus 2.55 in private care). Average stay was 5.4 days and average cost per hospital stay was R$741.36. Conclusion: treatment procedures for uncontrolled epileptic seizures are classified as medium complexity, most of which being urgent. Higher mortality rate was observed in urgent cases and private health care.


2021 ◽  
Author(s):  
Paulo Roberto Hernandes Júnior ◽  
Bruno Carvalho Brandão ◽  
Juliana de Souza Rosa ◽  
Heloá Santos Faria da Silva ◽  
Patrick de Abreu Cunha Lopes ◽  
...  

Background: epileptic seizures are treated with antiepileptics; nevertheless, about 30% of these patients do not present complete control with only drug therapy. Objectives: to describe the overview of treatment procedures for uncontrolled epileptic seizures in the state of São Paulo, correlating it with current epidemiology. Methods: observational, descriptive, and transversal data collect on treatment procedures for uncontrolled epileptic seizures, available on DATASUS website, from January 2008 up to December 2020, taking in account: number of hospitalizations, public health expenditures, complexity, mortality rate, deaths, hospital stay, and service character. Results: there were 131,397 hospitalizations for treatment procedures in this period, accounting for R$97,412,992.73, with 2008 the year with the greatest number of hospitalizations (12,041) and 2020 with the greatest expenditure (R$10,065,826.67). 7,091 of them were elective, while 124,290 were urgent. 45,307 were carried out in public care and 38,154 in private one. All of them were considered medium complexity. Mortality rate was 2.76%, corresponding to 3,621 deaths, with 2020 the year with the greatest mortality (3.67%) and 2008 with the lowest (2.21%). Mortality rate was lower in elective procedures (0.83 versus 2.87 in urgent ones) and when carried out in public sector (2.40 versus 2.55 in private care). Average stay was 5.4 days and average cost per hospital stay was R$741.36. Conclusion: treatment procedures for uncontrolled epileptic seizures are classified as medium complexity, most of which being urgent. Higher mortality rate was observed in urgent cases and private health care.


2021 ◽  
Author(s):  
Paulo Roberto Hernandes Júnior ◽  
Juliana de Souza Rosa ◽  
Patrick de Abreu Cunha Lopes ◽  
Bárbara Tisse da Silva ◽  
Heloá Santos Faria da Silva ◽  
...  

Background: Polyradiculoneuritis is considered to be the biggest cause of flaccid paralysis in the world and even after the progression phase, some patients may present with disabling residual deficits, both sensory and motor. Objectives: Analyze the current panorama of treatment procedures for acute demyelinating polyradiculoneuritis performed in the State of São Paulo and correlate the current epidemiology with the results obtained. Methods: A literature review and an observational, descriptive and transversal data collect on treatment for acute demyelinating polyradiculoneuritis, available at DATASUS from January 2008 to December 2020, and articles available at Scielo and PubMed. Results: There were 7,917 hospitalizations, representing a total expenditure of R$ 9,392,552.04, 2009 being the year with the highest number of hospitalizations (809) and 2017 with the highest amount spent during the period (R$ 967,284.65). 805 are elective and 7,109 are urgent, with 1,736 occurring in the public sector and 3,506 in the private sector. All of them were considered medium complexity. The total mortality rate was 1.57, corresponding to 124 deaths, 2019 being the year with the highest mortality rate, 2.94, and 2015 with the lowest rate, 0.53. The mortality rate for elective procedures was 0.99 compared to 1.63 for urgent procedures, whereas in the public sector it was 1.61 compared to 1.23 for the private sector. The average total hospital stay was 8.3 days, with an average cost of R$ 1,186.38. Conclusion: It is important to correctly notify the procedures performed, improving the epidemiological analysis and directing investments in health more appropriately.


2021 ◽  
Author(s):  
Paulo Roberto Hernandes Júnior ◽  
Juliana de Souza Rosa ◽  
Patrick de Abreu Cunha Lopes ◽  
Bárbara Tisse da Silva ◽  
Heloá Santos Faria da Silva ◽  
...  

Background: Muscular dystrophies are degenerative and genetic diseases characterized by progressive weakness and muscle atrophies. Objectives: To analyze the current panorama of muscular dystrophy treatment procedures performed in the State of São Paulo, correlating it with current epidemiology. Methods: literature review and observational, descriptive, and transversal data collect on the treatment of muscular dystrophies, available on the DATASUS website, from January 2008 to December 2020, and articles from Scielo and PubMed. Results: There were 2,600 hospitalizations with a total expenditure of R$ 28,004,202.59, with 2015 being the year with the highest number of hospitalizations (248), although 2014 was the year responsible for the highest amount spent during the period (R$ 2,858,500 , 87). Of the total procedures, 1,849 were carried out on an elective basis and 749 were urgent, with 1,330 occurring in the public sector and 286 in the private sector. The total mortality rate was 1.08, corresponding to 28 deaths, with 2016 being the year with the highest mortality rate, 4.91, while 2014 had the lowest rate, 0.41. The mortality rate for elective procedures was 0.54 compared to 2.40 for urgent procedures, whereas in the public sector it was 0.53 compared to 1.75 for the private sector. The average total hospital stay was 27.7 days, with an average cost of R$ 10,770.85. Conclusion: the treatment of muscular dystrophies usually occurs in an elective regime and in the public sector, with the mortality rate being lower in the public service compared to the private one.


2021 ◽  
Author(s):  
Paulo Roberto Hernandes Júnior ◽  
Juliana de Souza Rosa ◽  
Patrick de Abreu Cunha Lopes ◽  
Bárbara Tisse da Silva ◽  
Heloá Santos Faria da Silva ◽  
...  

Background: Intracerebral Hematoma has a high mortality rate. However, those who survive may experience sequelae, such as severe neurological deficits. Objectives: To analyze the current panorama of surgical treatment procedures for intracerebral hematoma performed in the State of São Paulo and to correlate the current epidemiology. Methods: A literature review and observational, descriptive and transversal data collect on surgical treatment of intracerebral hematoma, available at DATASUS from January 2008 to December 2020, and articles available at Scielo and PubMed, were carried out. Results: There were 7,716 hospitalizations, representing a total expenditure of R$ 43,880,884.82, with 2009 being the year with the highest number of hospitalizations (758) and 2010 the year with the highest amount spent (R$ 3,961,287.80). 777 procedures were carried out on an elective basis and 6,447 and on an urgent basis, with 3,074 occurring in the public sector and 2,004 in the private sector. All 7,716 considered to be of medium complexity. The total mortality rate was 35.82, corresponding to 2,764 deaths, with 2015 being the year with the highest mortality rate, 38.36, while 2020 had the lowest rate, 32.58. The mortality rate for elective procedures was 22.52 compared to 38.67 for urgent procedures, whereas in the public sector it was 34.39 compared to 37.77 for the private sector. The average total hospital stay was 15.7 days, with an average cost of R$ 5,687.00. Conclusion: There was a predominance of the emergency service and the public sector, and the mortality rate was higher in the private service.


2021 ◽  
Author(s):  
Paulo Roberto Hernandes Júnior ◽  
Juliana de Souza Rosa ◽  
Patrick de Abreu Cunha Lopes ◽  
Bárbara Tisse da Silva ◽  
Heloá Santos Faria da Silva ◽  
...  

Background: Polyneuropathy is the simultaneous dysfunction of several peripheral nerves that normally occurs as a result of diabetes. Objectives: To analyze the current panorama of treatment of polyneuropathies performed in the State of São Paulo and to correlate with the epidemiology. Methods: literature review and observational, descriptive and transversal data collect on treatment of polyneuropathies, available at DATASUS from January 2008 to December 2020, assessing the number of hospitalizations, the amount of public spending, complexity, mortality rate, deaths, permanence and character of service, and articles available in Scielo, Lilacs and PubMed. Results: There were 19,099 hospitalizations for polyneuropathy treatment procedures with a total expense of R$ 21,870,767.84, with 2014 being the year with the highest number of hospitalizations (1,740) and with the highest amount spent (R$ 2,034,880.25) . Of the total procedures, 3,732 were carried out on an elective basis and 15,362 in urgency, with 5,774 in the public sector and 6,396 in the private sector. All 19,099 considered to be of medium complexity. The total mortality rate was 1.63, corresponding to 312 deaths, with 2020 being the year with the highest mortality rate, 2.42, while 2014 had the lowest rate, 1.26. The mortality rate for elective procedures was 0.38 compared to 1.94 for urgent procedures, whereas in the public sector it was 1.25 compared to 1.77 for the private sector. The average total hospital stay was 9.3 days, with an average cost of R$ 1,145.13. Conclusion: Polyneuropathy is a disease that has a low mortality rate.


2021 ◽  
Author(s):  
Paulo Roberto Hernandes Júnior ◽  
Juliana de Souza Rosa ◽  
Patrick de Abreu Cunha Lopes ◽  
Bárbara Tisse da Silva ◽  
Heloá Santos Faria da Silva ◽  
...  

Background: The traumatic brain injury has a great impact on neurological emergencies. Objectives: To analyze the current panorama of conservative treatment procedures for mid-level traumatic brain injury performed in the State of São Paulo and to correlate with the current epidemiology. Methods: Literature review and observational, descriptive and transversal data collect on conservative treatment data for medium grade traumatic brain injury, available at DATASUS from January 2008 to December 2020 and articles available at Scielo, Lilacs and PubMed. Results: There were 63,218 hospitalizations for conservative treatment procedures in this period, accounting for R$ 68,668,413.92, with 2011 being the year with the highest number of hospitalizations (5,262), although 2020 with the greatest expenditure (R$ 5,984,875.09). 1,149 of them were elective, while 47,478 were urgent, with the occurrence of 24,527 in the public sector and 13,705 in the private sector. All 63,218 considered to be of medium complexity. The total mortality rate was 9.69, corresponding to 6,125 deaths, with 2009 being the year with the highest mortality rate, 10.34, while 2011 had the lowest rate, 9.14. The mortality rate for elective procedures was 6.44 compared to 9.89 for urgent procedures, whereas in the public sector it was 10.80 compared to 7.63 for the private sector. The average total hospital stay was 7.7 days, with an average cost of R$ 1,086.22. Conclusion: Medium grade traumatic brain injury has a short period of inhospital stay and a higher number of admissions and mortality rates in emergency care and in the public sector.


2021 ◽  
Author(s):  
Paulo Roberto Hernandes Júnior ◽  
Patrick de Abreu Cunha Lopes ◽  
Bárbara Tisse da Silva ◽  
Heloá Santos Faria da Silva ◽  
Tiago Veiga Gomes ◽  
...  

Background: Polyneuropathy is the simultaneous dysfunction of several peripheral nerves that normally occurs as a result of diabetes. Objectives: To analyze the current panorama of treatment of polyneuropathies performed in the State of São Paulo and to correlate with the epidemiology. Methods: literature review and observational, descriptive and transversal data collect on treatment of polyneuropathies, available at DATASUS from January 2008 to December 2020, assessing the number of hospitalizations, the amount of public spending, complexity, mortality rate, deaths, permanence and character of service, and articles available in Scielo, Lilacs and PubMed. Results: There were 19,099 hospitalizations for polyneuropathy treatment procedures with a total expense of R$ 21,870,767.84, with 2014 being the year with the highest number of hospitalizations (1,740) and with the highest amount spent (R$ 2,034,880.25) . Of the total procedures, 3,732 were carried out on an elective basis and 15,362 in urgency, with 5,774 in the public sector and 6,396 in the private sector. All 19,099 considered to be of medium complexity. The total mortality rate was 1.63, corresponding to 312 deaths, with 2020 being the year with the highest mortality rate, 2.42, while 2014 had the lowest rate, 1.26. The mortality rate for elective procedures was 0.38 compared to 1.94 for urgent procedures, whereas in the public sector it was 1.25 compared to 1.77 for the private sector. The average total hospital stay was 9.3 days, with an average cost of R$ 1,145.13. Conclusion: Polyneuropathy is a disease that has a low mortality rate.


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