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©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Pharmacol Ther. Jan 5, 2022; 13(1): 1-10
Published online Jan 5, 2022. doi: 10.4292/wjgpt.v13.i1.1
Hospitalizations and in-hospital mortality for inflammatory bowel disease in Brazil
Ana Luiza Vilar Guedes, Amanda Lopes Lorentz, Larissa Fernandes de Almeida Rios Rios, Beatriz Camara Freitas, Adriano Gutemberg Neves Dias, Ana Luísa Eckhard Uhlein, Felipe Oliveira Vieira Neto, Jobson Felipe Soares Jesus, Túlio de Sá Novaes Torres, Raquel Rocha, Vitor D Andrade, Genoile Oliveira Santana
Ana Luiza Vilar Guedes, Amanda Lopes Lorentz, Larissa Fernandes de Almeida Rios Rios, Beatriz Camara Freitas, Adriano Gutemberg Neves Dias, Ana Luísa Eckhard Uhlein, Felipe Oliveira Vieira Neto, Jobson Felipe Soares Jesus, Túlio de Sá Novaes Torres, Genoile Oliveira Santana, Life Sciences Department, State University of Bahia, Salvador 41150-000, Bahia, Brazil
Raquel Rocha, Sciences of Nutrition, Federal University of Bahia, Salvador 40110-060, Bahia, Brazil
Vitor D Andrade, Medicine Department, Universidade Salvador (UNIFACS), Salvador 41820-021, Bahia, Brazil
Genoile Oliveira Santana, Medicine and Health Postgraduate Program, Federal University of Bahia, Salvador 40110-060, Bahia, Brazil
Author contributions: Guedes ALV analyzed the data and wrote the manuscript; Lorentz AL, Rios LFA, Freitas BC, Dias AGN, Uhlein ALE, Vieira Neto FO, Jesus JFS, Torres TSN, and Rocha R participated in the acquisition and analysis of the data; Vitor D Andrade and Santana G developed the idea and reviewed the manuscript.
Institutional review board statement: This study was performed according to Resolution 466/2012 of the National Health Council. Since this study was conducted using a secondary database in the public domain, which is available on the internet, it was not necessary to obtain approval from the Ethics and Research Committee.
Informed consent statement: This study was performed according to Resolution 466/2012 of the National Health Council. Since this study was conducted using a secondary database in the public domain, which is available on the internet, it was not necessary to use a written consent form.
Conflict-of-interest statement: Santana GO: Advisory board – Janssen. Speaker – Abbvie, Ferring, Janssen, Pfizer, Takeda, and UCB Pharma. Research – Janssen, Lilly, Pfizer, Roche and Takeda. The other authors declare that they have no conflict of interest.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
https://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Raquel Rocha, DSc, MD, MSc, Professor, Sciences of Nutrition, Federal University of Bahia, Avenida Araújo Pinho, 32, Canela, Salvador 40110-060, Bahia, Brazil. raquelrocha2@yahoo.com.br
Received: June 8, 2021
Peer-review started: June 8, 2021
First decision: July 31, 2021
Revised: August 28, 2021
Accepted: January 5, 2022
Article in press: January 5, 2022
Published online: January 5, 2022
BACKGROUND
Inflammatory bowel disease (IBD) is associated with complications, frequent hospitalizations, surgery and death. The introduction of biologic drugs into the therapeutic arsenal in the last two decades, combined with an expansion of immunosuppressant therapy, has changed IBD management and may have altered the profile of hospitalizations and in-hospital mortality (IHM) due to IBD.
AIM
To describe hospitalizations from 2008 to 2018 and to analyze IHM from 1998 to 2017 for IBD in Brazil.
METHODS
This observational, retrospective, ecological study used secondary data on hospitalizations for IBD in Brazil for 2008-2018 to describe hospitalizations and for 1998-2017 to analyze IHM. Hospitalization data were obtained from the Hospital Information System of the Brazilian Unified Health System and population data from demographic censuses. The following variables were analyzed: Number of deaths and hospitalizations, length of hospital stay, financial costs of hospitalization, sex, age, ethnicity and type of hospital admission.
RESULTS
There was a reduction in the number of IBD hospitalizations, from 6975 admissions in 1998 to 4113 in 2017 (trend: y = -0.1682x + 342.8; R2 = 0.8197; P < 0.0001). The hospitalization rate also decreased, from 3.60/100000 in 2000 to 2.17 in 2010. IHM rates varied during the 20-year period, between 2.06 in 2017 and 3.64 in 2007, and did not follow a linear trend (y = -0.0005049x + 2.617; R2 = 0,00006; P = 0.9741). IHM rates also varied between regions, increasing in all but the southeast, which showed a decreasing trend (y = -0.1122x + 4.427; R2 = 0,728; P < 0.0001). The Southeast region accounted for 44.29% of all hospitalizations. The Northeast region had the highest IHM rate (2.86 deaths/100 admissions), with an increasing trend (y = 0.1105x + 1.110; R2 = 0.6265; P < 0.0001), but the lowest hospitalization rate (1.15). The Midwest and South regions had the highest hospitalization rates (3.27 and 3.17, respectively). A higher IHM rate was observed for nonelective admissions (2.88), which accounted for 81% of IBD hospitalizations. The total cost of IBD hospitalizations in 2017 exhibited an increase of 37.5% compared to 2008.
CONCLUSION
There has been a notable reduction in the number of hospitalizations for IBD in Brazil over 20 years. IHM rates varied and did not follow a linear trend.
Core Tip: This study provides an epidemiological profile of IBD hospitalizations in Brazil from 2008 to 2018 and analyzes in-hospital mortality (IHM) between 1998 and 2017. There was a reduction from 6975 hospital admissions in 1998 to 4113 in 2017 (trend: y = -0.1682x + 342.8; R2 = 0.8197; P < 0.0001). The hospitalization rate decreased from 3.60/100000 in 2000 to 2.17 in 2010. The total cost of hospitalizations in 2017 showed an increase of 37.5% compared to 2008. IHM rates varied during the 20-year period and did not follow a linear trend, decreasing in the Southeast region but increasing in the Northeast region.
