O impacto das fraturas do quadril no SUS 2008 - 2017: O papel do ortopedista

Abstract

Objective The present study intends to describe the profile of hospitalization and ambulatory rehabilitation of patients ≥ 50 years old due to hip fracture in the Brazilian Public Health System (SUS, in the Portuguese acronym). Methods This is a cross-sectional study of patients hospitalized due to hip fracture in the SUS between 2008 and 2017. Data included 441,787 hip fracture-related hospitalizations from the hospitalization database of the department of informatics of the Brazilian Unified Health System (SIH/DATASUS, in the Portuguese acronym), and data of patients who underwent rehabilitation from the ambulatory database of the department of informatics of the Brazilian Unified Health System (SIA/DATASUS, in the Portuguese acronym.). Results Most of hip fracture-related hospitalizations (83.5%) happen to people ≥ 50 years old, with an average annual growth of 5.6% in hip fracture-related hospitalizations. The costs for the government have been growing in the same proportion and reached almost BRL 130 million in 2017, although with a 13.6% decrease in average cost per hospitalization. Besides the financial impact, hip fractures result in an in-hospital mortality rate around 5.0% in patients aged ≥ 50 years old. In addition, the percentage of patients that have undergone hip fracture-related rehabilitation increased from 2008 (14.0%) to 2012 (40.0%), and remained stable after that. Conclusions The progressive increase in the incidence of hip fractures shows the financial and social impact, and the need for immediate actions to prevent this rising trend. Hip fractures are a risk for secondary fractures, the prevention is crucial, and the orthopedist plays a central role in this process.

A new FRAX model for Brazil

“…The BRAVOS study, on which the present report is based [ 13 ], confirms that there are large regional differences in the incidence of hip fracture in Brazil [ 11 , 12 ]. Lowest rates are reported in the North and Northeast regions with progressively higher rates in the Centralwest, South and Southeast regions, respectively [ 12 ].…”

“…Thus, a similarly low incidence was determined from a retrospective analysis of the Brazilian Public Health System [ 12 ]. Additionally, a national survey in 2017 estimated 47,974 hip fractures in patients covered by the Public Health System [ 11 ]. If this is uplifted by 25% (to account for the private sector [ 24 ]), the number of hip fractures in Brazil (59,966) is markedly less than that estimated from data used to build the original FRAX model (80,640 for 2015) [ 6 ] but consistent with the present study (56,526).…”

“…For other major fractures, incidence rates for Brazil were estimated using Swedish ratios for hip to other major osteoporotic fracture (humerus, forearm or clinical vertebral fractures). Since then, several more recent studies on the epidemiology of fractures have been published [ 11 , 12 ] including the Brazilian Validation Osteoporosis Study (BRAVOS), specifically conducted to update FRAX [ 13 ]. These more recent publications indicate that hip fracture incidence in recent years is substantially lower than that used for the original version of FRAX.…”

Limitations of using the DATASUS database as a primary source of data in surgical research: a scoping review

“…Several authors also highlighted the lack of information about the private health system on the DATASUS platform 14 , 16 , 17 , 20 - 22 , 31 , 41 , 45 , 48 - 50 , 55 .…”

Polycaprolactone/alendronate systems intended for production of biomaterials

“…Hip fracture, for example, is one of the most serious types of osteoporotic fracture in elderly patients and can result in morbidity and mortality 2 . In Brazil, the Unified Health System's expenses on treatment and assistance are high and this disease affects around ten million people 3 …”