A Population Study on Gender and Ethnicity Differences in Gallbladder Disease in Brazil

Abstract

- BACKGROUND: Gallbladder diseases (GBD) are one of the most common medical conditions requiring surgical intervention, both electively and urgently. It is widely accepted that sex and ethnic characteristics mighty influence both prevalence and outcomes. AIM: This study aimed to evaluate the differences on distributions of gender and ethnicity related to the epidemiology of GBD in the Brazilian public health system. METHODS: DATASUS was used to retrieve patients’ data recorded under the International Code of Diseases (ICD-10) - code K80 from January 2008 to December 2019. The number of admissions, modality of care, number of deaths, and in-hospital mortality rate were analyzed by gender and ethnic groups. RESULTS: Between 2008 and 2019, a total of 2,899,712 patients with cholelithiasis/cholecystitis (K80) were admitted to the hospitals of the Brazilian Unified Health System, of whom only 22.7% were males. Yet, the in-hospital mortality rate was significantly higher in males (15.9 per 1,000 male patients) than females (6.3 per 1,000 female patients) (p<0.05). Moreover, men presented a significantly higher risk of death (RR=2.5; p<0.05) and longer hospital stay (4.4 days vs. 3.3 days; p<0.05) than females. Compared to females, men presented a higher risk of death across all self-declared ethnic groups: whites (RR=2.4; p<0.05), blacks (RR=2.7; p<0.05), browns (RR=2.6; p<0.05), and Brazilian Indians (RR=2.13; p<0.05). CONCLUSION: In the years 2008-2019, women presented the highest prevalence of hospital admissions for GBD in Brazil, and men were associated with worse outcomes, including all ethnic groups.

Different genders should be considered for the extraglycemic benefits of oral antidiabetic drugs

“…The male population may have a higher risk of developing gallbladder or biliary tract diseases than the female population. 6 Moreover, the male population is also strongly associated with a higher mortality rate compared with the female population, 6 contributing to the concern about using DPP-4i as an antidiabetic agent in the T2DM male population. Since the extraglycemic benefits, such as the prevention of osteoporosis, are claimed by the authors, we comment that different genders may have a different impact on using DPP-4i as a choice in the management of patients with T2DM.…”

Gallbladder Polyps: Correlation and Agreement Between Ultrasonographic and Histopathological Findings in a Population With High Incidence of Gallbladder Cancer

“…Gallbladder cancer is more prevalent in women than in men. Classical risk factors of this pathology are gallstone disease, polyps, chronic infections of the gallbladder, obesity, alcohol, tobacco, elevated blood sugar, medications, and exposure to certain carcinogens 11 , 20 .…”