Epidemiology and Mortality of Thoracolumbosacral Spinal Arthrodesis in Brazil: The Last 10 Years

Abstract

Objective To describe the epidemiology and mortality of thoracolumbosacral arthrodesis surgery in Brazil in the last 10 years. Methods Study conducted using data from the SIH of the Unified Health System (SUS) covering the time period from 2008 to 2018 for all regions of Brazil. The data obtained were analyzed using the BioStat 5.3 program, using Chi-square statistical tests, observing a p-value <0.05 and a 95% confidence interval. Results A total of 66,631 anterior or posterior approach TLS surgeries were registered. The overall mortality rate was 9.37 deaths per thousand procedures. There are regions with mortality much higher than the national average. The mortality rate increases proportionally with the number of levels involved in posterior arthrodesis. Conclusions The study of the epidemiological profile of thoracolumbosacral arthrodesis is important, especially in a country whose population is heterogeneous but has different mortality rates among regions. Therefore, it is necessary to create measures that identify and prevent the factors that lead to the death of patients undergoing such a procedure. Level of evidence II; Retrospective, analytical, quantitative and descriptive study.

Notification of 6442 Cases of Bone Tuberculosis in Brazil: Epidemiological Profile From 2009 to 2018

“…Nevertheless, it is possible to set goals to improve notification quality and support new studies on the topic. 12 Regarding risk factors, 9.8% of the patients had HIV/AIDS (n=631), 4.1% (n=264) smoked, 6.6% (n=428) were alcohol users and 9% (n=582) had diabetes. It is important to note that diabetic patients have a higher risk of latent tuberculosis developing into active tuberculosis, with a risk of progression from initial infection 2.44 to 8.33 times higher in patients with DM than in those without the disease.…”

“…This creates case subnotification and subinformation, underestimating the real infection rate in locations far from Brazilian capitals. 12 The heterogeneity of its clinical forms and the difficulty in early diagnosis usually cause impactful delays in the success of the treatment and, therefore, lead to a degree of physical disability. 2,5 It is known that imaging tests do not have high specificity.…”

“…The data for variables related to risk factors were incomplete, making statistical association difficult and demonstrating the real need to improve promotion of the SINAN database. 12 Furthermore, specific studies are suggested in order to show the most frequent location of bone tuberculosis, the evolution of treatment and diagnostic methods. The percentage found of several variables ignored in the information system is a study bias.…”