Epidemiology and Estimated Cost of Surgery for Chronic Subdural Hematoma Conducted by the Unified Health System in Brazil (2008–2016)

Abstract

Introduction Chronic subdural hematoma (CSH) is one of the most frequent forms of intracranial hemorrhage. It is a collection of encapsulated, well-delimited fluid and/or coagulated blood in several clotting stages located between the dura mater and the arachnoid mater. Objective To describe the epidemiological aspects of CSH described in the database of the Brazilian Unified Health System (SUS, in the Portuguese acronym) regarding admission numbers, hospitalization expenses, health care professional expenses, mortality rate, and death numbers by region from 2008 to the first half of 2016. Methods The present work was performed between August and September 2016 with a review about the epidemiological aspects of CSH in Brazil according to the Informatics Department of the Unified Health System (DATASUS) database, encompassing the period from January 2008 to June 2016, and to scientific papers from the past 10 years which were electronically published at the PubMed, Scielo, and LILACS databases. Results From 2008 to the first half of 2016, the total values were the following: hospital admission authorizations (HAAs). 33,878; hospital expenses, BRL 65,909,429.22; health care professional expenses, BRL 25,158,683.21; deaths, 2,758; and mortality rates ranging from 6.47 to 12.63%. Conclusion In spite of the high clinical relevance of CSH, epidemiological studies about this condition are limited. As such, the present paper is an updated approach on CSH, focusing on its epidemiological aspects according to the DATASUS database.

Incidence of chronic subdural haematoma: a single-centre exploration of the effects of an ageing population with a review of the literature

“…Between the two time points studied in one paper (1969 and 1983), there was a 250% increase in reported crude incidence of cSDH [15]. This is matched by a repeated study within North Wales which demonstrated an increase in incidence in those over 65 from 8.2 to 48 between 1999 and 2017 [1] as well as studies from both Finland [21] and Brazil [14] where data was available over a 25-and 8-year period, respectively.…”

“…The results in Table 1 Table 1 Published crude estimates of the incidence (per 100,000/year) of chronic subdural haematoma identified through systematic literature search *Indicates that incidence was calculated in those aged 65 or older only. Magalhães [14] could be interpreted as suggesting an increasing incidence over time. Due to the disparate geographic locations of the studies as well as differences in case ascertainment, the potential for confounding of this association is high.…”

“…Some of this trend is almost certainly driven by increased rates of detection due to improved diagnostic technologies [15], especially when the rates in 1967-1973 [10] were based solely on operated or autopsy cases. However, studies where incidence was calculated at different time points in the same population appear to suggest a true rise [2,14,15,21]. Although some of this could arguably be confounded by widespread adoption of medical imaging technology, this should not be a significant factor for the rise in case numbers seen over the last decade in Brazil [14] or the linearity in incidence rise over the last 20 years in Finland [21].…”

“…Incidence ranged from 1.7 in the period 1967-1973 in Finland [10] to 48 in 2017 in North Wales [2]. For two studies [14,22], incidence rate was calculated from presented case numbers. In one of these [22], estimated total population was calculated as the midpoint between quoted values for the beginning and end of the study period.…”

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

“…The presence of a dot (•) indicates that the domain was cited by the article. First author, year Lack of data Data reliability Data accuracy Data integration Truche et al, 2020 5 • Do Nascimento, 2022 10 • • Ferreira, 2018 11 • Tonatto-Filho, 2019 12 • Olijnyk, 2022 13 • • Do Nascimento, 2021 14 • De Magalhães, 2017 15 • De Magalhães, 2019 16 • De Magalhães, 2017 17 …”