Brain aneurysms treatment in brazil: epidemiology and historical trend

Introduction: Neurosurgical clipping of the aneurysm was the standard treatment prior to the introduction of detachable coils, but endovascular coiling has recently been increasing so management of intracranial aneurysms has made debates about the best treatment modality in recent years. Objective: To provide nationwide estimates of the epidemiological, historical trends and economic profile of people suffering from brain aneurysm in Brazil and treated in public health system.

Methods: This population study uses descriptive statistics to characterize the demographic and economic profile of people treated by brain aneurysm in Brazil. The information used is available on the database of the Information Technology Department of the Unified Health System (DATASUS). The database consulted is fed by the filling out the form called “hospital admission authorization (AIH)” by the public and private health institutions that make up the Unified Health System (SUS). DATASUS database were accessed on May of 2018 and analysis of the data available from January 2008 to December 2017 was performed. The variables studied were: number of admissions, average cost per admissions, total cost of admissions, length of stay, number of deaths and mortality rates.

Results: The total number of procedures performed in the evaluated period was 47,179, with 25,932 clipping and 21,247 embolizations. In 2015, there was a reversal with the embolizations predominating over clipping from this period on. The mean permanence for the patients submitted to clipping was 15.9 days, and 7.5 days for those submitted to embolization. The mean value of AIH was R$ 18,016.22 for the coil group and R$ 7,732.30 for the clip group, and mortality was 10.9% in patients submitted to clipping and 5.8% in those submitted to embolization.

Conclusion: Following the worldwide trend, in Brazil there is an increase in the number of embolizations in relation to the clipping, so that nowadays the treatment per coil is more frequently used in comparison to the clip. It was also observed that mortality was higher in the group submitted to clipping.