The surgical-interventional cleavage in cardiovascular medicine: A brazilian health care system analysis
Year: 2025
Type: article
Study design: Observational Study
Abstract: This study aims to compare in-hospital mortality, costs, and length of stay between traditional cardiovascular surgery and interventional cardiology in SUS (2009–2023), evaluate temporal trends in technological substitution, and quantify long-term effects using risk-adjusted models. An ecological design analyzed aggregated data from 2,303,648 procedures. ARIMA models and negative binomial regression adjusted temporal trends and mortality risk. Results revealed accelerated technological substitution (-1.27% annual decline in surgeries; p < 0.001), with initial mortality advantage for interventional procedures (RR = 0.43; 95% CI: 0.11–0.76). However, synthetic projections showed benefit inversion by 2023 (+72.38 excess deaths), linked to an inverse learning curve for interventions (+0.83% mortality per 1% volume increase; p < 0.001). Cost savings (R$5,524/case) and shorter hospitalization (-5.07 days) coexisted with rising complexity in surgical cohorts, increasing baseline mortality risk by 0.59% annually (p < 0.001). The study concludes that technological substitution in SUS achieved economic efficiency but requires parallel investments in training and risk stratification for clinical sustainability.
Source: Research Society and Development
Authors: Gabriel Kaleb Martins, Maria Rayane Félix Pacífico, Maria Eduarda Dantas de Souza Reis, Karina de Jesus do Nascimento, Louise Pereira de Moraes Vieira, André Gonçalves Martins Santos, Emilly Karolliny Santos
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4407204211