Sickle Cell Disease Hospitalizations in Porto Alegre: Epidemiological Profile and Monitoring of Readmissions
Year: 2026
Type: article
Study design: Observational Study
Abstract: In Brazil, sickle cell disease (SCD) is associated with high morbidity and mortality resulting from vaso-occlusive crises, infections, and acute complications that frequently lead to recurrent hospitalizations. The systematic monitoring of hospitalizations constitutes a strategic tool for identifying higher-risk patients, supporting early interventions, and strengthening the health care network. To describe the epidemiological profile of SCD hospitalizations in Porto Alegre, with emphasis on patients with readmissions, based on the implementation of a structured monitoring system as a strategy to qualify the line of care. A descriptive, retrospective cohort study based on notifications of SCD hospitalizations recorded in the surveillance system for non-communicable diseases and conditions of Porto Alegre during 2025. Demographic variables, frequency of crises, number of readmissions (defined as two or more hospitalizations in the period), geographic distribution, and linkage to the care network were analyzed. A permanent surveillance flow was implemented, enabling longitudinal follow-up of cases and coordination among epidemiological surveillance, specialized care, and primary care. Since the implementation of mandatory SCD notification in the municipality of Porto Alegre in 2025, in accordance with Ordinance GM/MS No. 2.010/2023, 201 individuals with SCD were identified. Of these, 58 patients comprised the study cohort, totaling 117 hospitalizations during the follow-up period. Most hospitalizations (103/88.03%) were motivated by sickle cell crises, while 14 (11.97%) occurred due to other SCD-related complications. Among the followed patients, 29 (50.0%) had at least one readmission, concentrating multiple hospitalization episodes throughout the period. Female patients predominated (36/62.07%), self-declared Black individuals (40/68.97%), and those aged 0 to 19 years (34/58.62%), evidencing the significant impact of the disease on the pediatric and adolescent population. A spatial concentration of readmissions was also observed in the East/Northeast axis of the municipality, accounting for 48 (41.03%) of the recorded episodes. Regarding primary health care, 44 patients (75.86%) had a link to this level of care. The systematic monitoring of SCD hospitalizations in Porto Alegre allowed the identification of a specific group of patients with recurrent readmissions, predominantly composed of Black children and adolescents, who concentrate a significant share of the hospital burden of SCD in the municipality. Although 44 (75.86%) of the evaluated patients were linked to primary care, this linkage, in isolation, proved insufficient to prevent new hospitalizations. The implementation of the municipal surveillance system, combined with mandatory notification of cases identified by neonatal screening in both public and private networks, enables active case finding and longitudinal follow-up of these patients, allowing early identification of higher-risk individuals and directing more efficient care interventions. Thus, the Porto Alegre experience highlights the potential of integrated surveillance to strengthen the SCD line of care, qualify health management, and contribute to reducing potentially preventable hospitalizations.
Language: English
Subfield: Genetics (clinical)
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7223122176