Work

Chronic Rheumatic Heart Disease in Older Brazilians: Hospitalizations and In-Hospital Deaths, 2015-2024

Year: 2026

Type: article

Abstract: INTRODUCTION AND OBJECTIVES: Chronic rheumatic heart disease remains a cause of morbidity in older adults. This study analyzed hospitalizations and in-hospital deaths associated with the disease among Brazilians aged 60 years or older from 2015 to 2024, examining differences by sex and macroregion and temporal trends. METHODS: This ecological time-series study used data from the Brazilian Unified Health System Hospital Information System and official population estimates. Annual crude hospitalization and in-hospital death rates per 100,000 older adults were calculated by sex and macroregion. Joinpoint regression was used to estimate annual and average annual percent changes. RESULTS: Hospitalizations increased from 2,632 in 2015 to 3,683 in 2024, while crude hospitalization rates changed from 10.56 to 10.78 per 100,000 older adults. In-hospital deaths increased from 362 to 419, whereas corresponding rates declined from 1.45 to 1.23 per 100,000. Nationally, hospitalization rates among women declined by 7.05% annually during 2015-2020 and increased by 10.69% annually during 2020-2024 (both p < 0.001). Among men, rates declined by 6.83% annually during 2015-2021 (p = 0.004) and increased by 16.77% annually during 2021-2024 (p = 0.008). Over the full period, average national trends were not statistically significant for either outcome in either sex. Regional patterns were heterogeneous. In the Northeast, women showed sustained increases in hospitalization rates (5.08% annually; p = 0.021) and in-hospital death rates (11.88% annually; p < 0.001). CONCLUSIONS: Hospitalization rates declined and subsequently rebounded, while population-based in-hospital death rates and their temporal patterns varied by sex and region. These patterns reflect the joint contribution of hospitalization frequency and the proportion of admissions ending in death and should not be interpreted as deaths causally attributable to chronic rheumatic heart disease. Regional variation indicates an uneven distribution of recorded hospital utilization and outcomes but does not, by itself, establish inequalities in access to or quality of care. The recent increase in hospitalizations indicates greater hospital utilization and should not be interpreted as evidence of increased disease incidence. Continued surveillance incorporating both hospitalization rates and the proportion of admissions resulting in death is warranted to better characterize temporal and regional patterns among older adults.

Source: Cureus

DOI: 10.7759/cureus.118576