Deaths – ABC CARDIOL

IJCS

Editorial

Analyzing the Impact of Stroke in the Southeast Region of Brazil

Gabriel Porto Soares et al. Thais Rocha Salim

Stroke is among the main causes of death in the world, a fact that is no different in Brazil. It is grouped in diseases of the circulatory system that correspond to almost 30% of deaths in Brazil; in this group of diseases, ischemic heart diseases hold first place, immediately followed by cerebrovascular diseases.

It is impossible not to mention the fact that stroke, when it does not lead to death, generates disabilities and different degrees of deficiency, maintaining survival, but generating a great reduction in quality of life, in addition to inability to work and reduced autonomy with limitations in carrying out daily tasks.

[…]

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Original Article

In- and Out-of-Hospital Deaths by Acute Myocardial Infarction in Brazilian State Capitals

Sterffeson Lamare Lucena de Abreu et al. Joana D’Arc Matos França de Abreu Maria dos Remédios Freitas Carvalho Branco Alcione Miranda dos Santos

Abstract

Background:

Acute myocardial infarction (AMI) is the main cause of death in Brazil and the world. Approximately half of these deaths occur outside the hospital.

Objectives:

To analyze the distribution, temporal evolution, and sociodemographic characteristics (SDC) of in- and out-of-hospital deaths by AMI in Brazilian state capitals and their relationship with municipal development indicators (MDI).

Methods:

This is an ecological study of the number of deaths due to AMI reported annually by the 27 Brazilian state capitals from 2007 to 2016; these were divided into 2 groups: in-hospital (H) and out-of-hospital (OH). We evaluated the temporal evolution of mortality rates in each group and differences in SDC. Negative binomial regression models were used to compare the temporal evolution of the number of deaths in each group with the following variables: residing in the South/Southeast regions (S/SE), municipal human development index (MHDI), Gini coefficient, and expected years of schooling (EYS). We considered p-values<0.05 as statisticallysignificant.

Results:

The OH mortality rate increased with time for all state capitals. All studied SDC were different between groups (p<0.001). In the OH group, most deaths were of men and patients aged 80 years or older and not married. S/SE increased the incidence of OH deaths (incidence rate ratio [IRR]=2.84; 95% confidence interval [CI]=1.67–4.85), while higher EYS reduced it (IRR=0.86; 95% CI=0.77–0.97). In the H group, higher MHDI reduced the incidence of deaths (IRR=0.44; 95% CI=0.33–0.58), while higher EYS increased it (IRR=1.09; 95% CI=1.03–1.15).

Conclusions:

In- and out-of-hospital deaths due to AMI in Brazilian state capitals were influenced by MDI, presented sociodemographic differences and a progressive increase in out-of-hospital occurrences.

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Original Article

Temporal Trend of Mortality Due to Ischemic Heart Diseases in Northeastern Brazil (1996–2016): An Analysis According to Gender and Age Group

Gibson Barros de Almeida Santana et al. Thiago Cavalcanti Leal João Paulo Silva de Paiva Leonardo Feitosa da Silva … Lucas Gomes Santos Tatiana Farias de Oliveira Rodrigo da Rosa Mesquita Jéssica Alves Gomes Carlos Dornels Freire de Souza Amanda Karine Barros Ferreira Rodrigues

Abstract

Background

Ischemic heart disease (IHD) is the leading cause of death among cardiovascular diseases (CVD).

Objective

To describe the sociodemographic profile and analyze the trend in the mortality rate due to IHD, according to sex and by age group, in the states of the Northeast region of Brazil, from 1996 to 2016.

Methods

Ecological study involving IHD mortality in the northeastern states. Variables analyzed: sex, age, education, marital status, ICD-10 category and state of residence. Crude and standardized rates were calculated. Death data were collected from the Mortality Information System (SIM) and population data from the Brazilian Institute of Geography and Statistics (IBGE). In temporal analyzes the regression model by inflection points was used, with the calculation of annual percent change (APC) and average annual percent change of the period (AAPC). A 95% confidence interval and a significance level of 5% were considered.

Results

405916 deaths due to IHD were registered in the northeast region during the study period. The death profile is characterized by men (n=229006; 56,42%), elderly (n=301379; 74,25%), race/color brown (n=197936; 48,76%), elementary or <4 years at school (n=232599; 57,30%) and married (n=179599; 44,25%). There was an unusual highlight to the increase in the annual growth rate in the age group of adolescents (AAPC: 5,2%, p <0.01). The standardized regional mortality rate grew from 30,7 per 100,000 inhabitants in 1996 to 53.8 per 100,000 in 2016 (AAPC 2.8%; p<0.01). All nine states presented a statistically significant growth trend, with emphasis on Maranhão (AAPC 7,6%; p<0.01) and Piauí (AAPC 6,0%; p<0.01).

Conclusion

The prevalent observed profile was male, elderly, race/color brown, low education level and married. Mortality due to IHD presented an upward trend in all states, although with an uneven pattern among the federated units.

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Original Article

Increased Home Death Due to Cardiopulmonary Arrest in Times of COVID-19 Pandemic

Nathalia Sernizon Guimarães et al. Taciana Malheiros Lima Carvalho Jackson Machado-Pinto Roger Lage … Renata Mascarenhas Bernardes Alex Sander Sena Peres Mariana Amaral Raposo Ricardo Machado Carvalhais Renan Avelino Mancini Gabriella Yuka Shiomatsu Bruna Carvalho Oliveira Valéria de Melo Rodrigues Maria do Carmo Barros de Melo Unaí Tupinambás

Abstract

Background

Cardiovascular diseases constitute an important group of causes of death in the country. Ischemic heart diseases that are the main causes of cardiopulmonary arrest, leading to an impact on the mortality of the cardiovascular diseases in the health system.

Objective

Assess the number of home deaths by cardiopulmonary arrest notified by the Mobile Emergency Medical Service (SAMU) in March 2018, 2019 and 2020.

Methods

Observational study carried out from the analysis of cardiopulmonary arrest mortality data of citizens assisted by SAMU in Belo Horizonte, Minas Gerais, Brazil. Social and clinical characteristics and occurrence information of the patients were analyzed. The mortality rate due to cardiopulmonary arrest in relation to the total number of attendances was assessed. A significance level of 95% was considered.

Results

There was increase of home deaths due to cardiopulmonary arrest in March 2020 compared to March 2018 (p<0.001) and March 2019 (p=0.050). Of the deaths reported in 2020, 63.8% of the patients were aged 60 years or older, 63.7% of the occurrences were performed in the afternoon and approximately 87% of the cardiopulmonary arrest notified had associated clinical comorbidities, with systemic arterial hypertension and heart failure represented by 22.87% and 13.03% of the reported cases, respectively. The majority of the evaluated sample of this study did not have any medical care follow-up (88.7%).

Conclusion

Considering the increase in the number of the deaths, we suggest reflections and readjustments regarding the monitoring of chronic non-transmissible diseases during a pandemic, as well as improvements in death surveillance. (Arq Bras Cardiol. 2021; 116(2):266-271)

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Original Article

Medical care and deaths due to coronary artery disease in Brazil, 1980-1999

Ines Lessa

OBJECTIVE: To estimate the frequency of medical care preceding deaths due to coronary artery diseases (CAD) in different Brazilian regions and capitals and to describe trends in medical care from 1980 to 1999. METHODS: Information on medical care preceding deaths due to coronary artery diseases/acute myocardial infarction in adults > 20 years from 1980 to 1999 was collected in the DATASUS, the databank of the Brazilian Health Ministry. Sex, states, and capitals selected for 1999 were analyzed in the study. Medical care was stratified as follows: with, without, and ignored medical care. The descriptive analysis comprised frequencies, ratios of frequency, test for proportions, and increments or reductions in frequencies. RESULTS: Acute myocardial infarction (AMI) represented 75 to 85% of the CAD in the period; the frequency of deaths with medical care ranged from 48.9 to 63%, and that of ignored medical care ranged from 27.2 to 41.5%. The frequency of other CAD with medical care ranged from 56 to 76%. The frequency of deaths preceded by medical care decreased by 17.8%, and that with ignored medical care increased by 36.5% (RF=2). The values for the other CAD were -20.2% and +64.6% (RF=44.4). Deaths preceded by medical care were more frequent in females at all ages and in all Brazilian regions. CONCLUSION: The results show a high frequency of sudden death and suggest errors in diagnosis or codification and overestimation of the statistics about mortality. Validation of the death certificate diagnosis and frequent surveillance are required.

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