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. 2025 Apr;122(6):e20240505.
doi: 10.36660/abc.20240505.

Temporal Trends of Hospital Admissions Due to Heart Failure in Brazil

[Article in Portuguese, English]
José Marcos Girardi  1 , Isadora Araújo Girardi  2 , Ana Clara Silva Nascimento  2 , Daniel Monteiro de Lauro Silva  3 , Luisa Venture Gibaile Soares  2 , Sarah Alessandrini Lauriano Dias  2 , Sarah Quick Lourenço de Lima  4 , Flávia Araújo Girardi  4
Affiliations

Temporal Trends of Hospital Admissions Due to Heart Failure in Brazil

[Article in Portuguese, English]
José Marcos Girardi et al. Arq Bras Cardiol. 2025 Apr.

Abstract
in English, Portuguese

Background: Heart failure is a global pandemic that causes a significant reduction in quality of life, with an impact on hospital expenses. It is important to know the temporal trends of hospitalizations and mortality in order to outline coping strategies.

Objective: The objective of this study was to describe the temporal trends of hospitalizations due to heart failure and mortality during hospitalizations between 2000 and 2021 in Brazil.

Methods: We conducted a study on temporal trends in the rates of hospitalization and mortality during hospitalization, using data from the Department of Information Technology of the Brazilian Unified Health System, by means of joinpoint regression. We calculated the annual percentage change of the rates with respective 95% confidence intervals and alpha significance level of 0.05.

Results: We analyzed 2,851,437 hospitalizations in men and 2,749,424 hospitalizations in women between 2000 and 2021 in Brazil. Regarding hospitalization rates, there was an annual percentage decrease of 6.7% to 8.1% in men and a decrease of 7.5% to 8.3% in women. With respect to mortality rates, there was an annual percentage increase of 1.8% to 3.6% in men and an increase of 3.1% to 3.5% in women.

Conclusion: We observed a decrease in the rates of hospitalization due to heart failure and an increase in the mortality rates in all age ranges assessed, in both sexes, between 2000 and 2021 in Brazil. These findings may reflect better disease control and hospitalization only for more severe cases, but we emphasize the need for continued management of risk factors for the disease.

Fundamento: A insuficiência cardíaca é uma pandemia global e causa de redução significativa da qualidade de vida, com impacto nos gastos hospitalares, sendo importante conhecer a tendência temporal das internações e mortalidade para traçar estratégias de enfrentamento.

Objetivo: O objetivo deste estudo foi descrever a tendência temporal das internações hospitalares por insuficiência cardíaca e mortalidade durante as internações entre 2000 e 2021 no Brasil.

Métodos: Foi realizado estudo de tendência temporal das taxas de internação e mortalidade durante internações, utilizando-se dados do Departamento de Informática do Sistema Único de Saúde, por meio de regressão segmentada joinpoint. Foram calculadas as variações percentuais anuais das taxas com os respectivos intervalos de confiança de 95% e nível alfa de significância de 0,05.

Resultados: Foram analisadas 2.851.437 internações em homens e 2.749.424 em mulheres entre 2000 e 2021 no Brasil. Observou-se redução percentual anual das taxas de internação em homens de 6,7% a 8,1% e, em mulheres, redução de 7,5% a 8,3%. Observou-se aumento percentual anual das taxas de mortalidade em homens de 1,8% a 3,6% e, em mulheres, aumento de 3,1% a 3,5%.

Conclusão: Observou-se redução das taxas de internação por insuficiência cardíaca e aumento das taxas de mortalidade em todas as faixas etárias avaliadas para ambos os sexos entre 2000 e 2021 no Brasil. Estes resultados podem refletir melhor controle ambulatorial da doença e internação apenas para casos mais graves, mas ressaltamos a necessidade de abordagem continuada dos fatores de risco para a doença.

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Conflict of interest statement

Potencial Conflito de Interesse: Declaro não haver conflito de interesses pertinentes.

Figures

Figura Central:
Figura Central:. Tendência Temporal das Internações Hospitalares por Insuficiência Cardíaca no Brasil
Figura 1
Figura 1. – Valores observados e estimados por modelo de regressão joinpoint das taxas de internação por insuficiência cardíaca em homens, por faixas etárias, entre 2000 e 2021 no Brasil. Pontos: valores observados; linhas contínuas: valores estimados. Valores de APC (variação percentual anual) e respectivos intervalos de confiança 95%: 40 a 49 anos: –7,6%* (–8,0; –7,3); –5,3%* (–7,1; –4,7); –6,8%* (–8,0; –6,4); –4,1%* (–5,0; –3,4); –8,6%* (–10,0; –6,8). 50 a 59 anos: –7,6%* (–7,9; –7,4); –4,2%* (–5,5; –3,7); –8,1%* (–8,7; –7,0); –5,7%* (–6,1; –4,5); –8,7%* (–10,4; –6,9). 60 a 69 anos: –6,3%* (–6,9; –4,7); –8,7%* (–9,8; –7,9); –5,9%* (–6,1; –5,6); –11,2%* (–12,7; –8,9). 70 a 79 anos: –4,0%* (–5,5; –0,8); –7,7%* (–9,2; –6,9); –6,1%* (–6,4; –5,3); –14,0%* (–16,1; –10,7). 80 anos ou mais: –8,9%* (–10,0; –8,2); –6,4%* (–6,7; –5,8); –14,8%* (–17,3; –10,9). *APC significativamente diferente de zero utilizando-se nível de significância alfa = 0,05. Elaborado pelos autores (2024).
Figura 2
Figura 2. – Valores observados e estimados por modelo de regressão joinpoint das taxas de internação por insuficiência cardíaca em mulheres, por faixas etárias, entre 2000 e 2021 no Brasil. Pontos: valores observados; linhas contínuas: valores estimados. Valores de APC (variação percentual anual) e respectivos intervalos de confiança 95%: 40 a 49 anos: –10,6%* (–12,0; –9,6); –6,9%* (–7,1; –6,6). 50 a 59 anos: –9,9%* (–10,8; –9,2); –6,7%* (–6,9; –6,2); –12,6%* (–15,0; –9,3). 60 a 69 anos: –9,0%* (–9,9; –8,4); –6,6%* (–6,9; –5,8); –12,8%* (–15,6; –9,0). 70 a 79 anos: –6,7%* (–6,9; –6,5); –14,6%* (–17,4; –10,2). 80 anos ou mais: –10,5%* (–12,6; –8,7); –8,0%* (–11,0; –5,1); –6,1%* (–6,4; –5,0); –14,2%* (–16,7; –10,9). *APC significativamente diferente de zero utilizando-se nível de significância alfa = 0,05. Elaborado pelos autores (2024).
Figura 3
Figura 3. – Valores observados e estimados por modelo de regressão joinpoint das taxas de mortalidade durante as internações por insuficiência cardíaca em homens, por faixas etárias, entre 2000 e 2021 no Brasil. Pontos: valores observados; linhas contínuas: valores estimados. Valores de APC (variação percentual anual) e respectivos intervalos de confiança 95%: 40 a 49 anos: 1,8%* (1,5; 2,1). 50 a 59 anos: 2,3%* (1,2; 4,3); 5,9%* (2,3; 8,1). 60 a 69 anos: 2,7%* (2,4; 6,1); 0,9% (–0,9; 2,7); 11,8%* (6,2; 15,3). 70 a 79 anos: 2,9%* (2,6; 3,1); 7,5%* (3,5; 9,2). 80 anos ou mais: 3,6%* (3,4; 3,9). *APC significativamente diferente de zero utilizando-se nível de significância alfa = 0,05. Elaborado pelos autores (2024).
Figura 4
Figura 4. – Valores observados e estimados por modelo de regressão joinpoint das taxas de mortalidade durante as internações por insuficiência cardíaca em mulheres, por faixas etárias, entre 2000 e 2021 no Brasil. Pontos: valores observados; linhas contínuas: valores estimados. Valores de APC (variação percentual anual) e respectivos intervalos de confiança 95%: 40 a 49 anos: 4,0%* (3,4; 5,3); –0,3% (–3,1; 2,1); 4,7%* (3,5; 8,4). 50 a 59 anos: 3,0%* (2,4; 3,2); 7,6%* (3,2; 10,3). 60 a 69 anos: 2,9%* (2,3; 3,2); 8,9%* (3,3; 11,7). 70 a 79 anos: 2,9%* (2,5; 3,1); 9,3%* (3,5; 11,4). 80 anos ou mais: 3,1%* (2,8; 3,3). *APC significativamente diferente de zero utilizando-se nível de significância alfa = 0,05. Elaborado pelos autores (2024).
Central Illustration:
Central Illustration:. Temporal Trends of Hospital Admissions Due to Heart Failure in Brazil
Figure 1
Figure 1. – Observed and estimated joinpoint regression values for hospitalization due to heart failure in men, by age ranges, between 2000 and 2021 in Brazil. Dots: observed values; solid lines: estimated values. Annual percentage change (APC) values with respective 95% confidence intervals: 40 to 49 years: –7.6%* (–8.0; –7.3); –5.3%* (–7.1; –4.7); –6.8%* (–8.0; –6.4); –4.1%* (–5.0; –3.4); –8.6%* (–10.0; –6.8). 50 to 59 years: –7.6%* (–7.9; –7.4); –4.2%* (–5.5; –3.7); –8.1%* (–8.7; –7.0); –5.7%* (–6.1; –4.5); –8.7%* (–10.4; –6.9). 60 to 69 years: –6.3%* (–6.9; –4.7); –8.7%* (–9.8; –7.9); –5.9%* (–6.1; –5.6); –11.2%* (–12.7; –8.9). 70 to 79 years: –4.0%* (–5.5; –0.8); –7.7%* (–9.2; –6.9); –6.1%* (–6.4; –5.3); –14.0%* (–16.1; –10.7). 80 years or older: –8.9%* (–10.0; –8.2); –6.4%* (–6.7; –5.8); –14.8%* (–17.3; –10.9). *Significantly different APC applying alpha significance level = 0.05. Prepared by the authors (2024).
Figure 2
Figure 2. – Observed and estimated joinpoint regression values for hospitalization due to heart failure in women, by age ranges, between 2000 and 2021 in Brazil. Dots: observed values; solid lines: estimated values. Annual percentage change (APC) values with respective 95% confidence intervals: 40 to 49 years: –10.6%* (–12.0; –9.6); –6.9%* (–7.1; –6.6). 50 to 59 years: –9.9%* (–10.8; –9.2); –6.7%* (–6.9; –6.2); –12.6%* (–15.0; –9.3). 60 to 69 years: –9.0%* (–9.9; –8.4); –6.6%* (–6.9; –5.8); –12.8%* (–15.6; –9.0). 70 to 79 years: –6.7%* (–6.9; –6.5); –14.6%* (–17.4; –10.2). 80 years or older: –10.5%* (–12.6; –8.7); –8.0%* (–11.0; –5.1); –6.1%* (–6.4; –5.0); –14.2%* (–16.7; –10.9). *Significantly different APC applying alpha significance level = 0.05. Prepared by the authors (2024).
Figure 3
Figure 3. – Observed and estimated joinpoint regression values for mortality during hospitalization for heart failure in men, by age ranges, between 2000 and 2021 in Brazil. Dots: observed values; solid lines: estimated values. Annual percentage change (APC) values with respective 95% confidence intervals: 40 to 49 years: 1.8%* (1.5; 2.1). 50 to 59 years: 2.3%* (1.2; 4.3); 5.9%* (2.3; 8.1). 60 to 69 years: 2.7%* (2.4; 6.1); 0.9% (–0.9; 2.7); 11.8%* (6.2; 15.3). 70 to 79 years: 2.9%* (2.6; 3.1); 7.5%* (3.5; 9.2). 80 years or older: 3.6%* (3.4; 3.9). *Significantly different APC applying alpha significance level = 0.05. Prepared by the authors (2024).
Figure 4
Figure 4. – Observed and estimated joinpoint regression values for mortality during hospitalization for heart failure in women, by age ranges, between 2000 and 2021 in Brazil. Dots: observed values; solid lines: estimated values. Annual percentage change (APC) values with respective 95% confidence intervals: 40 to 49 years: 4.0%* (3.4; 5.3); –0.3% (–3.1; 2.1); 4.7%* (3.5; 8.4). 50 to 59 years: 3.0%* (2.4; 3.2); 7.6%* (3.2; 10.3). 60 to 69 years: 2.9%* (2.3; 3.2); 8.9%* (3.3; 11.7). 70 to 79 years: 2.9%* (2.5; 3.1); 9.3%* (3.5; 11.4). 80 years or older: 3.1%* (2.8; 3.3). *Significantly different APC applying alpha significance level = 0.05. Prepared by the authors (2024).
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