Please use this identifier to cite or link to this item: https://www.arca.fiocruz.br/handle/icict/7491
Title: Surgery for valvular heart disease: a population-based study in a Brazilian urban center.
Authors: Ribeiro, Guilherme de Sousa
Tartof, Sara Yee
Oliveira, Dalton W. S.
Guedes, Aldalice C. S.
Reis, Mitermayer Galvão dos
Riley, Lee Woodland
Ko, Albert Icksang
Affilliation: Federal University of Bahia. Institute of Collective Health. Salvador, BA, Brasil / Fundação Oswaldo Cruz. Centro de Pesquisa Gonçalo Moniz. Salvador, BA, Brasil
University of California. School of Public Health. Berkeley, California, USA
Fundação Oswaldo Cruz. Centro de Pesquisa Gonçalo Moniz. Salvador, BA, Brasil
Fundação Oswaldo Cruz. Centro de Pesquisa Gonçalo Moniz. Salvador, BA, Brasil
Fundação Oswaldo Cruz. Centro de Pesquisa Gonçalo Moniz. Salvador, BA, Brasil
University of California. School of Public Health. Berkeley, California, USA
Fundação Oswaldo Cruz. Centro de Pesquisa Gonçalo Moniz. Salvador, BA, Brasil / Yale School of Public Health. Epidemiology of Microbial Diseases Division. New Haven, Connecticut, USA
Abstract: BACKGROUND: In middle income countries, the burden of rheumatic heart disease (RHD) remains high, but the prevalence of other heart valve diseases may rise as the population life expectancy increases. Here, we compared population-based data on surgical procedures to assess the relative importance of causes of heart valve disease in Salvador, Brazil. METHODOLOGY/PRINCIPAL FINDINGS: Medical charts of patients who underwent surgery for valvular heart disease from January 2002-December 2005 were reviewed. Incidence of surgery for valvular heart disease was calculated. Logistic regression was used to identify factors associated with in-hospital death following surgery. The most common etiologies for valvular dysfunction in 491 valvular heart surgery patients were RHD (60.3%), degenerative valve disease (15.3%), and endocarditis (4.5%). Mean annual incidence for surgeries due to any valvular heart diseases, RHD, and degenerative valvular disease were 5.02, 3.03, and 0.77 per 100,000 population, respectively. Incidence of surgery due to RHD was highest in young adults; procedures were predominantly paid by the public health sector. In contrast, the incidence of surgery due to degenerative valvular disease was highest among those older than 60 years of age; procedures were mostly paid by the private sector. The overall in-hospital case-fatality ratio was 11.9%. Independent factors associated with death included increase in age (odds ratio: 1.04 per year of age; 95% confidence interval: 1.02-1.06), endocarditis (6.35; 1.92-21.04), multiple valve operative procedures (4.35; 2.12-8.95), and prior heart valve surgery (2.49; 1.05-5.87). CONCLUSIONS/SIGNIFICANCE: RHD remains the main cause for valvular heart surgery in Salvador, which primarily affects young adults without private health insurance. In contrast, surgery due to degenerative valvular disease primarily impacts the elderly with private health insurance. Strategies to reduce the burden of valvular heart disease will need to address the disparate factors that contribute to RHD as well as degenerative valve disease.
DeCS: Cidades/estatística & dados numéricos
Doenças das Valvas Cardíacas/epidemiologia
Doenças das Valvas Cardíacas/cirurgia
Brasil/epidemiologia
Adulto
Idoso
Brasil/epidemiologia
Feminino
Doenças das Valvas Cardíacas/etiologia
Doenças das Valvas Cardíacas/mortalidade
Hospitais/estatística & dados numéricos
Humanos
Meia-Idade
Masculino
Fatores de Risco
Issue Date: 2012
Publisher: Public Library of Science
Citation: RIBEIRO, G. S. et al. Surgery for valvular heart disease: a population-based study in a Brazilian urban center.Plos One, v. 7, p. e37855, 2012.
DOI: 10.1371/journal.pone.0037855
ISSN: 1932-6203
Copyright: open access
Appears in Collections:BA - IGM - Artigos de Periódicos

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