Epidemiological Analysis of Lower Limb Vascular Trauma over 16 years in Brazil - A Nationwide View

Abstract

Background: Lower limb vascular trauma (LLVT) represents a significant public health challenge due to its potential to cause complex injuries that are difficult to manage, leading to increased morbidity, mortality and healthcare costs. Objective: to investigate the incidence, lethality, population characteristics, and economic burden of LLVT in Brazil, the largest country in South America, from 2008 to 2023. Methods: We used data from DATASUS (Department of Information and Informatics of the Brazilian Public Health System), which is the world's largest public health system database. Our analysis focused on LLVT cases surgically treated in Brazil from 2008 to 2023. The study focused on demographic distribution, sex proportion, age groups, regional variations, hospital stays, intensive care unit (ICU) stays, lethality rates and financial expenditures. Results: The study encompassed 20,349 LLVT cases and found a decrease in the number of cases over the years. LLVT was predominantly seen in males (70%), with an average patient age of 39.68 years. The Northeast and North regions registered the highest incidence, while the Southeast had the lowest. Most patients had a short hospital stay, averaging two days. The majority of patients did not need to be admitted to the ICU, and those who did stayed for an average of 4.48 days. The lethality was 5.96%, with bilateral LLVT showing a slightly lower mortality rate than unilateral cases. The total expenditure over 16 years, inferred by the amount passed on to SUS, totaled 9,537,664 USD, indicating a substantial economic impact. Conclusion: LLVT has a significant impact on public health, mainly because it affects the economically active population, with a high risk of death or mutilating sequelae. Although there has been a general decrease in incidence, the persistence of high costs and high lethality rates indicate the need for targeted preventive measures. Future studies must investigate the causes and potential improvements in managing LLVT in Brazil.