Impact of COVID-19 on Neurosurgery in Brazil's Health System: The Reality of a Developing Country Affected by the Pandemic

Filho, Leonardo José Monteiro de Macêdo; Aragão, Ana Carolina A.; Santos, Vito Thayson D. dos; Galvão, Lívia B.A.; Shlobin, Nathan A.; Biase, Gaetano De; Suárez‐Meade, Paola; Almeida, João Paulo; Quiñones‐Hinojosa, Alfredo; Albuquerque, Lucas Alverne Freitas de

doi:10.1016/j.wneu.2021.08.030

Cited by 11 publications

(14 citation statements)

References 34 publications

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“…The second domain identified concerns the reliability of data provided by DATASUS (29.78%, n=14). The main aspect highlighted by the authors is dependence of the platform on filling out of forms in the executing hospitals, which generates the possibility of bias in the reporting of information 32 , 33 , 41 , 44 , 45 , 54 , with a probability of including multiple or wrong diagnoses in the database 16 , in addition to the risk of underreporting 31 , 46 . Forms are usually filled by administrative technicians and non-medical professionals, which increases the risk of bias in the information provided 52 .…”

Section: Resultsmentioning

confidence: 99%

Limitations of using the DATASUS database as a primary source of data in surgical research: a scoping review

VIANA,

FALEIRO,

MENDES

et al. 2023

Rev. Col. Bras. Cir.

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Objective: DATASUS is the Brazilian Public Unified Health System (SUS) department responsible for providing health data that are used as a primary source of data in several studies on surgery and surgical specialties although its main limitations have not been previously reviewed. The objective of this work is to synthesize information from studies on surgery that used DATASUS systems as a data source and to identify the main gaps in this platform. Methods: a scoping review was conducted according to the PRISMA-ScR method to identify papers on surgery, and other surgical specialties, that used the DATASUS platform as a primary data source. No restrictions were imposed regarding the type of study or year of publication. Grounded Theory was used to analyze the content of the articles. Results: 248 works were initially analyzed and 47 were included in the final analysis of this study. The original articles included were published between 2009 and 2022 and the majority (12.76%, n=6) were published in the Journal of the Brazilian College of Surgeons. Retrospective studies (40.43%, n=19) were the most common type of study found. Content analysis of the articles identified four predominant domains in the scientific literature about the limitations of using DATASUS in surgical research: lack of data, reliability, precision and data integration. Conclusion: the information systems available in DATASUS are the largest source of information about the SUS, but the scientific literature on the quality of data available in these systems remains scarce and studies aimed at measuring this metric are necessary.

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Section: Resultsmentioning

confidence: 99%

Limitations of using the DATASUS database as a primary source of data in surgical research: a scoping review

VIANA,

FALEIRO,

MENDES

et al. 2023

Rev. Col. Bras. Cir.

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“…This can be attributed to poor governmental management in some countries and a lack of residency training programs in neurosurgery [1]. These limitations can impact the success of neurosurgeries and contribute to low lifetime mortality rates [4,5,6]. Our study found that cost limitations in professionals' salaries and shunt procedures were signi cant challenges.…”

Section: Challenges For Developing Countriesmentioning

confidence: 87%

“…The number of procedures related to hydrocephalus increased between 2008-2019 in Brazil, contrasting with a decrease of 6.35% in 2020. This process may be a result of the COVID-19 pandemic since the neurosurgery centers decreased the overall number of procedures [4] according to the recommendations of the Brazilian Society of Pediatric Neurosurgery (Sociedade Brasileira de Neurocirurgia Pediátrica, SBNPed) [24]. These recommendations aim to minimize potential exposure of the patients and health professionals and prevent new cases since children need continuous parental assistance and greater medical support [4,24].…”

Section: Treatmentmentioning

confidence: 99%

“…Pediatric hydrocephalus is more prevalent in developing countries and presents a signi cant care burden compared to developed countries [1][2][3][4][5][6][7][8][9][10]. Several factors contribute to the higher incidence, including cultural beliefs, nutritional de ciencies, low infant birth weight, a higher incidence of perinatal and neonatal infections, delayed antenatal diagnosis, political instability, poverty, limited access to neurosurgical treatment, insu cient resources, low infrastructure capacity of tertiary health centers, great distances to these centers, and low family income [1,[4][5][6]. Additionally, the scarcity of available and trained neurosurgeons results in delayed presentation to medical care and higher morbidity and mortality rates [1,7].…”

Section: Introductionmentioning

confidence: 99%

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Pediatric Hydrocephalus in Brazil Public Health System: the Reality of a Developing Country in the Past 13 Years

Filho,

Mansouri,

Sarigul

et al. 2023

Preprint

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PURPOSE Pediatric hydrocephalus is a significant challenge in neurosurgery, particularly in resource-limited settings. This study focuses on the landscape of pediatric hydrocephalus neurosurgery in Brazil, a developing country, over the past 13 years. METHODS Data were collected from the Brazilian Hospital Information System, Live Birth Information System, and Mortality Information System records in the DATASUS (Departamento de Informática do SUS) database among January 2008 and the July 2021. Various health indicators were analyzed, including hospitalizations, treatment options, costs, and mortality rates. RESULTS During the period of study, Brazil recorded 8,493 new diagnoses of congenital hydrocephalus in live births, with 1,123 cases associated with spina bifida. The prevalence of congenital hydrocephalus was 241 cases per 100,000 live births, and 210 cases per 100,000 live births were attributed to congenital hydrocephalus not related to spina bifida. A total of 730 perinatal mortality cases related to congenital hydrocephalus were reported, with no clear trend over the 12-year period. The average number of perinatal mortality cases was 60.83 ± 13.98 per year. There were 1,063 infant mortality cases associated with hydrocephalus and 3,122 cases associated with congenital hydrocephalus, with no clear trend observed. The highest mortality rates for both diagnoses occurred between 3 to 5 months of age. Ethnicity and age were found to have significant relationships with mortality rates. A total of 217,900 hydrocephalus-related procedures were performed, with an increase in mean hospitalization cost and procedure numbers over the 13-year period. Mean cost per procedure had a significant negative effect on mean length of stay, while average professionals' salary did not have a significant effect. CONCLUSION Pediatric hydrocephalus in Brazil's public health system is a significant burden. Congenital hydrocephalus prevalence and mortality rates emphasize the need for better diagnosis and treatment. Early diagnosis, prenatal care, and adequate resources are crucial. This study offers insights into pediatric hydrocephalus in a developing country, highlighting challenges and future directions for improved care.

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“…Brazil, being a continental country with significant socioeconomic disparities across its regions, has experienced varying levels of health impact and resource availability during the COVID-19 pandemic (De Macêdo Filho et al, 2021). Given the restrictions on human and material resources, it is crucial to optimize these scarce resources to ensure effective therapies and avoid unnecessary procedures.…”

Section: Discussionmentioning

confidence: 99%

Assessment of Decompressive Craniectomy in Patients with Malignant Cerebral Infarction and Co-Occurring SARS-CoV-2 Infection

Silva,

Silva

2023

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Background: Malignant ischemic stroke is a known cerebrovascular complication in patients with SARS-CoV-2 infection, and decompressive craniectomy has been proposed as a treatment option. However, there is limited data available on the outcomes of patients with malignant stroke and concurrent SARS-CoV-2 infection. This study aimed to investigate whether decompressive craniectomy is beneficial for patients with malignant stroke and SARS-CoV-2 infection. Methods: This case-control study was conducted between March 2020 and December 2021, involving patients diagnosed with malignant stroke who underwent decompressive craniectomy. A total of 52 patients were included and divided into two groups: Group 1 consisted of patients with malignant ischemic stroke and concurrent SARS-CoV-2 infection (n = 20), while Group 2 comprised patients with malignant ischemic stroke without SARS-CoV-2 infection (n = 32). Medical data were collected for analysis. Results: The data analysis included variables such as diagnosis of COVID-19 and clinical outcome of death. Statistical tests, including the Chi-squared test with Yates's correction (p = 0.9094), Fischer's Exact Test (p = 0.7708), Coefficient φ (0.0568), and Odds Ratio (1.273, 95% CI: 0.4332 -4.343), were conducted using a contingency table. The results showed no significant association between SARS-CoV-2 infection and the clinical outcome of death. Conclusion: The findings indicate that patients with SARS-CoV-2 infection benefit from decompressive craniectomy for the treatment of malignant stroke to the same extent as patients without viral infection. This study provides valuable insights into the efficacy in patients with malignant stroke and SARS-CoV-2 infection. Further research is warranted to confirm these findings and explore additional factors that may influence patient outcomes in this context.

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Impact of COVID-19 on Neurosurgery in Brazil's Health System: The Reality of a Developing Country Affected by the Pandemic

Cited by 11 publications

References 34 publications

Limitations of using the DATASUS database as a primary source of data in surgical research: a scoping review

Limitations of using the DATASUS database as a primary source of data in surgical research: a scoping review

Pediatric Hydrocephalus in Brazil Public Health System: the Reality of a Developing Country in the Past 13 Years

Assessment of Decompressive Craniectomy in Patients with Malignant Cerebral Infarction and Co-Occurring SARS-CoV-2 Infection

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