[Ischemic heart disease lethalities in the state of Rio de Janeiro between 1999 and 2003].
OBJECTIVE
To estimate the lethality rate of acute and chronic ischemic heart disease (IHD) procedures, coronary artery bypass graft (CABG) procedures and percutaneous transluminal coronary angioplasty (PTCA) procedures in the hospitals that are registered as service providers for the Hospital Information System/Single Healthcare System (SIH/SUS) plan in the state of Rio de Janeiro (RJ) between 1999 and 2003.


METHODS
The procedures considered as CABGs and PTCAs were provided by Datasus (SUS databank). The rates were standardized in accordance with gender, age, and disease severity. The common factors among these procedures are that they are highly complex cardiovascular procedures performed in RJ in the year 2000. The IHD groups are: angina, acute myocardial infarction, other acute IHDs and chronic IHDs.


RESULTS
Lethality rates for angina, acute myocardial infarction (AMI), other acute and chronic IHDs were 2.8%, 16.2%, 2.9% and 3.9%, respectively, in the RJ. The lethality rates for CABG and PTCA, adjusted by age, sex and diagnostic groups, were elevated ranging from 1.9% to 12.8% for CABG procedures and as high as 3.2% for PTCA. When medical therapy was performed the rates were 2.3% for CABG and 11.1% for PTCA.


CONCLUSIONS
There has been a progressive increase in the number of CABG and PTCA procedures to treat IHDs in the RJ. Lethality rates were above the desirable level, mainly for chronic IHD hospital admissions (5.4% and 1.7%, respectively). Optimized medical therapy appears to be a worthwhile therapeutic option, reserving CABG and PTCA procedures for the cases with the worst prognoses. Lethality rates for AMI with medical therapy was comparable to current rates when thrombolytics were not used (16.7%).
Oliveira
Gláucia Maria Moraes de
GM
Faculdade de Medicina, Universidade Federal do Rio de Janeiro, Escola Nacional de Saúde Pública, Rio de Janeiro, RJ. glaucia@mls.com.br
Klein
Carlos Henrique
CH
Souza e Silva
Nelson Albuquerque de
NA
Godoy
Paulo Henrique
PH
Fonseca
Tânia Maria Peixoto
TM
D000208:Acute Disease; D000787:Angina Pectoris / Q000401:mortality; D015906:Angioplasty, Balloon, Coronary / Q000401:mortality*; D001938:Brazil / Q000453:epidemiology; D002908:Chronic Disease; D017023:Coronary Angiography / Q000401:mortality; D001026:Coronary Artery Bypass / Q000401:mortality*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000401:mortality; D017202:Myocardial Ischemia / Q000401:mortality*