title: Chagas' cardiomyopathy: the economic burden of an expensive and neglected disease.
abstract: BACKGROUND
  Chagas' cardiomyopathy (CC) is a rising etiology for heart failure (HF) that previously was restricted to some countries of Latin America. The chronic CC cases cause now a profound socio-economic impact. However this issue has not been well studied if compared to other causes of HF. The objective of this study was to assess the cost burden of CC during acute decompensated HF admissions (ADHF), and compare this cost to the other etiologies of HF.
  
  
  RESULTS
  By the end of 2006 we started a five year follow-up of 577 consecutive adult patients admitted at a high complexity cardiology university hospital in the city of Sao Paulo, Brazil. This study shows the data of the first admission of each patient of this follow-up. Patients were divided in two groups: CC (58 patients) and non-chagasic (NC) (519 patients). Mortality was different among groups, 19/58 (32.8%) in CC vs 113/519 (21.8%) in NC (p=0.046). The prevalence of signs of inadequate perfusion was higher in the CC group at admission, but in a multivariated analysis chagasic etiology and presence of diabetes were independent predictors of higher costs per day of hospitalization adjusted by mortality. Median costs per day were US$ 308 (277-542) vs US$ 467 (323-815) for NC and CC respectively (p<0.001).
  
  
  CONCLUSIONS
  Treating ADHF patients with CC etiology was more expensive and mortality was higher in this population at the first admission of this follow-up. This could be explained by the severity of Chagas' cardiomyopathy disease.
authors: Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil. Electronic address: abraoabuhab@uol.com.br.
authors: Abrão
authors: A
authors: Abuhab
authors: Evelinda
authors: E
authors: Trindade
authors: Gabriel Barros
authors: GB
authors: Aulicino
authors: Sandra
authors: S
authors: Fujii
authors: Edimar Alcides
authors: EA
authors: Bocchi
authors: Fernando
authors: F
authors: Bacal
mesh_terms: D000368:Aged; D002598:Chagas Cardiomyopathy / Q000150:complications* / Q000191:economics*; D017281:Cost of Illness; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000191:economics* / Q000469:parasitology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D058069:Neglected Diseases / Q000191:economics*; D010343:Patient Admission
keywords: Chagas' cardiomyopathy; Economic burden; Neglected disease