title: Trends in Procedure Type, Morbidity and In-Hospital Outcomes of Patients with Peripheral Artery Disease: Data from the Brazilian Public Health System.
abstract: BACKGROUND
  The prevalence of peripheral artery disease (PAD) is rising worldwide, with considerable impact on health care systems.
  
  
  METHODS
  We aimed to characterize the trends in therapeutic procedures and outcomes of PAD in the Brazilian Public Health System Database (DataSUS) between 2008 and 2012.
  
  
  RESULTS
  The number of hospitalizations remained stable from 2008 to 2012, although there was a significant change in the proportions of treatment modalities. In 2008, surgical revascularization (SR) = 8,001 (29%), endovascular revascularization (EVR) = 3,207 (11%), and clinical treatment (CT) = 16,887 (60%); and in 2012, SR = 7,882 (28%), EVR = 5,044 (18%), and CT = 15,225 (54%); P < 0.001, a 57% increase in EVR, and 9.8% decrease in CT. Total costs raised 37% (US $18.2-24.9 million, P < 0.001), with a marked 92% increase in EVR costs (US $5.1-9.8 million), compared with SR (11%) and CT (30%). Mortality decreased for EVR (2.0-1.4%, P = 0.048), increased for CT (5.1-5.8%, P = 0.002) and remained stable for SR. A nonsignificant increase was observed in total mortality (5.7-5.9%, P = NS).
  
  
  CONCLUSIONS
  Our analysis depicts the high-PAD mortality in Brazil emphasizing the need of preventing and controlling cardiovascular risk factors. The impact of PAD in costs increased, mainly because of costs related to EVR.
authors.affiliation: Division of Cardiology and Cardiovascular Surgery, Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil; Serviço de Hemodinâmica, Hospital das Clínicas, Belo Horizonte, MG, Brazil; Internal Medicine Department, Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil. Electronic address: ramosnas@gmail.com.
authors.forename: Bruno R
authors.initials: BR
authors.lastname: Nascimento
authors.affiliation: Division of Cardiology and Cardiovascular Surgery, Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.
authors.forename: Luisa C C
authors.initials: LC
authors.lastname: Brant
authors.affiliation: Division of Cardiology and Cardiovascular Surgery, Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.
authors.forename: Maria Letícia L
authors.initials: ML
authors.lastname: Lana
authors.affiliation: Internal Medicine Department, Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.
authors.forename: Eduardo L V
authors.initials: EL
authors.lastname: Lopes
authors.affiliation: Division of Cardiology and Cardiovascular Surgery, Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil; Internal Medicine Department, Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.
authors.forename: Antonio L P
authors.initials: AL
authors.lastname: Ribeiro
mesh_terms: D000368:Aged; D001938:Brazil; D016208:Databases, Factual; D057510:Endovascular Procedures / Q000009:adverse effects / Q000191:economics / Q000401:mortality / Q000639:trends*; D005260:Female; D017721:Hospital Costs / Q000639:trends; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D007902:Length of Stay / Q000639:trends; D008297:Male; D008875:Middle Aged; D009313:National Health Programs / Q000191:economics / Q000639:trends*; D010043:Outcome and Process Assessment, Health Care / Q000191:economics / Q000639:trends*; D058729:Peripheral Arterial Disease / Q000175:diagnosis / Q000191:economics / Q000401:mortality / Q000628:therapy*; D010818:Practice Patterns, Physicians' / Q000191:economics / Q000639:trends*; D011634:Public Health / Q000191:economics / Q000639:trends*; D017150:Public Sector / Q000191:economics / Q000639:trends*; D013997:Time Factors; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000009:adverse effects / Q000191:economics / Q000401:mortality / Q000639:trends*