IJCS | Volume 32, Nº6, November / December 2019

DOI: 10.5935/2359-4802.20190032 596 ORIGINAL ARTICLE International Journal of Cardiovascular Sciences. 2019;32(6):596-604 Mailing Address: Carolina Zenilda Nicolao Rua Dona Augusta, 333, apto.: 702/ bloco: 6. Postal Code: 90850-130, Menino Deus, Porto Alegre, RS - Brazil. E-mail: carolinazenilda@gmail.com Heart Failure: An Overview of Morbidity and Mortality in Rio Grande do Sul Carolina Zenilda Nicolao, 1 J uliana Bischoff Ferreira, 1 A driana Aparecida Paz, 1 G raciele Fernanda da Costa Linch, 1 Marciane Rover, 2 E miliane Nogueira de Souza 1, 2 Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), 1 Porto Alegre, RS - Brazil Instituto de Cardiologia - Fundação Universitária de Cardiologia do RS, 2 Porto Alegre, RS - Brazil Manuscript received June 06, 2018; revised manuscript August 05, 2018; accepted September 24, 2018. Abstract Background: Heart failure (HF) is the final pathway of most cardiac diseases. Although the prevalence of HF has increased, due to the ageing of the population, more comprehensive data have shown a reduction in the percentage of HF hospital admissions over the last years. Objective: Assess the morbidity and mortality of HF patients in Brazil, Rio Grande do Sul and Porto Alegre. Method: The study is a retrospective analysis of data from the Brazilian Unified Health System's ( Sistema Único de Saúde [SUS] ) Department of Informatics (DataSUS). We evaluated the incidence of HF hospital admissions, the average length of stay, hospital costs and sex ratio, during a ten-year period (2007 to 2016). Due to availability of the system, mortality rate and age range, the total duration of the study was nine years. Results: Within this period, the percentage of hospitalizations for HF decreased. On the other hand, the length of stay increased in all regions studied. Mortality rates were in decline in all regions. Hospital costs showed an increase of 110.8%. HF was more prevalent in patients between the seventh and eighth decades of life, with men being more affected than women, except in Rio Grande do Sul. Conclusion: We conclude that, in spite of the high costs of HF to healthcare providers, hospitalizations andmortality rates have shown a significant decline over the last years, which results from the advances in the treatment of this disease, through initiatives to improve patient education, engagement and planning in health care and self-care. (Int J Cardiovasc Sci. 2019;32(6):596-604) Keywords: Heart Failure/physiopathology; Aging; Hospitalization; Plans Health; SUS- Unified Health System; Mortality; Morbidity. Introduction Heart failure is a burden for public health worldwide due to highmortality, readmission rates and considerable costs to healthcare services. 1 About 30% of patients need rehospitalization within 60 to 90 days. 2 HF is increasing in prevalence around the world as a result of population ageing. The projections indicate that by 2030, 46% of the population will be affected by HF. 3 In relation to the expenses, HF admissions accounted for 2.3% of the amount spent on healthcare services in Brazil in 2017. 4 Although HF prevalence has increased, analysis of more comprehensive data on the situation of HF hospitalizations in Brazil, using data from DATASUS, showed a decrease in mortality rates in Brazil, especially in the South and Southeast regions. 5 This phenomenon seems to reflect an evolution in the treatment of the disease, including low-cost initiatives to improve treatment recommendations, patient education, engagement and post-discharge planning. 2 The impact of HF is expected to increase substantially, as a result of increased survival of CAD patients, in combination with population ageing. 6,7 This raises the need for registers to project, conduct and better understand this population of heterogeneous patients. The BREATHE study presented data related to the South and Southeast regions of Brazil. The study analyzed the data from five centers in the South region, where 172