Hospitalizations of children with sickle cell disease in the Brazilian Unified Health System in the state of Minas Gerais

• Published in: Jornal de pediatria 2017-05, Vol.93 (3), p.287-293
• Main Authors: Fernandes, Ana Paula P.C., Avendanha, Fernanda A., Viana, Marcos B.
• Format: Article
• Language: English
• Subjects: Anemia, Sickle Cell - diagnosis; Anemia, Sickle Cell - epidemiology; Brasil; Brazil; Brazil - epidemiology; Child, Preschool; Cross-Sectional Studies; Doença falciforme; Epidemiologia; Epidemiology; Female; Health system; Hospital Admitting Department; Hospitalization - statistics & numerical data; Humans; Infant, Newborn; Male; National Health Programs; Neonatal Screening; Newborn screening; PEDIATRICS; Serviço Hospitalar de Admissão de Pacientes; Sickle cell disease; Sistema Único de Saúde; Triagem neonatal
• ISSN: 0021-7557; 1678-4782; 1678-4782
• DOI: 10.1016/j.jped.2016.07.005

To identify and characterize hospital admissions and readmissions in the Brazilian Unified Public Health System (Sistema Único de Saúde [SUS]) in children with sickle cell disease diagnosed by the Minas Gerais Newborn Screening Program between 1999 and 2012. Hospital Admission Authorizations with the D57 (International Classification of Diseases-10) code in the fields of primary or secondary diagnosis were retrieved from the SUS Databank (1999–2012). There were 2991 hospitalizations for 969 children. 73.2% of children had hemoglobin SS/Sβ0-thalassemia and 48% were girls. The mean age was 4.3±3.2 years, the mean number of hospitalizations, 3.1±3.3, and the hospital length of stay, 5±3.9 days. Hospital readmissions occurred for 16.7% of children; 10% of admissions were associated with readmission within 30 days after discharge; 33% of readmissions occurred within seven days post-discharge. There were 41 deaths, 95% of which were in-hospital. Secondary diagnoses were not recorded in 96% of admissions, making it impossible to know the reason for admission. In 62% of cases, hospitalizations occurred in the child's county of residence. The total number of hospitalizations of children under 14 with sickle cell disease relative to the total of pediatric hospitalizations increased from 0.12% in 1999 to 0.37% in 2012. A high demand for hospital care in children with sickle cell disease was evident. The number of hospitalizations increased from 1999 to 2012, suggesting that the disease has become more “visible.” Knowledge of the characteristics of these admissions can help in the planning of care for these children in the SUS. Identificar e caracterizar as internações e reinternações hospitalares no Sistema Único de Saúde (SUS) de crianças com doença falciforme, diagnosticadas pelo Programa de Triagem Neonatal de Minas Gerais entre 1999 e 2012. Extraíram-se do banco de dados do SUS as Autorizações de Internação Hospitalar com o código D57 (Classificação Internacional de Doenças10) nos campos de diagnóstico primário ou secundário (1999-2012). Identificaram-se 969 crianças, totalizando 2.991 internações. 73,2% das crianças tinham hemoglobina SS/Sβ0- talassemia e 48% eram meninas. A média de idade foi de 4,3±3,2 anos, a do número de internações, 3,1±3,3 e a do tempo de permanência, 5±3,9 dias. As readmissões hospitalares ocorreram em 16,7% das crianças; 10% das internações se associaram à readmissão em até 30 dias pós-alta; 33% das readmissões ocorreram em até 7 dias pó