Características Epidemiológicas da ASMA no Brasil

Asthma is a disease that affects the lungs, having a chronic and inflammatory character that appears in childhood, in the classic clinical picture. The disease is marked by periods of exacerbations and remissions. Asthma affects 1 to 18% of the population in many countries. Despite being a prevalent disease in some countries, mortality rates are low. The objective of the present study is to carry out an analysis of the epidemiological characteristics of ASMA in Brazil. This is an epidemiological, temporal, descriptive and quantitative study on the epidemiological profile of hospitalizations for asthma in Brazil in the period between January 2013 and December 2023, carried out using data from the SUS health information department as a basis. (Health Unic System). The variables used were: hospital admissions, mortality rate, deaths, age group, color/race, sex, type of care and health macro-region. Data were crossed between the SUS health information system and research information gathered from reading articles linked to Scielo and Pubmed. The descriptors used were: bronchial asthma, occupational asthma and exercise-induced asthma. It is concluded that the highest number of hospitalizations for Asthma was in 2013, the region with the highest number of hospitalizations was the Northeast, with females being the most affected.El asma es una enfermedad que afecta a los pulmones, teniendo un carácter crónico e inflamatorio que aparece en la infancia, en el cuadro clínico clásico. La enfermedad se caracteriza por períodos de exacerbaciones y remisiones. El asma afecta entre el 1 y el 18% de la población en muchos países. A pesar de ser una enfermedad prevalente en algunos países, las tasas de mortalidad son bajas. El objetivo del presente estudio es realizar un análisis de las características epidemiológicas de la ZAEA en Brasil. Trata-se de um estudo epidemiológico, temporal, com caráter descritivo e quantitativo sobre o perfil epidemiológico de hospitalizações por asma no Brasil no período entre Janeiro de 2013 e Dezembro de 2023, realizado tendo como embasamento os dados do departamento de informação de saúde do SUS (Sistema único de Salud). Las variables utilizadas fueron: ingresos hospitalarios, tasa de mortalidad, defunciones, grupo etario, color/raza, sexo, tipo de atención y macrorregión de salud. Los datos fueron cruzados entre el sistema de información en salud del SUS y la información de investigación recopilada a partir de la lectura de artículos vinculados a Scielo y Pubmed. Los descriptores utilizados fueron: asma bronquial, asma ocupacional y asma inducida por ejercicio. Se concluye que el mayor número de internaciones por Asma fue en 2013, la región con mayor número de internaciones fue el Nordeste, siendo el sexo femenino el más afectado.Asma é uma doença que acomete os pulmões, tendo caráter crônico e inflamatório de aparecimento ainda na infância, no quadro clínico clássico. A doença é marcada por períodos de exacerbações e remissões. A asma é realidade em 1 a 18% da população em inúmeros países. Apesar de ser uma doença prevalente em alguns países, suas taxas de mortalidade são pequenas. O objetivo do presente estudo é realizar  a uma análise sobre as características epidemiológicas da ASMA no Brasil. Trata-se de   um   estudo epidemiológico, temporal, com caráter descritivo e quantitativo sobre o perfil epidemiológico de hospitalizações por asma no Brasil no período entre Janeiro de 2013 e Dezembro de 2023, realizado tendo  como  embasamento  os  dados  do  departamento  de informação  de  saúde  do  SUS  (Sistema  Único  de  Saúde).  As variáveis utilizadas foram: internações hospitalares, taxa de mortalidade, óbitos, faixa etária, cor/raça, sexo, caráter de atendimento e macrorregião de saúde. Foram cruzados dados entre o Sistema de informação da saúde do SUS com informações de pesquisa levantada a partir da leitura de artigos vinculados à Scielo e Pubmed. Os descritores utilizados foram: asma brônquica, asma ocipacional e asma induzida por exercício. Conclui- se que o maior número de hospitalizações por Asma foi em 2013, a região com maior número de internamentos foi a Nordeste, sendo o sexo feminino o mais acometido. &nbsp

Geoeconomic variations in epidemiology, ventilation management, and outcomes in invasively ventilated intensive care unit patients without acute respiratory distress syndrome: a pooled analysis of four observational studies

Background: Geoeconomic variations in epidemiology, the practice of ventilation, and outcome in invasively ventilated intensive care unit (ICU) patients without acute respiratory distress syndrome (ARDS) remain unexplored. In this analysis we aim to address these gaps using individual patient data of four large observational studies. Methods: In this pooled analysis we harmonised individual patient data from the ERICC, LUNG SAFE, PRoVENT, and PRoVENT-iMiC prospective observational studies, which were conducted from June, 2011, to December, 2018, in 534 ICUs in 54 countries. We used the 2016 World Bank classification to define two geoeconomic regions: middle-income countries (MICs) and high-income countries (HICs). ARDS was defined according to the Berlin criteria. Descriptive statistics were used to compare patients in MICs versus HICs. The primary outcome was the use of low tidal volume ventilation (LTVV) for the first 3 days of mechanical ventilation. Secondary outcomes were key ventilation parameters (tidal volume size, positive end-expiratory pressure, fraction of inspired oxygen, peak pressure, plateau pressure, driving pressure, and respiratory rate), patient characteristics, the risk for and actual development of acute respiratory distress syndrome after the first day of ventilation, duration of ventilation, ICU length of stay, and ICU mortality. Findings: Of the 7608 patients included in the original studies, this analysis included 3852 patients without ARDS, of whom 2345 were from MICs and 1507 were from HICs. Patients in MICs were younger, shorter and with a slightly lower body-mass index, more often had diabetes and active cancer, but less often chronic obstructive pulmonary disease and heart failure than patients from HICs. Sequential organ failure assessment scores were similar in MICs and HICs. Use of LTVV in MICs and HICs was comparable (42·4% vs 44·2%; absolute difference -1·69 [-9·58 to 6·11] p=0·67; data available in 3174 [82%] of 3852 patients). The median applied positive end expiratory pressure was lower in MICs than in HICs (5 [IQR 5-8] vs 6 [5-8] cm H2O; p=0·0011). ICU mortality was higher in MICs than in HICs (30·5% vs 19·9%; p=0·0004; adjusted effect 16·41% [95% CI 9·52-23·52]; p<0·0001) and was inversely associated with gross domestic product (adjusted odds ratio for a US$10 000 increase per capita 0·80 [95% CI 0·75-0·86]; p<0·0001). Interpretation: Despite similar disease severity and ventilation management, ICU mortality in patients without ARDS is higher in MICs than in HICs, with a strong association with country-level economic status