Bayesian Modeling and Estimation of Spatial Risk for Hospitalization and Mortality from Ischemic Heart Disease in Paraná, Brazil.

Autor:	de Carvalho Dutra A; Post-Graduation Program in Health Sciences, State University of Maringa, Parana, Brazil., Silva LL; Department of Emergency Medicine, Duke University School of Medicine, Durham, North Carolina, United States of America., Dos Santos AGA; Centro Universitário Integrado, Campo Mourao, Parana, Brazil., do Lago Franco R; Post-Graduation Program in Health Sciences, State University of Maringa, Parana, Brazil., Forato GAC; Post-Graduation Program in Health Sciences, State University of Maringa, Parana, Brazil., Bergamini M; Post-Graduation Program in Health Sciences, State University of Maringa, Parana, Brazil., Borba IM; Department of Medicine, State University of Maringa, Maringa, Parana, Brazil., de Campos EV; Regional University Hospital of Maringa, State University of Maringa, Parana, Brazil., Staton CA; Department of Emergency Medicine, Duke University School of Medicine, Durham, North Carolina, United States of America.; Duke Global Health Institute, Durham, North Carolina, United States of America., Marquezoni DP; Hospital das Clinicas of the Medical School of Botucatu, UNESP, Sao Paulo, Brazil., Nihei OK; Education, Letters and Health Center, State University of the West of Paraná, Foz do Iguaçu, Paraná, Brazil., Vissoci JRN; Duke Global Health Institute, Durham, North Carolina, United States of America., de Andrade L; Post-Graduation Program in Health Sciences, State University of Maringa, Parana, Brazil.; Department of Medicine, State University of Maringa, Maringa, Parana, Brazil.
Jazyk:	angličtina
Zdroj:	Global heart [Glob Heart] 2024 Aug 05; Vol. 19 (1), pp. 63. Date of Electronic Publication: 2024 Aug 05 (Print Publication: 2024).
DOI:	10.5334/gh.1347
Abstrakt:	Objective: Despite significant advancements in understanding risk factors and treatment strategies, ischemic heart disease (IHD) remains the leading cause of mortality worldwide, particularly within specific regions in Brazil, where the disease is a burden. Therefore, the aim of this study was to estimate the risk of hospitalization and mortality from IHD in the state of Paraná (Brazil), using spatial analysis to identify areas with higher risk based on socioeconomic, demographic and health variables. Methods: This is an ecological study based on secondary and retrospective IHD hospitalization and mortality data obtained from the Brazilian Hospitalization and Mortality Information Systems during the 2010-2021 period. Data were analyzed for 399 municipalities and 22 health regions in the state of Paraná. To assess the spatial patterns of the disease and identify relative risk (RR) areas, we constructed a risk model by Bayesian inference using the R-INLA and SpatialEpi packages in R software. Results: A total of 333,229 hospitalizations and 73,221 deaths occurred in the analyzed period, and elevated RR of hospitalization (RR = 27.412, CI 21.801; 34.466) and mortality (RR = 15.673, CI 2.148; 114.319) from IHD occurred in small-sized municipalities. In addition, medium-sized municipalities also presented elevated RR of hospitalization (RR = 6.533, CI 1.748; 2.006) and mortality (RR = 6.092, CI 1.451; 2.163) from IHD. Hospitalization and mortality rates were higher in white men aged 40-59 years. A negative association was found between Municipal Performance Index (IPDM) and IHD hospitalization and mortality. Conclusion: Areas with increased risk of hospitalization and mortality from IHD were found in small and medium-sized municipalities in the state of Paraná, Brazil. These results suggest a deficit in health care attention for IHD cases in these areas, potentially due to a low distribution of health care resources. Competing Interests: The authors have no competing interests to declare. (Copyright: © 2024 The Author(s).)
Databáze:	MEDLINE
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