Mortalidade e custos hospitalares de pacientes pós-acidente vascular cerebral no Sistema Único de Saúde: uma série temporal com análise de fatores associados

Abstract

Introduction: Stroke is one of the leading causes of mortality and disability in Brazil, with significant clinical, social, and economic impact. Objective: To analyze hospital mortality rates and hospitalization costs due to stroke within the Brazilian Unified Health System (SUS), from 2018 to 2023, considering sociodemographic, clinical, and healthcare-related variables. Methods: This was an observational time series study with analysis of associated factors, based on secondary data extracted from the Hospital Information System (SIHSUS). Results: A total of 1,321,282 hospitalizations for stroke (ICD-10: I60–I64) were included, involving patients aged 18 years and older. The findings showed a 22% increase in hospitalizations and a 54.5% increase in total stroke-related costs over the study period, while the hospital mortality rate declined, reaching 15.3% in 2023. Mortality was statistically associated with older age, male sex, Black or Brown race/skin color, residence in rural areas and in the North and Northeast regions, longer hospital stays, intensive care unit (ICU) admission, and stroke type (especially hemorrhagic stroke). Regarding costs, higher average expenditures were observed in hospitalizations that resulted in death, ICU admissions, longer stays, and hemorrhagic stroke diagnoses. Regional differences were also significant, with the highest average costs recorded in the South and Central-West regions. Conclusion: Stroke remains a major challenge for SUS, due to its high mortality and increasing financial burden. The findings highlight inequalities in healthcare delivery and reinforce the need for public policies focused on equitable access, strengthening of care networks, and rational allocation of SUS resources.