Disparidades entre regiões de saúde quanto ao uso das terapias de reperfusão e mortalidade do infarto do miocárdio no SUS de Sergipe: registro victim

Abstract

Background: The high complexity services concentration in Aracaju health region may generate therapy inequalities in patients with STEMI who initiate symptoms in other Sergipe health regions. Objective: To compare the access reperfusion therapies among patients with STEMI who initiated the symptoms in each of the seven Sergipe health regions, as well as to evaluate the 30-day mortality rate between groups. Methods: This is a subanalysis of the VICTIM study, in which 844 patients with STEMI were evaluated between 2014 and 2018, in the only hospital performing primary angioplathyin Sergipe SUS. The patients were divided into seven groups, regarding the place of symptoms onset, according to the health regions division: a) Aracaju; b) Itabaiana; c) Estância; d) Lagarto; e) Nossa Senhora do Socorro; f) Nossa Senhora da Glória; g) Propriá. For groups comparisons, significant difference was considered when p <0.05 Results: The mean primary angioplasty rate was 45.8%. Aracaju presented the highest (51.9%) and Gloria the lowest (17.1%) (p = 0.03). The thrombolytic mean rate was 2,6% without differences between regions. The Mean total arrival time at the hospital with angioplasty was 21 hours and 55 minutes, Socorro presented a longer interval (26hours and 24 minutes), Estância the lowest (16hours 22 minutes) (p = 0.001). The total 30-days mortality was 12.8%, when adjusted for age and sex, statistical significance was not found. Conclusion: It was registered not only the disparity in access to reperfusion therapies but also its subuse, especially about the fibrinolytic therapy. The overall 30-day mortality in patients who started the symptoms in Sergipe still high and their variation between regions is probably due to differences in the average age of groups.