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Título

Trends of the mortality rate of Traumatic Brain Injury in Brazil between 2011-2021

Resumo

Introduction: Traumatic Brain Injury (TBI) is a disorder caused by a sudden and external assault responsible for either anatomical lesions or functional impairment of the brain. TBI is a common cause of disability and death, with a significant impact on Brazil's public health system and its policies. Objective: To analyze the mortality rate due to TBI among the Brazilian population, from 2011 to 2021, through data collected from the Informatics Department of the Unified Health System (DataSUS). Methods: A retrospective, longitudinal, observational and analytic study. Intracranial trauma deaths (ICD-10 S06) data were obtained from the Mortality Information System (SIM) and the population data from the Brazilian Institute of Geography and Statistics (IBGE). The number of deaths from 2011 to 2021 was stratified by age group, and the mortality rate (MR) was calculated per 100,000 inhabitants. Age-specific MR trends were determined by joinpoint regression. The dependent variable was the natural logarithmic transformation of the MR, and the year of analysis was the regression variable. The Average Annual Percent Changes (AAPC) were obtained with a confidence interval of 95%. Results: The AAPC in mortality rate due to TBI registered in Brazil was -0.7% (95%CI: -1.2,-01; P<0.1), indicating a statistically significant reduction in the number of deaths due to intracranial trauma from 2011 to 2021. Analysis of age-specific trends in MR explains the apparent controversial results observed in Brazil. From 2014 to 2021, the age group 15-19 years revealed a statistically significant decline in MR, with an AAPC of -8.9% (95%CI: -11.3,-6.4; P<0.1). A different trend was observed in the age group 70-79 years, in which a statistically insignificant AAPC was recorded in both periods of analysis: an increase of 1.6% (95%CI: -1.0,4.3; P<0.1) from 2011 to 2016, and a reduction of -2.1% (95%CI: -4.4,0.2; P<0.1) from 2016 onwards. The age group 70-79 years showed stable rates of intracranial trauma mortality over the ten years analyzed. The age group of individuals over 80 years old indicated a statistically significant increase in the MR due to TBI only from 2011 to 2016, with an AAPC of 4.2% (95%CI: 1.0,7.4; P<0.1). Conclusion: Analysis of data systems such as DataSUS is relevant in establishing policies to prevent TBI in age groups with higher incidence. Identifying its symptoms, as well as correlating its signs with imaging exams, is essential for adequate treatment decisions.