Nationwide Epidemiological Analysis of Surgically Treated Upper Limb Vascular Trauma Over 16 Years in Brazil

Abstract

Background: Upper limb vascular trauma (ULVT) is a prevalent injury associated with significant morbidity and mortality. Despite its clinical importance, epidemiological studies on ULVT are scarce, particularly in developing countries where the incidence may be heightened by factors such as traffic accidents and violence. Objective: To analyze the epidemiology of ULVT across Brazil, a developing country, evaluating incidence rates, demographic characteristics, mortality rates, days of hospitalization, and related healthcare costs. Methods: A cross-sectional, retrospective analysis using data from the Brazilian public health system (SUS) over a sixteen-year period (2008-2023). The automated data extraction utilized Python-based tools to gather information on vascular trauma procedures identified by ICD-10 codes. Statistical analyses were performed to assess variations in incidence, mortality, and treatment costs across Brazilian regions. Results: A total of 25,573 cases of ULVT were recorded, representing approximately 0.02% of the studied population. The majority of cases occurred in males (79.8%) with a mean age of 34.71 years, with a peak incidence in the 20-24 age group. The region in Brazil with the highest incidence of ULVT was the North (16.6 cases per 100,000 inhabitants) and the region with the lowest was the Southeast (10.7 cases per 100,000 inhabitants). The average hospital stay was 4.39 days and 92,8% of patients did not need to be admitted to an intensive care unit (ICU). Of the patients admitted to the ICU, the average length of stay was 4.52 days. Overall lethality (deaths per cases of ULVT) was 2.37%, with higher lethality observed in bilateral ULVT cases (3.81%). Conclusions: ULVT is more prevalent in Brazil than in developed countries, even when adjusted for population size. However, mortality rates and hospitalization durations do not appear to differ significantly from those in developed countries.