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Peer-reviewedCC BYHematology, Transfusion and Cell Therapy

MORTALITY AND HOSPITALIZATION IN AUTOIMMUNE HEMOLYTIC ANEMIA: A 14-YEAR POPULATION-BASED STUDY IN BRAZIL, 2010-2023

  • Renato Watanabe DE OLIVEIRA1
  • Ligia Taveira Engler Raiz COELHO1
  • Gabriela Ana KANEVSKY2
  • Caroline Tianeze DE CASTRO3
  • Julio Cesar de Oliveira BARBOUR3
  • Renato Sampaio TAVARES4
4 affiliations
  1. 1Johnson & Johnson, São Paulo, SP, Brazil
  2. 2Johnson & Johnson, Argentina
  3. 3Precision Data, São Paulo, SP, Brazil
  4. 4Faculdade de Medicina, Universidade Federal de Goiás (UFG), Goiânia, GO, Brazil
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Abstract

Introduction: Autoimmune hemolytic anemia (AIHA) is a rare life-threatening disorder characterized by antibody-mediated red blood cell destruction. Population-based epidemiological data remain scarce globally, with no comprehensive studies from Latin America, limiting understanding of the disease burden, healthcare impact, and regional disparities. Objectives: To estimate the cumulative and annual mortality and hospitalization rates attributed to AIHA in Brazil from 2010-2023, and to describe the demographic, clinical, and regional patterns of the disease. Materials and Methods: This retrospective ecological study used Brazilian national mortality (SIM) and hospitalization (SIH) databases. We included all deaths and hospitalizations (age ≥20-years) with ICD-10 code D59.1 as primary or secondary cause from 2010‒2023. Standardized rates per 100,000 inhabitants used the 2016 mid-period population for cumulative rates and the population of each year for annual rates. The annual percent change (APC) was calculated using linear regression to assess temporal trends. Years of life lost (YLL) and years of potential life lost (YPLL) were estimated using the WHO Global Health Estimates standard life table. Results: Over 14 years, 737 deaths related to AIHA were recorded, resulting in a cumulative mortality rate of 0.52 per 100,000 individuals. The annual mortality rates were stable over the years varying from 0.03 per 100,000 in 2010 to 0.04 per 100,000 in 2023, with an APC of +1.58% (95% CI: -0.21 to 3.40; p=0.084). Mortality rates were higher in females compared to males, at 0.63 versus 0.40 per 100,000, respectively. Mortality increased with age, from 0.35 per 100,000 in the 20‒29 age group to 3.22 per 100,000 in those aged ≥80 years. Roraima (2.5), Acre (1.2) and Tocantins (1.0) presented the highest cumulative mortality rates per 100,000 inhabitants. AIHA-related deaths resulted in an estimated 26,659 YLL over the study period, with women accounting for a disproportionate share of the total burden (16,260 YLL) compared with men (10,400 YLL). YPLL totaled 14,526 years, indicating a substantial impact of premature mortality. A total of 3,215 patients accounted for 6,404 hospitalizations, with a cumulative rate of 2.27 per 100,000. Annual hospitalization rates were also stable over the years, varying between 0.22 per 100,000 in 2010 and 0.19 per 100,000 in 2023, with an APC of -0.77% (95% CI: -2.12 to 0.59; p=0.246). Hospitalization rates increased with age, from 4.57 per 100,000 in the 20-29 age group to 7.25 per 100,000 in those aged 80 and above. Roraima (19.7), Rondonia (12.7) and Distrito Federal (11.2) had the highest cumulative hospitalization rate per 100,000. Among all hospitalizations, 80.82% were emergency admissions, 33.5% included blood transfusions, and 9.6% included splenectomy. Conclusion: despite stable mortality and hospitalization rates over the last 14-years, AIHA is a disease with significant morbidity and mortality, associated with premature death, affecting women and older adults more frequently. The high reliance on emergency care and transfusions, together with regional disparities, suggests possible gaps in the standardized management of these patients. The results reinforce the need for improved therapeutic strategies and equitable access to specialized hematological care.

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Cite

BibTeXRIS
BibTeX
@article{oliveira2026mortality,
  title = {{MORTALITY AND HOSPITALIZATION IN AUTOIMMUNE HEMOLYTIC ANEMIA: A 14-YEAR POPULATION-BASED STUDY IN BRAZIL, 2010-2023}},
  author = {Renato Watanabe DE OLIVEIRA and Ligia Taveira Engler Raiz COELHO and Gabriela Ana KANEVSKY and Caroline Tianeze DE CASTRO and Julio Cesar de Oliveira BARBOUR and Renato Sampaio TAVARES},
  journal = {Hematology, Transfusion and Cell Therapy},
  year = {2026},
  month = oct,
  doi = {10.1016/j.htct.2026.106678},
  url = {https://doi.org/10.1016/j.htct.2026.106678},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - MORTALITY AND HOSPITALIZATION IN AUTOIMMUNE HEMOLYTIC ANEMIA: A 14-YEAR POPULATION-BASED STUDY IN BRAZIL, 2010-2023
AU  - Renato Watanabe DE OLIVEIRA
AU  - Ligia Taveira Engler Raiz COELHO
AU  - Gabriela Ana KANEVSKY
AU  - Caroline Tianeze DE CASTRO
AU  - Julio Cesar de Oliveira BARBOUR
AU  - Renato Sampaio TAVARES
PY  - 2026
DA  - 2026/10/23
JO  - Hematology, Transfusion and Cell Therapy
DO  - 10.1016/j.htct.2026.106678
UR  - https://doi.org/10.1016/j.htct.2026.106678
AB  - Introduction: Autoimmune hemolytic anemia (AIHA) is a rare life-threatening disorder characterized by antibody-mediated red blood cell destruction. Population-based epidemiological data remain scarce globally, with no comprehensive studies from Latin America, limiting understanding of the disease burden, healthcare impact, and regional disparities. Objectives: To estimate the cumulative and annual mortality and hospitalization rates attributed to AIHA in Brazil from 2010-2023, and to describe the demographic, clinical, and regional patterns of the disease. Materials and Methods: This retrospective ecological study used Brazilian national mortality (SIM) and hospitalization (SIH) databases. We included all deaths and hospitalizations (age ≥20-years) with ICD-10 code D59.1 as primary or secondary cause from 2010‒2023. Standardized rates per 100,000 inhabitants used the 2016 mid-period population for cumulative rates and the population of each year for annual rates. The annual percent change (APC) was calculated using linear regression to assess temporal trends. Years of life lost (YLL) and years of potential life lost (YPLL) were estimated using the WHO Global Health Estimates standard life table. Results: Over 14 years, 737 deaths related to AIHA were recorded, resulting in a cumulative mortality rate of 0.52 per 100,000 individuals. The annual mortality rates were stable over the years varying from 0.03 per 100,000 in 2010 to 0.04 per 100,000 in 2023, with an APC of +1.58% (95% CI: -0.21 to 3.40; p=0.084). Mortality rates were higher in females compared to males, at 0.63 versus 0.40 per 100,000, respectively. Mortality increased with age, from 0.35 per 100,000 in the 20‒29 age group to 3.22 per 100,000 in those aged ≥80 years. Roraima (2.5), Acre (1.2) and Tocantins (1.0) presented the highest cumulative mortality rates per 100,000 inhabitants. AIHA-related deaths resulted in an estimated 26,659 YLL over the study period, with women accounting for a disproportionate share of the total burden (16,260 YLL) compared with men (10,400 YLL). YPLL totaled 14,526 years, indicating a substantial impact of premature mortality. A total of 3,215 patients accounted for 6,404 hospitalizations, with a cumulative rate of 2.27 per 100,000. Annual hospitalization rates were also stable over the years, varying between 0.22 per 100,000 in 2010 and 0.19 per 100,000 in 2023, with an APC of -0.77% (95% CI: -2.12 to 0.59; p=0.246). Hospitalization rates increased with age, from 4.57 per 100,000 in the 20-29 age group to 7.25 per 100,000 in those aged 80 and above. Roraima (19.7), Rondonia (12.7) and Distrito Federal (11.2) had the highest cumulative hospitalization rate per 100,000. Among all hospitalizations, 80.82% were emergency admissions, 33.5% included blood transfusions, and 9.6% included splenectomy. Conclusion: despite stable mortality and hospitalization rates over the last 14-years, AIHA is a disease with significant morbidity and mortality, associated with premature death, affecting women and older adults more frequently. The high reliance on emergency care and transfusions, together with regional disparities, suggests possible gaps in the standardized management of these patients. The results reinforce the need for improved therapeutic strategies and equitable access to specialized hematological care.
SN  - 2531-1379
SN  - 2531-1387
ER  -