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Peer-reviewedCC BYArquivos de gastroenterologia

TRENDS IN HOSPITALIZATIONS, COSTS, AND IN-HOSPITAL MORTALITY IN PRIMARY BILIARY CHOLANGITIS: A DECADE OF REAL-WORLD EVIDENCE FROM BRAZIL’S UNIFIED HEALTH SYSTEM Tendências nas hospitalizações, custos e mortalidade intra-hospitalar por colangite biliar primária: uma década de evidências de mundo real do Sistema Único de Saúde do Brasil

  • Guilherme Grossi Lopes CANÇADO1,2
  • Cláudia Alves COUTO1
  • Luciana Costa FARIA1
  • Bernardo de Faria MORAES1
  • Paulo Lisboa BITTENCOURT3
  • Cristiane Alves Villela-Nogueira4
  • Vivian ROTMAN4
  • Debora Raquel Benedita TERRABUIO5,6
  • Eduardo Luiz Rachid CANÇADO5
  • Maria Lúcia FERRAZ6
6 affiliations
  1. 1Universidade Federal de Minas Gerais, Hospital das Clínicas, Instituto Alfa de Gastroenterologia, Belo Horizonte, MG, Brasil.
  2. 2Hospital da Polícia Militar de Minas Gerais, Departamento de Gastroenterologia e Hepatologia, Belo Horizonte, MG, Brasil.
  3. 3Hospital Português, Salvador, BA, Brasil.
  4. 4Universidade Federal do Rio de Janeiro, Faculdade de Medicina, Hospital Universitário Clementino Fraga Filho, Departamento de Clínica Médica, Rio de Janeiro, RJ, Brasil.
  5. 5Universidade de São Paulo, Departamento de Gastroenterologia, São Paulo, SP, Brasil.
  6. 6Universidade Federal de São Paulo, Disciplina de Gastroenterologia, São Paulo, SP, Brasil.
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Abstract

Background: : Primary biliary cholangitis (PBC) is a rare autoimmune liver disease with limited epidemiological data from Latin America.

Objectives: : To analyzed nationwide trends in PBC-related hospitalizations and in-hospital mortality within Brazil’s Unified Health System (SUS) from 2015 to 2024.

Methods: : National hospital admission data for ICD-10 code K74.3 were analyzed. Hospitalization rates per 100,000 inhabitants, in-hospital mortality, costs, and mean length of stay were estimated. Temporal changes were assessed using interrupted time-series segmented regression, and descriptive analyses were stratified into pre-pandemic, pandemic (COVID-19), and post-pandemic periods.

Results: : Between 2015 and 2024, 2,913 hospitalizations were recorded. The annual hospitalization rate ranged from 0.11 per 100,000 in 2022 to 0.19 per 100,000 in 2020, with a mean of 0.15 per 100,000 over the study period. Mean admission-level in-hospital mortality was 15.4%, ranging from 11.7%-18.5%. Mean length of stay was 7.9 days, with little variation over time. A transient increase in hospitalizations was observed in 2020 (β2 = +0.046, P=0.03), followed by a negative slope change in the post-2020 period (β2 = −0.009, P=0.04), suggesting temporary disruption related to the COVID-19 pandemic. The Southeast had the highest hospitalization burden. Inflation-adjusted expenditures totaled R$ 11.38 million (USD 2,112,227.43), with a mean cost of R$ 3,908 (USD 725.10) per admission.

Conclusion: : PBC-coded hospitalizations in Brazil are infrequent but associated with substantial in-hospital mortality. Strengthening outpatient management and regional equity in hepatology care remains a public health priority.

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Cite

BibTeXRIS
BibTeX
@article{cancado2026trends,
  title = {{TRENDS IN HOSPITALIZATIONS, COSTS, AND IN-HOSPITAL MORTALITY IN PRIMARY BILIARY CHOLANGITIS: A DECADE OF REAL-WORLD EVIDENCE FROM BRAZIL’S UNIFIED HEALTH SYSTEM Tendências nas hospitalizações, custos e mortalidade intra-hospitalar por colangite biliar primária: uma década de evidências de mundo real do Sistema Único de Saúde do Brasil}},
  author = {Guilherme Grossi Lopes CANÇADO and Cláudia Alves COUTO and Luciana Costa FARIA and Bernardo de Faria MORAES and Paulo Lisboa BITTENCOURT and Cristiane Alves Villela-Nogueira and Vivian ROTMAN and Debora Raquel Benedita TERRABUIO and Eduardo Luiz Rachid CANÇADO and Maria Lúcia FERRAZ},
  journal = {Arquivos de gastroenterologia},
  year = {2026},
  month = oct,
  doi = {10.1590/s0004-2803.24612026-070},
  url = {https://europepmc.org/article/PMC/PMC13722406},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - TRENDS IN HOSPITALIZATIONS, COSTS, AND IN-HOSPITAL MORTALITY IN PRIMARY BILIARY CHOLANGITIS: A DECADE OF REAL-WORLD EVIDENCE FROM BRAZIL’S UNIFIED HEALTH SYSTEM Tendências nas hospitalizações, custos e mortalidade intra-hospitalar por colangite biliar primária: uma década de evidências de mundo real do Sistema Único de Saúde do Brasil
AU  - Guilherme Grossi Lopes CANÇADO
AU  - Cláudia Alves COUTO
AU  - Luciana Costa FARIA
AU  - Bernardo de Faria MORAES
AU  - Paulo Lisboa BITTENCOURT
AU  - Cristiane Alves Villela-Nogueira
AU  - Vivian ROTMAN
AU  - Debora Raquel Benedita TERRABUIO
AU  - Eduardo Luiz Rachid CANÇADO
AU  - Maria Lúcia FERRAZ
PY  - 2026
DA  - 2026/10/30
JO  - Arquivos de gastroenterologia
DO  - 10.1590/s0004-2803.24612026-070
UR  - https://europepmc.org/article/PMC/PMC13722406
AB  - Background: : Primary biliary cholangitis (PBC) is a rare autoimmune liver disease with limited epidemiological data from Latin America.  Objectives: : To analyzed nationwide trends in PBC-related hospitalizations and in-hospital mortality within Brazil’s Unified Health System (SUS) from 2015 to 2024.  Methods: : National hospital admission data for ICD-10 code K74.3 were analyzed. Hospitalization rates per 100,000 inhabitants, in-hospital mortality, costs, and mean length of stay were estimated. Temporal changes were assessed using interrupted time-series segmented regression, and descriptive analyses were stratified into pre-pandemic, pandemic (COVID-19), and post-pandemic periods.  Results: : Between 2015 and 2024, 2,913 hospitalizations were recorded. The annual hospitalization rate ranged from 0.11 per 100,000 in 2022 to 0.19 per 100,000 in 2020, with a mean of 0.15 per 100,000 over the study period. Mean admission-level in-hospital mortality was 15.4%, ranging from 11.7%-18.5%. Mean length of stay was 7.9 days, with little variation over time. A transient increase in hospitalizations was observed in 2020 (β2 = +0.046, P=0.03), followed by a negative slope change in the post-2020 period (β2 = −0.009, P=0.04), suggesting temporary disruption related to the COVID-19 pandemic. The Southeast had the highest hospitalization burden. Inflation-adjusted expenditures totaled R$ 11.38 million (USD 2,112,227.43), with a mean cost of R$ 3,908 (USD 725.10) per admission.  Conclusion: : PBC-coded hospitalizations in Brazil are infrequent but associated with substantial in-hospital mortality. Strengthening outpatient management and regional equity in hepatology care remains a public health priority.
SN  - 0004-2803
SN  - 1678-4219
ER  -