Analysis of hospital morbidity and mortality and costs associated with surgical anesthesia procedures in Brazil

a literature review based on cross-sectional studies

Abstract

Morbidity and mortality in emergency surgeries pose a challenge for anesthesiology and public health in Brazil, particularly in cases of vascular diseases, which often require high-cost interventions with adverse outcomes. This study aimed to assess the landscape of hospital morbidity and mortality and the economic impact of anesthetic-surgical procedures in the Unified Health System (SUS) between 2019 and 2025, correlating surgical volume, mortality rates, and hospitalization costs with regional distribution. A systematic review was conducted in PubMed using the search terms “Surgical Procedures, Operative,” “Anesthesia,” “Morbidity,” “Mortality,” “Costs and Cost Analysis,” “Cross-Sectional Studies,” and “Brazil.” Of 14 articles, 7 original cross-sectional studies were selected for reporting morbidity, mortality, and cost outcomes in surgeries in Brazil. The results indicate that more than 69.5 million surgeries were performed between 2008 and 2019, with a projection of over 42 million for 2019–2025. Mortality in emergency surgeries was consistently higher than in elective surgeries, reaching 5.24% in open revascularizations compared to 1.56% in endovascular procedures. The North and Northeast regions have the highest mortality rates and the lowest reimbursement rates. Outpatient thermal ablation stood out for its safety and cost-effectiveness.Therefore, it can be concluded that the transition to less invasive techniques and the correction of regional disparities are essential measures for improving the quality of perioperative care and optimizing the allocation of public resources.