Temporal evolution of hospitalizations for Crohn’s disease and anorectal complications in southern and southeastern Brazil: a population-based study from 2012 to 2024
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Abstract
Introduction: Among the most debilitating complications of Chron’s disease are perianal manifestations, including anorectal abscesses and fistulas throughout the course and are associated with significant morbidity, impaired quality of life, and surgical interventions.
Objective: To describe the epidemiology and temporal trends of hospitalizations for anorectal abscesses, anal fistulas and fissures, and Crohn’s disease in the Unified Health System of the South and Southeast regions of Brazil between 2012 and 2024.
Method: Retrospective ecological time series study using administrative data on public hospital admissions in the South and Southeast regions between 2012 and 2024. Hospitalizations were identified by the codes of the International Classification of Diseases, tenth revision, corresponding to Crohn’s disease, anorectal abscesses, and anal fistulas. The volume of hospitalizations, hospital mortality, length of stay, and costs were analyzed. Temporal trends were evaluated by linear regression and mean annual percentage change.
Results: A total of 211,086 hospitalizations were analyzed. Those due to Crohn’s disease increased by 128.9%, while anorectal abscesses grew by 45.6%. In-hospital mortality was higher in Crohn’s disease, followed by abscesses and fistulas, with a longer average length of hospital stay, and average cost. Abscesses and fistulas showed a strong male predominance. The Southeast region concentrated approximately 75% of hospitalizations.
Conclusion: Hospitalizations for Crohn’s disease and anorectal abscesses have increased substantially in the more developed regions of Brazil, representing an increasing burden on the public health system. The findings reinforce the need for better allocation of resources, early diagnosis, and multidisciplinary management strategies for complex perianal disease
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