Unveiling the gap of heart failure: a DATASUS study

Heart failure (HF) decompensation is the main cause of hospitalizations in developed countries. In Brazil, it represents the third general cause. Aiming to analyze the treatment journey for different types of HF in Brazil, the present study seeks to define a flowchart and clinical rationale that covers the procedures (and their respective frequency) in patients with HF in the Brazilian Unified Health System (SUS) included in DATASUS database. By doing so, the final objectives were: a) To identify potential patients with HF to present an estimate of the underreporting of the disease in the country; b) To describe the estimated mortality of potential patients with HF in Brazil. We used data from DATASUS, which encompasses information from the Brazilian Unified Health System (SUS). Specifically, we utilized the SUS-SIM (Mortality Information System) and SUS-SIA (Ambulatory Information System). Results: According to the data, we had a potential missing of patients with HF of 54,000 patients per year at diagnosis and 200,000 deaths that could lead to HF (both sexes). Considering the sensitivity analysis when there was a 20% underestimation in the number of potential HF cases, the underestimation rate of cases diagnosed with HF was 12%. We also found that when there was an underestimation of 40% in potential cases of death due to HF, there was an average underestimation of 41% in cases of death diagnosed as HF. the results highlight the importance of accurate diagnosis and a comprehensive approach to identifying potential cases of HF to improve the recording and management of this condition. Underestimation of these cases may have significant implications for public health and clinical management of HF emphasizing the need for strategies to increase early detection and adequate case recording. The next steps would be how much this underestimation impacts the public health in Brazil, particularly in terms of financial resources.