Key result
AMI hospitalization in Alagoas is linked to ~34% higher in-hospital mortality than neighboring states.
Why the study?
The study aimed to describe and compare in-hospital mortality, mean length of stay, and hospitalization values for AMI across Alagoas, Pernambuco, and Sergipe, Brazil, between 2021 and 2025.
Observational (n=21,957)
Yes
Significant regional disparities exist in public-sector AMI hospitalizations in Northeastern Brazil, with Alagoas demonstrating a 34% to 40% higher relative risk of in-hospital mortality, longer hospital stays, and higher average hospitalization costs compared to neighboring Pernambuco and Sergipe.
Higher AMI mortality in Alagoas signals potential care gaps; hypothesis-generating for regional disparities and requires prospective confirmation.
Objective: To describe and compare in-hospital mortality, mean length of stay, and hospitalization values recorded in SIH/SUS for acute myocardial infarction (AMI) in the states of Alagoas, Pernambuco, and Sergipe, Brazil, between 2021 and 2025. Methods: Descriptive ecological study using secondary data from the Hospital Information System of the Brazilian Unified Health System (SIH/SUS), obtained through TABNET/DATASUS. The variables analyzed included hospital admissions, in-hospital deaths, in-hospital mortality, mean length of stay, and mean value of the Hospital Admission Authorization (AIH). The association between state and hospital outcome was assessed using Pearson's chi-square test. Pairwise comparisons were performed with Bonferroni correction, and relative risks (RR) with 95% confidence intervals (95% CI) were calculated. Results: A total of 21,957 hospital admissions for AMI and 2,847 in-hospital deaths were recorded. Cumulative in-hospital mortality was 16.22% in Alagoas, 12.11% in Pernambuco, and 11.56% in Sergipe. Alagoas had higher in-hospital mortality than Pernambuco (RR = 1.34; 95% CI 1.24–1.45) and Sergipe (RR = 1.40; 95% CI 1.26–1.56). No statistically significant difference was observed between Pernambuco and Sergipe (RR = 1.05; 95% CI 0.95–1.15; p = 0.342). Alagoas also had the longest mean hospital stay (11.4 days) and the highest mean AIH value (R$ 2,477.88). Conclusion: Differences in hospital indicators related to AMI admissions were observed among the states analyzed, with higher in-hospital mortality in Alagoas. The ecological and aggregated nature of the data does not allow determination of the factors responsible for these differences. Further studies incorporating patients' clinical characteristics and aspects related to the organization of cardiovascular care and access to it are warranted.
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Carvalho et al. (2026) conducted an observational in Acute myocardial infarction (AMI) (n=21,957). Hospitalization in Alagoas vs. Hospitalization in Pernambuco was evaluated on Cumulative in-hospital mortality (RR 1.34, 95% CI 1.24-1.45, p=<0.0001). Hospitalization for AMI in Alagoas was associated with higher in-hospital mortality (16.22%) compared to Pernambuco (12.11%; RR 1.34, p<0.0001) and Sergipe (11.56%; RR 1.40, p<0.0001).
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