ABSTRACT Objective To analyze the survival of patients with Chagas disease, beneficiaries of social security and social assistance, in Brazil, from 1942 to 2016. Methods This is a retrospective cohort study with data from the Brazilian Ministry of Social Security. The event of interest was death, and the survival functions were estimated by the Kaplan-Meier and Cox regression methods. Results In the period “onset of the disease until death”, women (HR=0.54; 95%CI 0.43–0.53) and receiving social security benefits (HR=0.13; 95%CI 0.11–0.23) were associated with longer survival. Lower survival was associated with the cardiac form of the disease (HR=2.64; 95%CI 2.23–3.12), living in a rural area (HR=1.23; 95%CI 1.14–1.21), and manifestation of the disease between the years 2000 and 2016 (HR=5.32; 95%CI 4.74–5.93). Likewise, in the period “work disability until death”, women (HR=0.51; 95%CI 0.41–0.52) and receiving social security benefits (HR=0.24; 95%CI 0,14–0.45) were associated with longer survival, as well as the cardiac form of the disease (HR=1.95; 95%CI 1.83–2.13), living in a rural area (HR=1.31; 95%CI 1.21–1.54), and manifestation of the disease between 2000 and 2016 (HR=1.53; 95%CI 1.33–1.71) were associated with lower survival. Conclusion The main predictors of mortality and survival of patients with Chagas disease who receive social security and assistance benefits in Brazil were presented. These findings can guide the definition of priorities for follow-up actions by Primary Health Care, currently recommended for the longitudinal management of the disease. 194 Security death KaplanMeier Kaplan Meier methods onset , death” HR=0.54 HR054 HR 0 54 (HR=0.54 95CI CI 95 0.43–0.53 043053 43 53 HR=0.13 HR013 13 (HR=0.13 0.11–0.23 011023 11 23 HR=2.64 HR264 2 64 (HR=2.64 2.23–3.12, 223312 2.23–3.12 3 12 2.23–3.12) HR=1.23 HR123 1 (HR=1.23 1.14–1.21, 114121 1.14–1.21 14 21 1.14–1.21) 200 201 HR=5.32 HR532 5 32 (HR=5.32 4.74–5.93. 474593 4.74–5.93 . 4 74 93 4.74–5.93) Likewise work HR=0.51 HR051 51 (HR=0.51 0.41–0.52 041052 41 52 HR=0.24 HR024 24 (HR=0.24 0,14–0.45 014045 45 HR=1.95 HR195 (HR=1.95 1.83–2.13, 183213 1.83–2.13 83 1.83–2.13) HR=1.31 HR131 31 (HR=1.31 1.21–1.54, 121154 1.21–1.54 1.21–1.54) HR=1.53 HR153 (HR=1.53 1.33–1.71 133171 33 71 presented followup follow up Care 19 HR=0.5 HR05 (HR=0.5 9 0.43–0.5 04305 HR=0.1 HR01 (HR=0.1 0.11–0.2 01102 HR=2.6 HR26 6 (HR=2.6 22331 2.23–3.1 HR=1.2 HR12 (HR=1.2 11412 1.14–1.2 20 HR=5.3 HR53 (HR=5.3 47459 4.74–5.9 7 0.41–0.5 04105 HR=0.2 HR02 (HR=0.2 0,14–0.4 01404 HR=1.9 HR19 (HR=1.9 18321 1.83–2.1 8 HR=1.3 HR13 (HR=1.3 12115 1.21–1.5 HR=1.5 HR15 (HR=1.5 1.33–1.7 13317 HR=0. HR0 (HR=0. 0.43–0. 0430 0.11–0. 0110 HR=2. HR2 (HR=2. 2233 2.23–3. HR=1. HR1 (HR=1. 1141 1.14–1. HR=5. HR5 (HR=5. 4745 4.74–5. 0.41–0. 0410 0,14–0. 0140 1832 1.83–2. 1211 1.21–1. 1.33–1. 1331 HR=0 (HR=0 0.43–0 043 0.11–0 011 HR=2 (HR=2 223 2.23–3 HR=1 (HR=1 114 1.14–1 HR=5 (HR=5 474 4.74–5 0.41–0 041 0,14–0 014 183 1.83–2 121 1.21–1 1.33–1 133 HR= (HR= 0.43– 04 0.11– 01 22 2.23– 1.14– 47 4.74– 0.41– 0,14– 18 1.83– 1.21– 1.33– (HR 0.43 0.11 2.23 1.14 4.74 0.41 0,14 1.83 1.21 1.33 0.4 0.1 2.2 1.1 4.7 0,1 1.8 1.2 1.3 0. 2. 1. 4. 0,
RESUMO Objetivo Analisar a sobrevida de portadores da doença de Chagas, beneficiários da previdência e da assistência social no Brasil, 1942-2016. Métodos Estudo de coorte retrospectivo com dados do Ministério da Previdência Social. O evento de interesse foi o óbito, e as funções de sobrevida foram estimadas pelos métodos Kaplan-Meier e de regressão de Cox. Resultados No período “início da doença até o óbito”, o sexo feminino (HR=0,54; IC95% 0,43–0,53) e recebimento de benefícios previdenciários (HR=0,13; IC95% 0,11–0,23) foram associados a maior sobrevida. A menor sobrevida esteve associada à forma cardíaca da doença (HR=2,64; IC95% 2,23–3,12), residência em zona rural (HR=1,23; IC95% 1,14–1,21) e manifestação da doença entre os anos de 2000 e 2016 (HR=5,32; IC95% 4,74–5,93). Da mesma forma, no período “incapacidade laboral até o óbito”, o sexo feminino (HR=0,51; IC95% 0,41–0,52) e o recebimento de benefícios previdenciários (HR=0,24; IC95% 0,14–0,45) foram associados a maior sobrevida, assim como forma cardíaca da doença (HR=1,95; IC95% 1,83–2,13), residência em zona rural (HR=1,31; IC95% 1,21–1,54) e manifestação da doença entre os anos de 2000 e 2016 (HR=1,53; IC95% 1,33–1,71) associaram-se a menor sobrevida. Conclusão Os principais preditores de mortalidade e sobrevida de portadores de doença de Chagas que recebem benefícios previdenciários e assistenciais no Brasil foram apresentados. Estes achados podem nortear a definição de prioridades de ações de acompanhamento pela atenção primária à saúde, preconizada atualmente para o manejo longitudinal da doença. 19422016. 19422016 1942 2016. 1942-2016 Social óbito KaplanMeier Kaplan Meier Cox início , óbito” HR=0,54 HR054 HR 0 54 (HR=0,54 IC95 IC 0,43–0,53 043053 43 53 HR=0,13 HR013 13 (HR=0,13 0,11–0,23 011023 11 23 HR=2,64 HR264 2 64 (HR=2,64 2,23–3,12, 223312 2,23–3,12 3 12 2,23–3,12) HR=1,23 HR123 1 (HR=1,23 1,14–1,21 114121 14 21 200 201 HR=5,32 HR532 5 32 (HR=5,32 4,74–5,93. 474593 4,74–5,93 . 4 74 93 4,74–5,93) incapacidade HR=0,51 HR051 51 (HR=0,51 0,41–0,52 041052 41 52 HR=0,24 HR024 24 (HR=0,24 0,14–0,45 014045 45 HR=1,95 HR195 95 (HR=1,95 1,83–2,13, 183213 1,83–2,13 83 1,83–2,13) HR=1,31 HR131 31 (HR=1,31 1,21–1,54 121154 HR=1,53 HR153 (HR=1,53 1,33–1,71 133171 33 71 associaramse associaram se apresentados saúde 1942201 194 1942-201 HR=0,5 HR05 (HR=0,5 IC9 0,43–0,5 04305 HR=0,1 HR01 (HR=0,1 0,11–0,2 01102 HR=2,6 HR26 6 (HR=2,6 22331 2,23–3,1 HR=1,2 HR12 (HR=1,2 1,14–1,2 11412 20 HR=5,3 HR53 (HR=5,3 47459 4,74–5,9 7 9 0,41–0,5 04105 HR=0,2 HR02 (HR=0,2 0,14–0,4 01404 HR=1,9 HR19 (HR=1,9 18321 1,83–2,1 8 HR=1,3 HR13 (HR=1,3 1,21–1,5 12115 HR=1,5 HR15 (HR=1,5 1,33–1,7 13317 194220 19 1942-20 HR=0, HR0 (HR=0, 0,43–0, 0430 0,11–0, 0110 HR=2, HR2 (HR=2, 2233 2,23–3, HR=1, HR1 (HR=1, 1,14–1, 1141 HR=5, HR5 (HR=5, 4745 4,74–5, 0,41–0, 0410 0,14–0, 0140 1832 1,83–2, 1,21–1, 1211 1,33–1, 1331 19422 1942-2 HR=0 (HR=0 0,43–0 043 0,11–0 011 HR=2 (HR=2 223 2,23–3 HR=1 (HR=1 1,14–1 114 HR=5 (HR=5 474 4,74–5 0,41–0 041 0,14–0 014 183 1,83–2 1,21–1 121 1,33–1 133 1942- HR= (HR= 0,43– 04 0,11– 01 22 2,23– 1,14– 47 4,74– 0,41– 0,14– 18 1,83– 1,21– 1,33– (HR 0,43 0,11 2,23 1,14 4,74 0,41 0,14 1,83 1,21 1,33 0,4 0,1 2,2 1,1 4,7 1,8 1,2 1,3 0, 2, 1, 4,