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Abstract：
Background Pericardial diseases manifest in various clinical forms, including acute pericarditis, constrictive pericarditis, pericardial effusion, and cardiac tamponade, with acute pericarditis being the most prevalent. These conditions significantly contribute to mortality rates. Therefore, this article aimed to analyze mortality trends in the Brazilian population based on age and sex, shedding light on the impact of pericardial diseases on public health outcomes. Methods This is a retrospective time-series analysis of pericardial disease mortality rates in Brazil (2000-2022). Data was obtained from the Department of Informatics of the Unified Health System (DATASUS), and the 10th edition of the International Classification of Diseases (ICD-10) codes: I30, I31, and I32 were included for analysis. We gathered population and demographic data categorized by age range and sex from the Brazilian Institute of Geography and Statistics (IBGE). Subsequently, we computed the age-standardized mortality rate per 100,000 individuals and assessed the annual percentage changes (APCs) and average annual percentage changes (AAPCs) using joinpoint regression, along with their corresponding 95% confidence intervals (CIs). Results In terms of mortality trends based on sex, overall mortality rates remained stable for males and combined sexes over the study period. However, there was a notable increase in mortality rates among females (AAPC=1.18), particularly between 2020 and 2022, with a significant APC of 27.55. Analyzing pericardial diseases across different age groups (20 to 80 years and above), it wasobserved that mortality rates significantly increased in the 70-79 and 80 years and above age groups throughout the study period (AAPC=1.0339 and AAPC=3.4587, respectively). These two age groups experienced the highest significant rise in mortality between 2020 and 2022. Other age groups did not exhibit a significant change in AAPC. Conclusions This comprehensive analysis spanning two decades (2000-2022), examined the mortality trends of pericardial diseases in Brazil and revealed relative stability overall. Males exhibited an overall higher mortality number due to pericardial diseases; however, females showed the most significant increase in mortality trend throughout the whole period. In the first segment (2000-2015), mortality rose across all cohorts, which was attributed to substandard healthcare facilities and infectious diseases like tuberculosis. The second segment (2016-2020) saw a decline in mortality, likely due to improved healthcare, particularly the increased availability of echocardiograms. However, the third segment (2020-2022) witnessed a sharp rise in mortality, coinciding with the COVID-19 pandemic, with post-COVID-19 symptoms, particularly pericarditis. Pericarditis-related death rates declined compared to pericardial effusion, and mortality rates correlated directly with age, with older cohorts experiencing higher mortality due to increased comorbidities, and decline in health and immunocompetency.
摘要：
背景心包疾病表现为各种临床形式，包括急性心包炎,缩窄性心包炎,心包积液,和心脏填塞,以急性心包炎最为普遍.这些情况极大地导致了死亡率。因此,本文旨在根据年龄和性别分析巴西人口的死亡率趋势，阐明心包疾病对公共卫生结果的影响。方法对巴西（2000-2022年）心包疾病死亡率进行回顾性时间序列分析。数据来自统一卫生系统（DATASUS）的信息学部门，并纳入第10版国际疾病分类(ICD-10)编码:I30,I31和I32进行分析.我们从巴西地理与统计研究所（IBGE）收集了按年龄范围和性别分类的人口和人口统计数据。随后，我们计算了每100,000个人的年龄标准化死亡率，并使用连接点回归评估了年度百分比变化（APC）和平均年度百分比变化（AAPC），以及它们相应的95%置信区间(CI)。结果在基于性别的死亡率趋势方面，在研究期间,男性和合并性别的总死亡率保持稳定.然而,女性死亡率显著上升(AAPC=1.18)，特别是在2020年至2022年之间，APC为27.55。分析不同年龄段（20至80岁及以上）的心包疾病，观察到在整个研究期间,70-79岁和80岁及以上年龄组的死亡率显著增加(分别为AAPC=1.0339和AAPC=3.4587).这两个年龄组在2020年至2022年期间的死亡率增幅最高。其他年龄组的AAPC没有显着变化。结论这项跨越二十年(2000-2022年)的综合分析，研究了巴西心包疾病的死亡率趋势，并揭示了总体相对稳定。男性由于心包疾病而表现出总体较高的死亡率；然而，女性在整个时期的死亡率上升趋势最为显著。在第一部分（2000-2015）中，死亡率在所有队列中上升，这归因于不合格的医疗设施和结核病等传染病。第二部分(2016-2020年)死亡率下降，可能是由于医疗保健的改善，特别是超声心动图的可用性增加。然而,第三部分(2020-2022)见证了死亡率的急剧上升，恰逢COVID-19大流行，有COVID-19后症状，尤其是心包炎.与心包积液相比，心包炎相关的死亡率下降，死亡率与年龄直接相关，由于合并症增加，老年人群的死亡率更高，健康和免疫能力下降。
