Temporal evolution, mortality indicators, and costs of emergency exploratory laparotomies in Brazil

a national analysis from 2015 to 2025

Abstract

Objective: to analyse the temporal evolution, mortality indicators, and costs of emergency exploratory laparotomies performed in Brazil from 2015 to 2025. Methods: a retrospective and analytical epidemiological study using data from the Hospital Information System (SIH/SUS). A total of 345,565 emergency admissions were analysed. Simple linear regression was used for temporal trends and ANOVA for regional disparities, processed in IBM SPSS Statistics 21.0 software. Results: the average institutional mortality rate was 16.8%. The 2020-2021 biennium (covid-19 pandemic) was characterised by a reduction in surgical volume (27,000 cases), accompanied by a statistically significant increase in lethality (18.5%; p < 0.001). Strong regional disparity was identified, with higher mortality in the North (19.3%) and Northeast (18.5%) regions compared to the South (15.1%). The average cost per admission increased by 66% over the decade (R² = 0.965; p < 0.001). Conclusions: emergency laparotomy in Brazil maintains high lethality, worsened by sanitary crises and regional infrastructure inequities, coupled with a progressive and linear escalation of operational costs for the public system.