Epidemiological Profile of Hysterectomies Within the Public Health System Across Different Regions of Brazil Between 2013 and 2023

Objective: To evaluate the assistive care profile of hysterectomies, including the average length of hospital stay, average cost per procedure, and mortality rate among the five Brazilian regions. Methods: A total of 740,528 procedures were selected, encompassing the number of hospitalizations, average procedure cost, average length of stay, and mortality rate for total, subtotal, vaginal, puerperal, and videolaparoscopic hysterectomies performed in each unit of the Federation between January 2013 and December 2023. Results: Total hysterectomy was the most prevalent (78.30%), while puerperal hysterectomy was the least prevalent (0.80%). The Northeast region performed the most hysterectomies (42.6%), and the Central-West region performed the fewest (9.20%). Puerperal hysterectomy had the longest hospital stay (5.1 days), the highest mortality rate (567.15/10,000), and the highest average cost (R$1,504.00). Videolaparoscopic hysterectomy was of low prevalence, despite being the least invasive, having the lowest mortality rate (2.91/10,000), and the shortest length of stay (2.30 days). It was the second procedure with the lowest average cost (R$624.00), preceded by vaginal hysterectomy (R$597.00). Conclusion: The region with the highest number of procedures was the Northeast, with total hysterectomy being the most prevalent type across Brazil. Puerperal hysterectomy presented the longest average length of stay, the highest average cost, and the highest mortality rate, and was most prevalent in the Southeast region. Videolaparoscopic hysterectomy had the shortest average length of stay and the lowest mortality rate.