Mortalidade por câncer colorretal no Brasil e medidas inerciais baseadas em smartphones durante o teste do degrau de Chester como preditor de tempo de internação no pós-operatório de câncer abdominopélvico

Abstract

INTRODUCTION: Cancers involving the abdominal and pelvic regions are among the main causes of mortality in Brazil, among which the colorectal type (CRC) is the third leading cause of death in the world. OBJECTIVE: To analyze the social and demographic factors that predict higher mortality from colorectal cancer and worse survival rates, as well as to verify whether screening, diagnosis and treatment procedures have an impact on mortality reduction. In addition, to evaluate whether the Chester Step Test (CST), through work, estimated VO2max and analysis of movement through the gyroscope, is a predictor of postoperative hospital stay of cancer patients undergoing abdominopelvic surgeries. METHOD: Secondary and open access data from the Department of Information and Informatics of the SUS and the IBGE Automatic Recovery System were analyzed. 51 cancer patients were also evaluated in the preoperative period of abdominopelvic surgery through CST associated with a smartphone gyroscope. RESULTS: In Brazil, CRC mortality increased after 45 years of age. The highest adjusted mortality rates were found among whites and in the South of the country. A higher risk of death was observed among single, married and widowed people in the North and Northeast than those legally separated in the South. Lower survival rates were observed among brown individuals, those legally separated and residents of the North region. High mortality in the North was associated with an increase in rates of first-line chemotherapy and a decrease in second-line chemotherapy, and in the South, with second-line chemotherapy and abdominoperineal resection of the rectum. For patients in the preoperative period of abdominopelvic surgery, the length of stay 30 days after the operation was longer when those who underwent CST level 1 had less mobility and greater energy expenditure. In addition, the work rate increased with the progression of the test from level 3 onwards. High VO2max is a predictor of length of stay for those who completed levels 3 and 4 of the test. CONCLUSION: Regional differences in sociodemographic and clinical factors can serve as guidelines for adjusting public health policies. In addition, the use of the gyroscope was more accurate in detecting lower mobility and higher energy expenditure. VO2max was able to predict longer postoperative hospital stays and the work variable was less sensitive in assessing patients' physical capacity.