Hospitalizations and mortality due to endometriosis in Brazil, 2014-2024

Abstract

Introduction: Endometriosis is a chronic condition that affects approximately 10% of women of reproductive age, characterized by the presence of functional endometrial tissue outside the uterine cavity and the myometrium. Although it is considered benign, its complications may lead to death. Objective: To analyze the trajectory of patients with endometriosis in Brazil, identifying temporal trends in hospital admissions and mortality from 2014 to 2024. Methodology: This is a mixed, ecological, and cross-sectional study with a descriptive and analytical design and a quantitative approach, using microdata from the Hospital Information System (SIH/SUS) and the Mortality Information System (SIM), provided by DATASUS, including variables such as ICD-10 category, sex, age group, race/color, educational level, and region. Results: A higher concentration of hospitalizations was observed among women aged 30 to 39 years (42.9%; n=59,386), as well as a higher proportion of in-hospital deaths in the same age group (21.5%; n=34,049). Although studies indicate a higher risk among White women, national data showed a predominance of hospitalizations and deaths among mixed-race (parda) women, in addition to higher mortality between 30 and 49 years of age (30.1%–36.1%; n=55–66). Hospital case fatality remained low (0.11%–0.15%), and the mortality rate did not exceed 0.02%, demonstrating that, despite the clinical and psychosocial impact of the disease, progression to death is rare. Temporal analysis revealed a decline in hospitalizations between 2014 and 2020, followed by growth through 2024, while mortality increased until 2019 and subsequently decreased in the following years. The increase in hospitalizations, especially in the Southern region, may be associated with expanded access to specialized services and residual effects of the COVID-19 pandemic, suggesting the influence of structural and healthcare-related factors on the dynamics of the indicators. Conclusion: Endometriosis presents a heterogeneous epidemiological profile in Brazil, marked by age, racial, and regional variations, with low hospital case fatality, reinforcing the importance of strengthening women’s healthcare networks, early diagnosis, and epidemiological surveillance.