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National perspective of the surgical treatment of platibasia and malformation of Arnold Chiari

Background: Platybasia is a bone anomaly, characterized by the flattening of the skull base. Its etiology is still questioned, but it is believed to occur in a congenital way. Objectives: To analyze the panorama of Arnold Chiari’s platelet and malformation surgical treatment procedures in the State of São Paulo and correlate it with the current epidemiology. Methods: observational, descriptive and cross-sectional collection of Arnold Chiari’s platelet and malformation surgical treatment data, available at DATASUS website, from January 2008 up to December 2020 - evaluating the number of hospitalizations, public spending, complexity, mortality rate, deaths, permanence and character of care. Results: 1,573 hospitalizations were observed for such procedures in this period, representing a total expenditure of R$ 5,680,871.82. 2011 was the year with the highest number of hospitalizations (142), it was also the year with the greatest expenditure (R$ 582,194.40). 1,006 of the were elective and 567 were urgent, with 509 occurring in the public sector and 482 in private one. All 1,573 considered to be of high complexity. The mortality rate was 2.16, corresponding to 34 deaths, 2010 was the year with the highest mortality, 4.10 and 2012 the lowest, 0.83. Mortality rate was lower in elective procedures (1.89 versus 2.65 in urgent ones) and when carried out in public sector (2.36 versus 2.49 in private care). The hospital stay was 12.7 days, with a cost of R$ 3,611.49. Conclusion: Platybasia is a highly complexity condition with a long period of hospital stay. However, the predominance of care is elective, with low mortality.