Hospitalizations and Mortality Due to Multiple Sclerosis in Brazil (2018–2025): An Epidemiological Assessment within the Unified Health System

Abstract

Background: Multiple sclerosis (MS) is a chronic immune-mediated disease of the central nervous system and a major cause of non-traumatic neurological disability in young adults. Hospital data offer an indirect indicator of disease activity and access to care.

Objective: To describe national patterns, demographic characteristics, and in-hospital outcomes of MS hospitalizations in Brazil from 2018 to 2025, emphasizing the use of procedure 0303040289 – Treatment of Multiple Sclerosis Relapse as a clinical proxy of relapse management within the public health system.

Methods: Ecological, retrospective study using data from the Hospital Information System of the Brazilian Unified Health System (SIH/SUS). All admissions with ICD-10 code G35 were analyzed by year, region, sex, age group, race/skin color, type of care (elective or urgent), and in-hospital mortality. Hospitalization and mortality rates per 100,000 inhabitants were estimated using official IBGE population data.

Results: A total of 46,594 MS hospitalizations were recorded (2018–2025), predominantly among women (71.3%) and adults aged 20–49 years (77%). The Southeast accounted for 73.2% of admissions. Hospitalizations were equally distributed between elective (49.4%) and urgent (50.6%) cases. Overall in-hospital case fatality was 0.54%, higher in urgent admissions (0.89%) than in elective ones (0.17%; p < 0.001). Procedure 0303040289 represented 90.9% of all admissions, with stable mortality (0.40%) and a progressive increase until 2024.

Conclusion: Multiple sclerosis hospitalizations increased in Brazil, with strong regional disparities. The high representation of procedure 0303040289 confirms its clinical specificity and usefulness as a surveillance marker of relapse management within the SUS network.