Clinical and Epidemiological Profile of Hospital Admissions in a Tertiary Center in the Brazilian Amazon: A 10-Year Analysis Short title: Hospitalization Profile in the Brazilian Amazon Section Original Research Paper

Abstract

Introduction: Hospital-level epidemiological data from the Brazilian Amazon remain scarce, limiting understanding of long-term patterns of healthcare utilization and clinical outcomes in the region. Objective: This study aimed to characterize 10 years of hospital utilization, diagnostic profiles, and clinical outcomes at a tertiary-care center in the Western Brazilian Amazon. Methods: Retrospective observational cohort study including adult hospitalizations at a tertiary-care center in Manaus, Brazil, from May 2016 to June 2025. Electronic medical record and administrative data included demographics, ICD-10 diagnoses, admission unit, in-hospital mortality, length of stay, 30-day readmissions, and emergency and outpatient volumes. Analyses were descriptive using monthly and annual aggregates. Results: A total of 112,520 admissions were recorded. Most patients were women (61.2%), and the mean age was 29.2 years. The most common diagnostic groups were others, pregnancy/childbirth/puerperium, and digestive diseases, with marked rises in respiratory diagnoses from 2020 onward. Crude hospital mortality was 1.4%, peaking at 11.1% in May 2020 and January 2021. Median monthly mean length of stay was 9 days, and the 30-day readmission rate was 4.1%. The hospital managed 1.9 million emergency visits and 3.5 million outpatient consultations, with 5.8 admissions per 100 emergency visits. Conclusion: This study offers longitudinal insight into service demand, diagnostic distributions, and outcome patterns, underscoring the importance of sustained, data-driven monitoring to support planning and enhance hospital resilience.

Keywords: Hospitalization; Epidemiology; Health services