Sex differences in 1,114,625 varicose vein surgeries: an 18-year cross-sectional analysis of the Brazilian public health system

OBJECTIVE: Chronic venous disease is a highly prevalent condition with significant morbidity. Although there is a well-documented predominance of chronic venous disease among women, the differences in surgical treatment based on sex, especially in low- and middle-income countries, are not well understood. The aim of this study was to investigate these disparities within Brazil's public healthcare system. METHODS: This cross-sectional study analyzed all varicose vein surgeries (n=1,114,625) performed in the public sector from 2007 to 2024. Data were extracted from the national open database (Sistema de Informações HospitalaresDepartamento de Informática do Sistema Único de Saúde (Department of Informatics of the Unified Health System). We compared demographics, procedural and mortality rates, age at surgery, length of hospital stays, and patterns of travel for surgery between the sexes. RESULTS: Women constituted most of the procedures (80.5%). Men underwent bilateral surgery at a significantly older median age than women (49 vs. 47 years, p