<b> </b><b> Bayesian Modeling</b>

<b>ABSTRACT</b><b>OBJECTIVE</b>Despite significant advancements in understanding risk factors and treatment strategies, ischemic heart disease (IHD) remains the leading cause of mortality worldwide, particularly within specific regions in Brazil where the disease is a burden. Therefore, the aim of this study was to estimate the risk of hospitalization and mortality from IHD in Paraná State, Brazil, using spatial analysis.<b>METHODS</b>This is an ecological study based on secondary and historical mortality data obtained from the Brazilian Mortality Information System and Hospitalization Information System during 2010-2021 period, stratified by Health Regions in Paraná State. To assess the spatial patterns of the disease and identify relative risk (RR) areas, we constructed a risk model by Bayesian inference using the R-INLA and SpatialEpi packages in R software. <b>RESULTS</b>A total of 333,229 hospitalizations and 73,221 deaths with elevated RR of 27.42 of hospitalizations and 15.68 of mortality for IHD in small-sized municipalities. Hospitalization and death rates were higher in men and whites aged 40-59. Regions 2 and 6 had the highest hospitalization risks, while all other regions presented RR of death &gt;1. The RR median of hospitalizations remained constant, but mortality median increased over time.<b>CONCLUSION </b>Areas with increased risk of hospitalization and mortality of IHD was found between small and medium municipalities in Parana State, Brazil. These results suggested that there is a deficit of care in health attention for IHD cases in small and medium-sized municipalities, which can be justified by a low distribution of healthcare resources.<br><b>摘要</b><b>研究目的</b>尽管在危险因素认知与治疗策略方面已取得显著进展，但缺血性心脏病（ischemic heart disease, IHD）仍是全球范围内的首要致死病因，尤其是在巴西部分疾病负担沉重的地区。因此，本研究旨在利用空间分析方法，估算巴西巴拉那州缺血性心脏病患者的住院与死亡风险。<b>研究方法</b>本研究为生态学研究，基于2010-2021年从巴西死亡信息系统（Brazilian Mortality Information System）和住院信息系统（Hospitalization Information System）获取的二手历史死亡数据，按巴拉那州卫生区域进行分层。为评估该疾病的空间分布模式并识别相对风险（relative risk, RR）区域，本研究采用R软件中的R-INLA与SpatialEpi包，通过贝叶斯推断构建风险模型。<b>研究结果</b>小型市镇中共有333229例缺血性心脏病住院病例与73221例死亡病例，其相对风险分别为27.42（住院）和15.68（死亡）。40~59岁男性及白人的住院率与死亡率更高。第2和第6卫生区域的住院风险最高，其余所有区域的死亡相对风险均大于1。住院相对风险的中位数保持稳定，但死亡相对风险的中位数随时间呈上升趋势。<b>研究结论</b>巴西巴拉那州的中小型市镇区域存在缺血性心脏病住院与死亡风险升高的情况。本研究结果提示，中小型市镇的缺血性心脏病患者医疗照护存在不足，这可归因于医疗资源分布不均。