Gout Linked to Increased Length of Hospital Stay in Patients With Heart Failure Exacerbation

Gout diagnosis is associated with increased length of stay in patients hospitalized for heart failure exacerbation, according to study results presented at the American College of Rheumatology (ACR) Convergence 2020, held virtually from November 5 to 9, 2020.

Although previous studies have reported that hospital stay is a risk factor for acute gout flare, which may increase length of stay, limited data are available on the effect of gout diagnosis and flare on the length of stay in patients hospitalized for heart failure exacerbation.

Study authors collected data from electronic health records of patients admitted to the Columbia University Irving Medical Center. Patients eligible for the study were aged at least 18 years, hospitalized with a primary diagnosis of heart failure exacerbation from July 2012 to June 2017, and had 2 or more gout diagnoses before hospitalization for heart failure. Patients were age- and sex-matched 1:2 with control participants who did not have any diagnosis of gout before hospitalization. Primary study outcome was length of stay. Two-sample t-test and linear mixed effect model were used for statistical analysis.

The case-control study included 545 admissions for heart failure exacerbation among 293 patients with a history of gout, and 5461 admissions among 3798 patients without a history of gout. Overall, 246 admissions of patients with gout and 492 admissions of matched control participants without gout were included in the analysis.

Results showed significantly longer hospital stays for patients with a history of gout compared with those without gout (log length of stay, 1.86 vs 1.72 days, respectively; P =.0278). A gout flare was reported in 42 of 326 admissions (13%) and the median length of stay for patients with a gout flare was longer than that of those without a flare (10 vs 6 days) or without gout (6 days). There was a significant difference between patients who experienced a flare compared with control participants (log length of stay, 2.41 vs 1.77 days, respectively; P <.0001). However, no significant difference was reported between patients with gout who did not experience a flare and control participants (P =.2465).

After adjustment for study variables, including age, baseline electrolytes, and body mass index, the length of stay remained significantly longer for patients with gout flare compared with control participants (P <.0001), but not for those who did not experience a flare (P =.042).

“Patients [with heart failure] with gout had significantly longer hospitalizations than those without gout, an effect driven primarily by those patients [with gout] who flare during hospitalization,” the study authors concluded.

Reference

DeMizio D, Wu G, Wei Y, Bathon J, Wang R. Gout increases length of stay in patients hospitalized for heart failure exacerbation. Presented at: ACR Convergence 2020; November 5-9, 2020. Abstract 0600.