Hospitalization Increases Risk for Acute Gout Flares

The risk for gout flares increases 10-fold during hospitalization and longer hospital stays are linked to in-hospital gout flares, according to a study recently published in The Journal of Rheumatology.

Using the data available from the Rochester Epidemiology Project, the study researchers explored the incidence of gout in Olmsted County, Minnesota by culling all relevant details from inpatient and outpatient medical records. Researchers examined all hospitalizations for people diagnosed with gout, including their admissions and discharge dates, reason for admission, and other data including  body mass index and kidney function.

A total of 429 people with incident gout were included. The researchers identified 158 people with gout from 1989 to 1992 and 271 people from 2009 to 2010. Researchers conducted follow-up for an approximate median length of 5 years for the 2 groups. Findings illustrated that 169 people accounted for 454 total hospitalizations. Although hospitalization rates did increase for people with gout, the difference was not significant from 1989-1992 to 2009-2010 (rate ration [RR], 1.19; 95% CI, 0.98-1.45). However, gout flare rate increased significantly during hospitalization (RR, 10.2; 95% CI, 6.8–14.5). The researchers also reported that in-hospital gout flares increased hospital stays by an average of 1.8 days (P <.001).

The study researchers note that their investigation may have been limited by the retrospective nature of the design. The incidence of gout may not have accounted for every case because flares in outpatient settings relied on self-report. Generalizability was also low because the majority of people living in Olmsted County were of Northern European descent.

The study authors conclude, “[hospitalization] is strongly associated with acute flares in patients with preexisting gout. The significantly prolonged hospitalization in patients who experience gout flare after admission warrant further studies to identify strategies to mitigate this risk and possibly reduce attendant costs.”

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Reference

Zleik N, Elfishawi MM, Kvrgic Z, et al. Hospitalization increases the risk of acute arthritic flares in gout: a population-based study over 2 decades [published on July 1, 2018]. J Rheumatol. doi: 10.3899/jrheum.171320