Abstract
Background
Although anecdotal evidence suggests that the risk of recurrent gout attack increases
with hospitalization, no study has formally tested this hypothesis.
Methods
We conducted an online case-crossover study of individuals with gout. We obtained
information on gout attacks over a 1-year period, including onset date, symptoms and
signs, medications, and exposure to potential risk factors, including hospitalization,
during the 2-day hazard period before each gout attack. The same exposure information
also was obtained over 2-day intercritical gout control periods. We performed conditional
logistic regression to examine the relationship of hospitalization with recurrent
gout attacks and whether such a relationship was modified by concomitant use of anti-gout
medications.
Results
Of 724 participants (mean age, 54.5 years; 78.5% male), 35 hospitalizations occurred
during a hazard or control period. The adjusted odds of gout attacks was increased
4-fold with hospitalization (odds ratio, 4.05; 95% confidence interval, 1.78-9.19)
compared with no hospitalization. The effect of hospitalization tended to attenuate
with the use of allopurinol, colchicine, or nonsteroidal anti-inflammatory drugs,
but not statistically significantly.
Conclusions
Our study confirmed that the risk of gout attacks increases among patients with gout
during hospitalization. Appropriate measures should be considered for prevention of
gout attacks during hospitalization for patients with preexisting gout.
Keywords
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References
- Prevalence of gout and hyperuricemia in the US general population: the National Health and Nutrition Examination Survey 2007-2008.Arthritis Rheum. 2011; 63: 3136-3141
- Epidemiology of gout: is the incidence rising?.J Rheumatol. 2002; 29: 2403-2406
- Preventing and treating acute gout attacks across the clinical spectrum: a roundtable discussion.Cleve Clin J Med. 2010; 77: S2-25
- Gout is associated with more comorbidities, poorer health-related quality of life and higher healthcare utilisation in US veterans.Ann Rheum Dis. 2008; 67: 1310-1316
- Comparison of patient characteristics and gout-related health-care resource utilization and costs in patients with frequent versus infrequent gouty arthritis attacks.Rheumatology (Oxford). 2012; 51: 2004-2012
- The online case-crossover study is a novel approach to study triggers for recurrent disease flares.Clin Epidemiol. 2007; 60: 50-55
- Preliminary criteria for the classification of the acute arthritis of primary gout.Arthritis Rheum. 1977; 20: 895-900
- Gouty arthritis in acute cerebrovascular disease.Cerebrovasc Dis. 2009; 28: 391-396
- Pathogenesis of gout.Ann Intern Med. 2005; 143: 499-516
- Purine-rich foods: an innocent bystander of gout attacks?.Ann Rheum Dis. 2012; 71: 1435-1436
- Changes in urinary uric acid excretion in obstructive sleep apnea before and after therapy with nasal continuous positive airway pressure.Chest. 1998; 113: 1604-1608
- Postsurgical gout.Am Surg. 1995; 61: 56-59
- Gouty attacks occur frequently in postoperative gastric bypass patients.Surg Obes Relat Dis. 2008; 4: 11-15
- Impact of deficits in gout care on hospitalizations.J Clin Rheumatol. 2011; 17: 389-391
- Clinical features and risk factors of postsurgical gout.Ann Rheum Dis. 2008; 68: 1271-1275
Article info
Publication history
Published online: September 19, 2013
Footnotes
Funding: This work was supported by the Arthritis Foundation, American College Rheumatology Research and Education Fund, and National Institutes of Health (AR47785 and T32 AR07598). The funding bodies had no role in the study design, data collection, analysis, interpretation, or writing of the manuscript.
Conflict of Interest: None.
Authorship: All authors had access to the data and played a role in writing this manuscript.
Identification
Copyright
© 2013 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
