Hospitalization Increases the Risk of Acute Arthritic Flares in Gout: A Population-based Study over 2 Decades

doi:10.3899/jrheum.171320

. 2018 Aug;45(8):1188-1191.

doi: 10.3899/jrheum.171320. Epub 2018 Jul 1.

Hospitalization Increases the Risk of Acute Arthritic Flares in Gout: A Population-based Study over 2 Decades

Nour Zleik^{1

2}, Mohanad M Elfishawi^{1

2}, Zoran Kvrgic^{1

2}, Clement J Michet Jr^{1

2}, Cynthia S Crowson^{3

4}, Eric L Matteson^{1

2}, Tim Bongartz^{1

2}

Affiliations

¹ From the Division of Rheumatology, Mayo Clinic College of Medicine and Science, Rochester, Minnesota, USA.
² N. Zleik, MD, Rheumatology Fellow, Division of Rheumatology, Augusta University; M.M. Elfishawi, MD, Internal Medicine Resident, Icahn School of Medicine at Mount Sinai; Z. Kvrgic, CCRP, Study Coordinator, Mayo Clinic; C.J. Michet Jr., MD, Consultant, Mayo Clinic; C.S. Crowson, MS, Associate Professor, Mayo Clinic; E.L. Matteson, MD, MPH, Consultant, Mayo Clinic; T. Bongartz, MD, MS, Vanderbilt University.
³ From the Division of Rheumatology, Mayo Clinic College of Medicine and Science, Rochester, Minnesota, USA. crowson@mayo.edu.
⁴ N. Zleik, MD, Rheumatology Fellow, Division of Rheumatology, Augusta University; M.M. Elfishawi, MD, Internal Medicine Resident, Icahn School of Medicine at Mount Sinai; Z. Kvrgic, CCRP, Study Coordinator, Mayo Clinic; C.J. Michet Jr., MD, Consultant, Mayo Clinic; C.S. Crowson, MS, Associate Professor, Mayo Clinic; E.L. Matteson, MD, MPH, Consultant, Mayo Clinic; T. Bongartz, MD, MS, Vanderbilt University. crowson@mayo.edu.

PMID: 29961683
PMCID: PMC6072557
DOI: 10.3899/jrheum.171320

Hospitalization Increases the Risk of Acute Arthritic Flares in Gout: A Population-based Study over 2 Decades

Nour Zleik et al. J Rheumatol. 2018 Aug.

. 2018 Aug;45(8):1188-1191.

doi: 10.3899/jrheum.171320. Epub 2018 Jul 1.

Authors

Nour Zleik^{1

2}, Mohanad M Elfishawi^{1

2}, Zoran Kvrgic^{1

2}, Clement J Michet Jr^{1

2}, Cynthia S Crowson^{3

4}, Eric L Matteson^{1

2}, Tim Bongartz^{1

2}

Affiliations

¹ From the Division of Rheumatology, Mayo Clinic College of Medicine and Science, Rochester, Minnesota, USA.
² N. Zleik, MD, Rheumatology Fellow, Division of Rheumatology, Augusta University; M.M. Elfishawi, MD, Internal Medicine Resident, Icahn School of Medicine at Mount Sinai; Z. Kvrgic, CCRP, Study Coordinator, Mayo Clinic; C.J. Michet Jr., MD, Consultant, Mayo Clinic; C.S. Crowson, MS, Associate Professor, Mayo Clinic; E.L. Matteson, MD, MPH, Consultant, Mayo Clinic; T. Bongartz, MD, MS, Vanderbilt University.
³ From the Division of Rheumatology, Mayo Clinic College of Medicine and Science, Rochester, Minnesota, USA. crowson@mayo.edu.
⁴ N. Zleik, MD, Rheumatology Fellow, Division of Rheumatology, Augusta University; M.M. Elfishawi, MD, Internal Medicine Resident, Icahn School of Medicine at Mount Sinai; Z. Kvrgic, CCRP, Study Coordinator, Mayo Clinic; C.J. Michet Jr., MD, Consultant, Mayo Clinic; C.S. Crowson, MS, Associate Professor, Mayo Clinic; E.L. Matteson, MD, MPH, Consultant, Mayo Clinic; T. Bongartz, MD, MS, Vanderbilt University. crowson@mayo.edu.

PMID: 29961683
PMCID: PMC6072557
DOI: 10.3899/jrheum.171320

Abstract

Objective: To assess in-hospital gout flares in patients with gout.

Methods: Hospitalizations were evaluated for gout flares in a cohort of Olmsted County, Minnesota, residents with incident gout in 1989-1992 or 2009-2010.

Results: There were 429 patients followed up to 5 years. Of these, 169 patients experienced 454 hospitalizations. Hospitalization rates increased without reaching statistical significance from 1989-1992 to 2009-2010 [rate ratio (RR) 1.19, 95% CI 0.98-1.45]. The gout flare rate increased significantly during hospitalization (RR 10.2, 95% CI 6.8-14.5). In-hospital gout flare increased the average hospital stay by 1.8 days (p < 0.001).

Conclusion: Hospitalization increased the risk of gout flares 10-fold. In-hospital gout flares were associated with longer hospitalization.

Keywords: GOUT; HEALTHCARE USE; HOSPITALIZATION; HYPERURICEMIA.

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Conflict of interest statement

Conflict of interest statement: The authors declare no conflicts of interest.

Figures

**Figure 1**
Cumulative incidence of first hospitalization following a diagnosis of gout in 1989–1992 (dashed line) and 2009–2010 (solid line).

See this image and copyright information in PMC

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References

1. Kuo CF, Grainge MJ, Zhang W, Doherty M. Global epidemiology of gout: prevalence, incidence and risk factors. Nat Rev Rheumatol. 2015;11:649–62. - PubMed
1. Zhu Y, Pandya BJ, Choi HK. Prevalence of gout and hyperuricemia in the US general population: the National Health and Nutrition Examination Survey 2007-2008. Arthritis Rheum. 2011;63:3136–41. - PubMed
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1. Jinno S, Hasegawa K, Neogi T, Goto T, Dubreuil M. Trends in Emergency Department Visits and Charges for Gout in the United States between 2006 and 2012. J Rheumatol. 2016;43:1589–92. - PMC - PubMed
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[1] Kuo CF, Grainge MJ, Zhang W, Doherty M. Global epidemiology of gout: prevalence, incidence and risk factors. Nat Rev Rheumatol. 2015;11:649–62. - PubMed

[2] Kuo CF, Grainge MJ, Zhang W, Doherty M. Global epidemiology of gout: prevalence, incidence and risk factors. Nat Rev Rheumatol. 2015;11:649–62. - PubMed

[3] Zhu Y, Pandya BJ, Choi HK. Prevalence of gout and hyperuricemia in the US general population: the National Health and Nutrition Examination Survey 2007-2008. Arthritis Rheum. 2011;63:3136–41. - PubMed

[4] Zhu Y, Pandya BJ, Choi HK. Prevalence of gout and hyperuricemia in the US general population: the National Health and Nutrition Examination Survey 2007-2008. Arthritis Rheum. 2011;63:3136–41. - PubMed

[5] Singh JA, Yu S. Time Trends, Predictors, and Outcome of Emergency Department Use for Gout: A Nationwide US Study. J Rheumatol. 2016;43:1581–8. - PMC - PubMed

[6] Singh JA, Yu S. Time Trends, Predictors, and Outcome of Emergency Department Use for Gout: A Nationwide US Study. J Rheumatol. 2016;43:1581–8. - PMC - PubMed

[7] Jinno S, Hasegawa K, Neogi T, Goto T, Dubreuil M. Trends in Emergency Department Visits and Charges for Gout in the United States between 2006 and 2012. J Rheumatol. 2016;43:1589–92. - PMC - PubMed

[8] Jinno S, Hasegawa K, Neogi T, Goto T, Dubreuil M. Trends in Emergency Department Visits and Charges for Gout in the United States between 2006 and 2012. J Rheumatol. 2016;43:1589–92. - PMC - PubMed

[9] Shields GE, Beard SM. A Systematic Review of the Economic and Humanistic Burden of Gout. PharmacoEconomics. 2015;33:1029–47. - PubMed

[10] Shields GE, Beard SM. A Systematic Review of the Economic and Humanistic Burden of Gout. PharmacoEconomics. 2015;33:1029–47. - PubMed

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Hospitalization Increases the Risk of Acute Arthritic Flares in Gout: A Population-based Study over 2 Decades

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Hospitalization Increases the Risk of Acute Arthritic Flares in Gout: A Population-based Study over 2 Decades

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