Disappointment Behind Acute Gout Hospitalizations Save
Analysis of emergency department visits from two UK hospitals shows a high rate of hospitalization, and low use of urate-lowering therapies (ULT) and treat-to-target (T2T) management.
Between 2017 and 2020 there were 1,220 emergency attendances for gout flares - 23.5% required hospitalization (median length of stay: 3.6 days). Moreover, 10% of patients had recurrent ER visits attendances for gout flares.
Using multivariate logistic regression models, predictors of hospitalization from gout included:
- older age
- overnight ED arrival time
- higher serum urate
- higher CRP
- higher WBC at presentation
Caveats from this study:
- Only 22.6% of patients with pre-existing gout were receiving ULT at presentation.
- Rheumatology consultation and synovial aspirates were rarely obtained.
- Six months post-discharge, 44% were receiving ULT; but few had T2T optimization, with only 9.1% achieving a urate ≤360 micromol/L.
Gout management, at presentation, hospitalization and post discharge, remains woefully inadequate.
ADD THE FIRST COMMENT
Disclosures
The author has no conflicts of interest to disclose related to this subject
If you are a health practitioner, you may Login/Register to comment.
Due to the nature of these comment forums, only health practitioners are allowed to comment at this time.