Questions persist for 400% increase in hospitalizations among gout patients
DESTIN, Fla. — All-cause hospitalization increased 410% among patients with gout during the last 22 years, nearly 100 times more than the overall population in the United States, according to findings presented during the 2018 Congress of Clinical Rheumatology.
“We are trying to determine other reasons for this increase, one of which could be that the prevalence of gout is increasing, which is generally true but not to the same extent as we have seen here,” Gurkirpal Singh, MD, adjunct clinical professor of medicine at Stanford University, told Healio Rheumatology. “Another reason could be that gout is being diagnosed more, which is also probably unlikely because gout is not a difficult disease to diagnose.”
To evaluate all-cause hospitalizations in patients with gout in the U.S., Singh and colleagues examined data from the Nationwide Inpatient Sample for all inpatient hospitalizations with a primary or secondary diagnosis of gout over 21 years. The researchers then compared this data with total all-cause U.S. hospitalizations during the same period.
According to study findings, all-cause hospitalizations in the overall U.S. population increased from 33.7 million in 1993 to 35.4 million in 2014 — a 4.8% increase; however, among patients with gout, all-cause hospitalizations increased from 167,441 in 1993 to 854,475 in 2014.
“Hospitalizations in patients with gout in the United States have increased dramatically over the past two decades — by more than 400% — which is astonishing when you consider that overall hospitalization only increased approximately 4% during the same time period,” Singh said.
The researchers also noted that hospitalizations among patients with gout in 2014 accounted for a national cost of more than $42.6 billion, with more than 4.6 million hospital days.
“I think what is happening more is that now we have better datasets,” Singh told Healio Rheumatology. “Previously, if a patient had a heart attack and was admitted to the hospital, no one would know if they had gout, whereas now with electronic medical records, all the information is populated and the hospital is informed of the patient’s gout status. However, that has an important indication: It would mean that all of the information that we have been using to discuss the comorbidities in gout, including increased risk of heart attacks and kidney disease, is completely outdated. Those figures are based on 10-year-old and 20-year-old data when we didn’t have as good datasets — the real numbers could be tenfold higher.” – by Bob Stott
Singh G. Not just a swollen big toe: increasing all-cause hospitalizations in patients with gout in the United States: 1993–2014. Presented at: Congress of Clinical Rheumatology; May 17-20, 2018; Destin, Florida.
Disclosure: Dr. Singh reports research support from Horizon Pharma.