All-cause hospitalizations among patients with gout in the United States have increased by 410% from 1993 to 2014, a rate much higher than in the US population as a whole, according to a new study presented at the 2017 Annual European Congress of Rheumatology in Madrid.

The increase in gout patient hospitalizations may reflect, in part, better recognition and coding of co-morbidities, investigators Gurkipal Singh, MD, of Stanford University, and colleagues explained.

Dr Singh’s team analyzed all inpatient hospitalizations in the Nationwide Inpatient Sample (NIS) from 1993 to 2014. The NIS is a stratified random sample of all US community hospitals that includes information on all patients, regardless of insurance coverage.

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A total of 789.8 million all-cause hospitalizations occurred during the 22-year period. Patients with gout accounted for 9,741,598 of these hospitalizations. All-cause hospitalizations among gout patients increased from 167,441 in 1993 (a rate of 64.2 hospitalizations per 100,000 person-years) to 854,475 in 2014 (a rate of 267.9 hospitalizations per 100,000 person-years), an increase of 410%, Dr Singh’s group reported in a poster presentation.

By comparison, all-cause hospitalizations in the general US population increased from 33.7 million in 1993 to 35.4 million in 2014, an increase of 4.8%.

In 2014, gout patient hospitalizations accounted for more than 4.6 million hospital days for a total national cost of $42.6 billion, according to the investigators.

The investigators said their findings call for better outpatient management of gout with urate-lowering therapies and optimal treatment of co-morbidities that might result in fewer hospitalizations.

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Singh G, Mithal A, Mithal A. Not just a swollen big toe: Increasing all-cause hospitalizations in patients with gout in the United States: 1993 – 2014. Poster presented at the Annual European Congress of Rheumatology in Madrid (June 14 – 17). Abstract THU0409. DOI: 10.1136/annrheumdis-2017-eular.5458