Regions Hospital, Saint Paul, Minnesota, and University of Minnesota, Minneapolis.
Regions Hospital, Saint Paul, Minnesota, University of Minnesota, Minneapolis, and HealthPartners Institute, Bloomington, Minnesota.
Arthritis Care Res (Hoboken). 2022 Mar;74(3):461-467. doi: 10.1002/acr.24490. Epub 2022 Feb 14.
To evaluate demographic characteristics, care encounters, comorbidities, and clinical differences in Hmong and non-Hmong patients with gout.
Using retrospective chart review, all inpatient encounters (Hmong versus non-Hmong) were reviewed from 2014 to 2017. Acute or chronic gout was the primary or secondary diagnosis for the encounter.
Hmong gout patients were on average 11 years younger than non-Hmong patients, but after adjustment for age, sex, and type of encounter, they had similar rates of hypertension, diabetes mellitus, and heart disease. Hmong patients had significantly decreased renal function at the time of presentation; the odds ratio of chronic kidney disease for Hmong patients was 2.33 versus 1.48 for non-Hmong patients (P < 0.05), the mean creatinine level was 3.3 mg/dl versus 2.0 mg/dl (β = 1.35, P < 0.001), and the glomerular filtration rate was 44.8 ml/minute versus 49.3 ml/minute (β = -6.95, P < 0.001). Hmong gout patients were more likely to use emergency care versus elective or urgent care, they were less likely to be using medications for the treatment of gout prior to admission (32.3% versus 58.2%), and the length of hospital stay was increased (8.8 versus 5.2 days; P < 0.05).
Hmong gout patients who had a tertiary care encounter were 11 years younger than non-Hmong patients with similar rates of comorbidities but had worse renal function despite the age differences. They were more likely to use emergency services, to be insured through Medicaid, and not to use preventive medications for gout prior to their encounter. Intensive efforts are needed in the Hmong population for culturally appropriate preventive care management of gout along with diabetes mellitus, hypertension, heart disease, and kidney disease.
评估苗族和非苗族痛风患者的人口统计学特征、医疗照护经历、合并症和临床差异。
使用回顾性病历审查，对 2014 年至 2017 年的所有住院患者（苗族与非苗族）进行了审查。急性或慢性痛风为就诊的主要或次要诊断。
苗族痛风患者比非苗族患者平均年轻 11 岁，但在调整年龄、性别和就诊类型后，他们的高血压、糖尿病和心脏病发病率相似。苗族患者在就诊时的肾功能明显下降；苗族患者发生慢性肾脏病的几率是非苗族患者的 2.33 倍（比值比，2.33；95%置信区间，1.13~4.81；P < 0.05），其平均肌酐水平为 3.3 mg/dl（β = 1.35，P < 0.001），肾小球滤过率为 44.8 ml/min（β = -6.95，P < 0.001）。与非苗族患者相比，苗族痛风患者更有可能使用急诊护理，而不是择期或紧急护理；苗族患者在入院前使用治疗痛风的药物的可能性较低（32.3%比 58.2%），住院时间较长（8.8 天比 5.2 天；P < 0.05）。
在接受三级保健的苗族痛风患者中，尽管年龄存在差异，但与非苗族患者相比，他们的合并症发病率相似，但肾功能更差。他们更有可能使用急诊服务，通过医疗补助保险支付费用，且在就诊前未使用预防性痛风药物。需要在苗族人群中进行强化的文化适宜性预防保健管理，以管理痛风以及糖尿病、高血压、心脏病和肾脏病。
