DeMizio Daniel, Wu Guojing, Wei Ying, Bathon Joan, Wang Runsheng
Division of Rheumatology, Columbia University Irving Medical Center, 630 West 168th Street, Suite 3-450, New York, NY 10032, USA.
Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY, USA.
Ther Adv Musculoskelet Dis. 2022 Jun 14;14:1759720X221102853. doi: 10.1177/1759720X221102853. eCollection 2022.
It is unclear whether patients with a history of gout have longer hospitalizations in general, or only when suffering a flare. This study examines the effect of gout diagnosis and gout flare on the length of stay (LoS) in patients admitted for heart failure (HF) exacerbation.
We conducted a matched retrospective cohort study and searched electronic medical records for patients admitted for HF with a prior diagnosis of gout from 1 July 2012 to 30 June 2017 and matched them to patients admitted for HF without gout. Cases who had a gout flare during the admission were identified. The log of the length of stay (log LoS) was utilized for normalization of the data. We used a linear mixed-effect model to compare the adjusted LoS of gout patient with flare, gout patient without flare, and controls.
A total of 978 admissions for HF exacerbation in 738 patients, including 246 individual with gout and 492 matched controls, were identified and included in the analysis. The log LoS was significantly longer in cases (1.86 ± 0.95) compared with controls (1.72 ± 0.94; = 0.0278). The log LoS was significantly longer in those with gout who flared (2.41 ± 0.96) compared to those without gout (1.72 ± 0.94, < 0.0001). After adjusting for potential confounders, the log LoS of patients who flared ( < 0.0001) remained significantly longer than controls, as well as those who did not flare ( = 0.042), but to a lesser extent.
HF patients with gout had significantly longer hospitalizations than those without gout, a finding driven primarily by gout flare during hospitalization.
目前尚不清楚痛风病史患者总体住院时间是否更长,还是仅在痛风发作时住院时间更长。本研究探讨痛风诊断和痛风发作对因心力衰竭(HF)加重而住院患者住院时长(LoS)的影响。
我们进行了一项匹配的回顾性队列研究,在电子病历中搜索2012年7月1日至2017年6月30日期间因HF入院且先前诊断为痛风的患者,并将他们与因HF入院但无痛风的患者进行匹配。确定入院期间发生痛风发作的病例。使用住院时长的对数(log LoS)对数据进行标准化。我们使用线性混合效应模型比较痛风发作患者、无发作的痛风患者和对照组的调整后LoS。
共确定738例患者的978次HF加重住院病例,包括246例痛风患者和492例匹配的对照组,并纳入分析。病例组的log LoS(1.86±0.95)显著长于对照组(1.72±0.94;P = 0.0278)。痛风发作患者的log LoS(2.41±0.96)显著长于无痛风患者(1.72±0.94,P < 0.0001)。在调整潜在混杂因素后,发作患者(P < 0.0001)的log LoS仍显著长于对照组,未发作患者(P = 0.042)也是如此,但程度较轻。
痛风HF患者的住院时间显著长于无痛风患者,这一发现主要由住院期间的痛风发作所致。