Outcomes of gout in patients with cirrhosis: A national inpatient sample-based study.

BACKGROUND

Hyperuricemia is a prerequisite for the development of gout. Elevated serum uric acid (UA) levels result from either overproduction or decreased excretion. A positive correlation between serum UA levels, cirrhosis-related complications and the incidence of nonalcoholic fatty liver disease has been established, but it is unknown whether hyperuricemia results in worsening cirrhosis outcomes. We hypothesize that patients with cirrhosis will have poorer gout outcomes.

AIM

To explore the link between cirrhosis and the incidence of gout-related complications.

METHODS

This was a cross-sectional study. The national inpatient sample was used to identify patients hospitalized with gout, stratified based on a history of cirrhosis, from 2001 to 2013 the International Classification of Diseases, Ninth Revision, Clinical Modification codes. Primary outcomes were mortality, gout complications and joint interventions. The test and independent -test were performed to assess categorical and continuous data, respectively. Multiple logistic regression was used to control for confounding variables.

RESULTS

Patients without cirrhosis were older (70.37 ± 13.53 years 66.21 ± 12.325 years; < 0.05). Most patients were male (74.63% in the cirrhosis group 66.83%; adjusted < 0.05). Patients with cirrhosis had greater rates of mortality (5.49% 2.03%; adjusted < 0.05), gout flare (2.89% 2.77%; adjusted < 0.05) and tophi (0.97% 0.75%; adjusted = 0.677). Patients without cirrhosis had higher rates of arthrocentesis (2.45% 2.21%; adjusted < 0.05) and joint injections (0.72% 0.52%; adjusted < 0.05).

CONCLUSION

Gout complications were more common in cirrhosis. Those without cirrhosis had higher rates of interventions, possibly due to hesitancy with performing these interventions given the higher complication risk in cirrhosis.