Background/Purpose:Gout is a common cause of inflammatory arthritis due to accumulation of monosodium urate crystals in joints, bones and soft tissues. The aim of the study will be to understand the epidemiological characteristics of acute gout (ICD 9 code: 274.01) as a primary diagnosis in hospital discharges in the year 2014 using the National Inpatient Sample (NIS).

Methods:The NIS is a nationally representative sample of 20% of all non-federal hospitals in the USA with information from approximately 1000 hospitals pertaining to records from 7 million inpatient hospital admissions. The epidemiological characteristics we studied were age, gender, race, payer (Medicare/Medicaid/private insurance/uninsured), patient residence (large central metro, suburbs, medium and small metro and rural areas) and region (northeast, mid-west, southern and west) and associated co-morbidities: hypertension,diabetes,heart failure, chronic kidney disease,osteoarthritis & heart failure. Multiple linear regression was used to analyze factors that were associated with an increased length of stay.

Results:For 2014, from a total of nearly 7 million records (7,071,762), there were 11,415 admissions for acute gout as the primary diagnosis (0.16%) which translated to 3.6 admissions per 100,000 persons.The majority of admissions were in the age group of 65 – 84 years (46.1 %) followed by 45-64 age group (34.3%). A majority of the admissions were males (67.3%) compared to females (32.3%). Gout was most prevalent among Caucasians (65.8%). African Americans represented 14.8% of all admissions followed by Hispanics at 12.1%. Asian or pacific islanders were 2.8% whereas Native Americans represented 0.6%.The total aggregate costs were $76,249,619 for 2014 amounting to a mean of $6,654 per admission. Medicare remained the highest payer (62.8%) followed by private insurance (17.7%) and finally Medicaid (12.9%). Uninsured patients accounted for 5.2% of all admissions.Patients from a large central metro were the majority of inpatient admissions (39.1%) followed medium and small sized metro (25.1%). 24.1% of patients were from the suburbs and whereas only 11% were from a rural area.The southern region accounted for majority of admissions(33.2%)followed by northeast region(26.9%).23.8% were from Midwest and Western region had only 15.9% of all admissions. The mean length of stay(LOS)was 3.9 ± 0.06 days. CKD was present in 47.8%,hypertension in 37.5%,CAD in 35.5%, heart failure in 35.1%,diabetes in 28.4% and osteoarthritis in 16% of patients. Using multivariate analysis the only factors significantly affecting LOS were female gender and presence of heart failure. Female gender was inversely related to LOS (p<0.001) whereas heart failure exacerbation resulted in an increased LOS (p<0.001)

Conclusion: Acute gout places a significant burden on in-hospital resources. Although CKD was present in nearly half of patients, only gender & heart failure resulted in significantly affecting LOS.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/epidemiological-characteristics-of-inpatient-admissions-for-acute-inflammatory-gout-arthropathy-and-factors-affecting-length-of-stay-a-national-level-study/