Hospital Gout management: A Lost Opportunity

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Hospital Gout management: A Lost Opportunity

Gout is one of the most prevalent crystal-induced arthropathy widespread in 1-4% population globally with subprime management agendas. A retrospective audit was conducted in Christchurch Hospital from June 1, 2013, to May 31, 2014, by Sarah Wright and colleagues to examine acute flares and urate-lowering management agreed with international recommendations among gout patients.

The study involved comorbidities, demographics, treatment of acute gout, urate lowering and concomitant medications. During the evaluation, gout was classified as a primary or secondary discharge diagnosis.

A total 216 patients were identified with 235 acute gout admissions. Out of which, four patients admitted three times, and 11 patients admitted two times. The primary gout diagnosis was made among 95 admissions and the 75 admissions diagnosed with acute gout. The management of acute gout was done among 170 patients with prednisone monotherapy. Further, the serum urate was diagnosed in 123 admissions out of 235. Out of these 123, only 19 entries identified with target urate level (< 0.36 mmol/l). By this time, the urate-lowering therapy was recommended to 60 admissions out of 235. A total of nine entries out of 175 did not initiate urate-lowering treatment at admission commenced allopurinol, whereas, 32 out of 174 admissions treated with urate-lowering therapy which was prescribed in the discharge plan.

The overall analysis illustrates that gout admissions rates are identical to that noticed in other studies. The admitted gout patients who failed to begin, change or prescribe adaptations in urate-lowering therapy attain target urate represents a critical lost opportunity to enhance everlasting gout management.


J Rheumatol. 2017 Aug 1. pii: jrheum.170387

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Original title of article:

Management of Gout in a Hospital Setting: A Lost Opportunity


Sarah Wright; et al.

Diagnostic, Prednisone, Gout, Gout management, Acute, Hospital, Lost opportunity
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