Arthritis & Rheumatism, Volume 62,
November 2010 Abstract Supplement

Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Atlanta, Georgia November 6-11, 2010.


The Association of Race with Gout: A Broadly Representative Inpatient Survey.

Gelber1,  Allan C., Maynard2,  Janet W., Haywood Jr2,  Carlton

Baltimore, MD
Johns Hopkins University, Baltimore, MD

Purpose:

Gout is a leading cause of inflammatory arthritis. Established risk factors for gout include age, gender, hypertension and obesity. Relatively few studies have examined the association of race with gout status. We sought to determine, in a large, nationally representative survey of inpatient hospital stays, whether race was independently related to gout risk.

Method:

We examined the 2004 Nationwide Inpatient Sample. In that calendar year, 37 states contributed data to the survey. For each hospital stay, one primary and 14 secondary ICD-9 diagnoses were recorded, as well as race, age, gender, socioeconomic status (SES) measures of health insurance and median household income for ZIP code. Hospital size and teaching status were recorded. We ascertained all hospital stays with a primary or secondary diagnosis of gout. The presence of co-morbid hypertension, obesity, acute and chronic renal insufficiency and sickle cell disease was identified. Our analyses were restricted to the 26 states that used race as a demographic code, and to patients aged 18–65 years. Using logistic regression, we examined the independent association of race with prevalent gout, with adjustment for demographic variables, co-morbidity profile, SES and hospital characteristics.

Results:

A total of 2,332,974 hospital stays met the inclusion criteria. There were 18,851 (0.8%) hospitalizations in which a discharge diagnosis of gout was recorded. Overall, the study population was 62% female, 22.3% black and 77.7% white. Mean age was 43 years. In the dataset, 20% were receiving Medicaid, 29% had a household income <$36,000, 7% were diagnosed with obesity, 29% with hypertension, 2% with acute and 1.5% with chronic renal failure. These admissions were comprised of 47% urban teaching hospitals; 44% in the South, 26% in Northeast. Compared to the white patients, the risk of gout among the black patients in the survey is as follows:

ModelOR95% CI
Race, unadjusted1.441.40–1.49
Race, age-adjusted1.711.66–1.76
Race, gender-adjusted1.461.41–1.51
Race, hypertension-adjusted1.141.11–1.18
Race, obesity-adjusted1.431.39–1.48
Race, age, gender, hypertension, obesity1.511.46–1.56
Race, age, gender, co-morbidity, SES, hospital profile-adjusted1.511.45–1.56

Conclusion:

In a broadly representative 2004 sample of US hospitalizations, black race was associated with a 50% increase in risk for coexistent gout. Clinicians evaluating hospitalized adult patients who manifest joint pain and swelling, ought to consider the greater burden of gout among the black segment of the American population.

To cite this abstract, please use the following information:
Gelber, Allan C., Maynard, Janet W., Haywood Jr, Carlton; The Association of Race with Gout: A Broadly Representative Inpatient Survey. [abstract]. Arthritis Rheum 2010;62 Suppl 10 :1565
DOI: 10.1002/art.29331

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