For a study, researchers sought to look into the risks and patterns of hospitalization for ambulatory care-sensitive conditions (ACSCs) in gout.
Those with no doctor-diagnosed gout from 1998 to 2005 (n=576,659) in Skne, Sweden, were tracked from January 1, 2006, until a hospital admission for an ACSC, death, move outside Skåne, or December 31, 2016. They utilized Cox proportional and additive hazard models to evaluate the impact of gout on hospital admissions for ACSCs, using a new gout diagnosis (International Classification of Diseases, 10th revision, code M10) as a time-varying exposure. In an age- and sex-matched cohort research, we studied the trajectory of hospital admissions for ACSCs from 3 years before to 3 years after gout diagnosis using generalized estimating equations and group-based trajectory modeling.
Gout was related with a 41% higher incidence of hospital admission for ACSCs (hazard ratio 1.41, 95% CI 1.35-1.47), equating to 121 (95% CI 104-138) more hospital admissions for ACSCs per 10,000 person-years compared to those who did not have gout. Our trajectory analysis revealed that those with gout had greater rates of hospitalization for ACSCs from 3 years before to 3 years after diagnosis, with the greatest prevalence rate ratio (2.22, 95% CI 1.92-2.53) at 3 months after diagnosis. They found three types of individuals with gout who had separate trajectories of hospital admissions for ACSCs: nearly none (88.5%), low-increasing (9.7%), and moderate-sharply rising (1.8%). The most important predictor of trajectory class membership was the Charlson Comorbidity Index.
The increased likelihood of hospitalization for ACSCs in gout underscores the need for improved disease treatment through outpatient care, particularly among foreign-born, elderly patients with comorbidities.