To study the epidemiology of hospitalized serious infections in people with gout.
We identified people with gout hospitalized with a primary diagnosis of pneumonia, sepsis/bacteremia, urinary tract infection (UTI), skin and soft tissue infections (SSTI), or opportunistic infections (OI) in 1998-2016 U.S. National Inpatient Sample, and examined factors associated with utilization and mortality.
We noted 1,140,085 hospitalized serious infections in gout (11% of all gout hospitalizations; 1998-2000, 8.9%; 2015-2016, 14.5%). Compared to no gout, people with gout with hospitalized serious infections were older (65 vs. 74 years), more had Deyo-Charlson comorbidity score ≥2 (42% vs. 65%) and fewer were female (53% vs. 35%), or non-White (40% vs. 35%), respectively. The most common infection was pneumonia (52%) in 1998-2000 and sepsis (52%) in 2015-2016. Median hospital charges and hospital stay were higher for sepsis and OI in 2015-2016 ($41k-$42k; 5.1-5.5 days) versus UTI, pneumonia or SSTI ($15k-17k; 3-3.9 days). Compared to sepsis, multivariable-adjusted odds of healthcare utilization and in-hospital mortality were significantly lower in UTI, SSTI and pneumonia, and non-home discharge or in-hospital mortality were lower in OI. Among hospitalized infections, older age, Medicaid, higher Deyo-Charlson score, being Black, and Northeast and non-rural hospital location were associated with significantly higher healthcare utilization and mortality; and female sex, Medicare insurance and lower income with higher utilization.
Given an increasing rate of serious infections in people with gout, especially sepsis and pneumonia, development of effective interventions targeting factors associated with utilization and mortality will improve outcomes and reduce burden.
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