Abstract
Little is known about the effect of gout on in-hospital complications and healthcare utilization after total hip arthroplasty (THA). We used the 1998-2014 U.S. National Inpatient Sample (NIS) to examine this question using cohort study design. Multivariable-adjusted Cox regression analyses included age, race, gender, underlying diagnosis, Deyo-Romano comorbidity index, insurance payer, and income. In adjusted analyses, we found that gout was associated with 9-20% higher healthcare utilization and 6% higher hazard of transfusion after primary THA. These findings can inform surgeons and patients of gout-associated complications post-THA.
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Change history
29 July 2019
The above article originally published with an error present in Table 1. The data <Emphasis Type="Bold">“Home”</Emphasis> on the first column of the Table 1 should be interchange with the previous data <Emphasis Type="Bold">“Inpatient facility†”. This is presented correctly in this article.</Emphasis>
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Funding
This material is the result of work supported by research funds from the Division of Rheumatology at the University of Alabama at Birmingham and the resources and use of facilities at the Birmingham VA Medical Center, Birmingham, AL, USA.
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Mr. Cleveland had full access to all of the data in the study and takes the responsibility for the integrity of the data and accuracy of the data analysis. He was supervised by Dr. Singh, who reviewed all results.
Study concept and design: Singh
Data acquisition, analysis, and interpretation of results: Singh and Cleveland
Drafting of the manuscript: Singh
Critical revision of the manuscript for important intellectual content: Singh and Cleveland
Statistical analysis: Cleveland
Obtained funding: Singh
Administrative, technical, or material support: Singh
Study supervision: Singh
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Conflict of interest disclosures
JAS has received research grants from Takeda and Savient and consultant fees from Savient, Takeda, Regeneron, Merz, Iroko, Bioiberica, Crealta/Horizon and Allergan pharmaceuticals, WebMD, UBM LLC, and the American College of Rheumatology. JAS owns stock options in Amarin pharmaceuticals and Viking therapeutics. JAS serves as the principal investigator for an investigator-initiated study funded by Horizon pharmaceuticals through a grant to DINORA, Inc., a 501 (c)(3) entity. JAS is a member of the executive of OMERACT, an organization that develops outcome measures in rheumatology and receives arms-length funding from 36 companies; a member of the American College of Rheumatology’s (ACR) Annual Meeting Planning Committee (AMPC); Chair of the ACR Meet-the-Professor, Workshop and Study Group Subcommittee; and a member of the Veterans Affairs Rheumatology Field Advisory Committee. JAS is the editor and Director of the UAB Cochrane Musculoskeletal Group Satellite Center on Network Meta-analysis. DC has no conflicts to declare. There are no non-financial competing interests for any of the authors.
Role of the funder/supporter
The funding body did not play any role in design, in the collection, analysis, and interpretation of data; in the writing of the manuscript; and in the decision to submit the manuscript for publication.
Additional contributions
We thank the patients at the University of Alabama gout clinic for asking us questions about comorbidities of gout and whether gout may be related to their other conditions, which prompted us to ask this question.
Ethics/IRB approval and consent to participate
The University of Alabama at Birmingham’s Institutional Review Board approved this study and waived the need for informed consent for this database study. All investigations were conducted in conformity with ethical principles of research.
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Singh, J.A., Cleveland, J.D. Gout and healthcare utilization and complications after hip arthroplasty: a cohort study using the US National Inpatient Sample (NIS). Clin Rheumatol 38, 1213–1216 (2019). https://doi.org/10.1007/s10067-019-04434-3
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DOI: https://doi.org/10.1007/s10067-019-04434-3