Outpatient Gout Follow-up After an Emergency Department Visit for Gout Flares

医学 痛风 急诊科 优势比 队列 置信区间 内科学 门诊部 高尿酸血症 物理疗法 尿酸 精神科
作者
Lesley E. Jackson,Elizabeth Lopez,Kenneth G. Saag,Rahima Begum,Gary Cutter,Maria I. Danila
出处
期刊:Jcr-journal of Clinical Rheumatology [Lippincott Williams & Wilkins]
标识
DOI:10.1097/rhu.0000000000002231
摘要

Objective Gout follow-up after an emergency department (ED) visit for gout flare may improve outcomes, which could be influenced by demographics and social determinants of health. We aimed to determine the factors associated with outpatient gout follow-up within our health care system within 6 months following an ED visit for a gout flare. Methods This historical cohort study was conducted at an academic medical center that includes 3 EDs and 1 urban urgent care. Among patients with a gout flare during their ED visit, we determined the presence/absence of an outpatient visit for gout within 6 months of the ED visit. We reported the proportion of patients who received outpatient gout follow-up. We used multivariable logistic regression to test the association between key covariates and outpatient follow-up for gout. Results From September 2021 to August 2022, we analyzed 159 patients with gout flare at the ED visit, of whom 56 (35.2%) had an outpatient visit addressing gout within 6 months. Being married (odds ratio [OR], 2.66; confidence interval [CI], 1.25–5.68; p = 0.01), absence of comorbidities (OR, 3.86; CI, 1.01–14.71; p = 0.048), use of colchicine at the ED visit or discharge (OR, 2.67; CI, 1.18–6.02; p = 0.02), and increased age (OR, 1.44; CI, 1.15–1.82; p = 0.002, for each 5-year increase) were associated with increased odds of gout follow-up. Conclusions Among a cohort of patients seeking urgent/emergent care for gout flare, only one-third followed up for gout in the outpatient setting. Modifiable factors such as colchicine prescription use were associated with gout follow-up, which may represent areas to target in future studies focused on promoting improved outpatient follow-up for gout.

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