RT Journal Article
SR Electronic
T1 Frequency, Risk, and Cost of Gout-related Episodes Among the Elderly: Does Serum Uric Acid Level Matter?
JF The Journal of Rheumatology
JO J Rheumatol
FD The Journal of Rheumatology
SP 1032
OP 1040
DO 10.3899/jrheum.080487
VO 36
IS 5
A1 ERIC Q. WU
A1 PANKAJ A. PATEL
A1 REEMA R. MODY
A1 ANDREW P. YU
A1 KEVIN E. CAHILL
A1 JACKSON TANG
A1 ESWAR KRISHNAN
YR 2009
UL http://www.jrheum.org/content/36/5/1032.abstract
AB Objective. We examined the association between serum uric acid (SUA) level and the frequency, risk, and cost of gout flares among the elderly. Methods. Data were extracted from the Integrated Healthcare Information Services claims database (1999–2005). Patients were included if they had gout, were aged 65 years and older and had both medical and pharmacy benefits, and electronic laboratory data. Patients with gout and gouty episodes were identified using algorithms based on ICD-9-CM codes and medications. Logistic regression and negative binomial regressions were used to study the relationship between SUA concentration and the annual frequency and one-year risk of gout episodes. Generalized linear models were used to examine the direct healthcare costs associated with gout episodes in the 30 days following each episode. Results. Elderly patients with gout (n = 2237) with high (6–8.99 mg/dl) and very high (> 9 mg/dl) SUA concentrations were more likely to develop a flare within 12 months compared to patients with normal (< 6 mg/dl) SUA levels (OR 2.1, 95% CI 1.7–2.6; OR 3.4, 95% CI 2.6–4.4, respectively). In multivariate regressions, the average annual number of flares increased by 11.9% (p < 0.001) with each unit-increase in SUA level above 6 mg/dl (p < 0.001). Among patients with very high SUA levels, average adjusted total healthcare and gout-related costs per episode were $2,555 and $356 higher, respectively, than those of patients with normal SUA levels (both p < 0.001). Conclusion. Higher SUA levels are associated with increased frequency and risk of gout episode, and with higher total and gout-related direct healthcare costs per episode.