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Gout and hospital admission for ambulatory care sensitive conditions:risks and trajectories

Kiadaliri, Ali LU orcid ; Neogi, Tuhina and Englund, Martin LU orcid (2022) In The Journal of rheumatology 49(7). p.731-739
Abstract
Objective To investigate the risks and trajectories of hospital admission for ambulatory care sensitive conditions (HACSCs) in gout.

Methods Among individuals aged 35-85 years residing in Skåne, Sweden, in 2005, those with no doctor-diagnosed gout during 1998–2005 (n=576,700) were followed from January 1st 2006 until an HACSC, death, relocation outside Skåne, or December 31st 2016. Treating a new gout diagnosis (ICD 10 code: M10) as a time-varying exposure, we used Cox proportional and additive hazard models to estimate the effects of gout on HACSCs. We investigated the trajectory of HACSCs from 3 years before to 3 years after gout diagnosis using generalized estimating equations and group-based trajectory modelling in an age- and... (More)
Objective To investigate the risks and trajectories of hospital admission for ambulatory care sensitive conditions (HACSCs) in gout.

Methods Among individuals aged 35-85 years residing in Skåne, Sweden, in 2005, those with no doctor-diagnosed gout during 1998–2005 (n=576,700) were followed from January 1st 2006 until an HACSC, death, relocation outside Skåne, or December 31st 2016. Treating a new gout diagnosis (ICD 10 code: M10) as a time-varying exposure, we used Cox proportional and additive hazard models to estimate the effects of gout on HACSCs. We investigated the trajectory of HACSCs from 3 years before to 3 years after gout diagnosis using generalized estimating equations and group-based trajectory modelling in an age- and sex-matched cohort study.

Results Gout was associated with 41% increased rate of HACSCs (hazard ratio 1.41; 95% CI: 1.35, 1.47), corresponding to 121 (104, 138) more HACSCs per 10,000 person-years compared with those without gout. Our trajectory analysis showed that higher rates of HACSCs among persons with gout were observed from 3 years before to 3 years after diagnosis with the highest prevalence rate ratio (2.22, 95% CI: 1.92, 2.53) at the 3-month period after diagnosis. We identified three classes with distinct trajectories of HACSCs among gout persons: almost none (88.5%), low-rising (9.7%), and moderate-sharply rising (1.8%). Charlson comorbidity index was the most important predictor of trajectory class membership.

Conclusion Increased risk of HACSCs in gout highlights the need for better management of the disease at outpatient care, especially among foreign-born older patients with comorbidities. (Less)
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author
; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
The Journal of rheumatology
volume
49
issue
7
article number
jrheum.220038
pages
9 pages
publisher
Journal of Rheumatology Publishing Company Limited
external identifiers
  • pmid:35428711
  • scopus:85133523132
ISSN
0315-162X
DOI
10.3899/jrheum.220038
language
English
LU publication?
yes
id
6af29c14-ca6f-4673-bac2-5f848e6b3c5c
date added to LUP
2022-04-18 16:18:23
date last changed
2022-09-22 15:36:49
@article{6af29c14-ca6f-4673-bac2-5f848e6b3c5c,
  abstract     = {{Objective To investigate the risks and trajectories of hospital admission for ambulatory care sensitive conditions (HACSCs) in gout.<br/><br/>Methods Among individuals aged 35-85 years residing in Skåne, Sweden, in 2005, those with no doctor-diagnosed gout during 1998–2005 (n=576,700) were followed from January 1st 2006 until an HACSC, death, relocation outside Skåne, or December 31st 2016. Treating a new gout diagnosis (ICD 10 code: M10) as a time-varying exposure, we used Cox proportional and additive hazard models to estimate the effects of gout on HACSCs. We investigated the trajectory of HACSCs from 3 years before to 3 years after gout diagnosis using generalized estimating equations and group-based trajectory modelling in an age- and sex-matched cohort study.<br/><br/>Results Gout was associated with 41% increased rate of HACSCs (hazard ratio 1.41; 95% CI: 1.35, 1.47), corresponding to 121 (104, 138) more HACSCs per 10,000 person-years compared with those without gout. Our trajectory analysis showed that higher rates of HACSCs among persons with gout were observed from 3 years before to 3 years after diagnosis with the highest prevalence rate ratio (2.22, 95% CI: 1.92, 2.53) at the 3-month period after diagnosis. We identified three classes with distinct trajectories of HACSCs among gout persons: almost none (88.5%), low-rising (9.7%), and moderate-sharply rising (1.8%). Charlson comorbidity index was the most important predictor of trajectory class membership.<br/><br/>Conclusion Increased risk of HACSCs in gout highlights the need for better management of the disease at outpatient care, especially among foreign-born older patients with comorbidities.}},
  author       = {{Kiadaliri, Ali and Neogi, Tuhina and Englund, Martin}},
  issn         = {{0315-162X}},
  language     = {{eng}},
  number       = {{7}},
  pages        = {{731--739}},
  publisher    = {{Journal of Rheumatology Publishing Company Limited}},
  series       = {{The Journal of rheumatology}},
  title        = {{Gout and hospital admission for ambulatory care sensitive conditions:risks and trajectories}},
  url          = {{http://dx.doi.org/10.3899/jrheum.220038}},
  doi          = {{10.3899/jrheum.220038}},
  volume       = {{49}},
  year         = {{2022}},
}