Treatment of acute gout in hospitalized patients.
OBJECTIVE
To record practice patterns of treatment of acute gout in hospitalized patients.


METHODS
We performed a retrospective chart review of hospitalized patients diagnosed with gout.


RESULTS
Seventy-nine (43%) patients were diagnosed with acute gout during their hospitalization. Fifty-eight (73%) patients with acute gout were found to have a reduction in their glomerular filtration rate. Twenty patients (25%) underwent arthrocentesis. The most widely used drugs for acute gout were colchicine, n = 42 (53%), and nonsteroidal antiinflammatory drugs (NSAID), n = 40 (51%). Combination therapy was used in 52% of patients with acute gout. Thiry-six (86%) patients treated with colchicine and 32 (80%) patients treated with NSAID had renal failure.


CONCLUSIONS
Crystal analysis, the gold standard for diagnosing gout, was performed in only 25% of patients suspected of acute gout. Combination antiinflammatory agents are used in over 50% of patients despite the absence of evidence to support use of such combinations. Renal failure was present in 73% of patients with acute gout. Colchicine and NSAID should therefore be used with caution in these patients. Practice patterns vary widely and often appear to be in conflict with recommended diagnostic and treatment measures for acute gout.
Petersel
Danielle
D
Rheumatology Division, Department of Medicine, University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School, New Brunswick, New Jersey 08903-0019, USA.
Schlesinger
Naomi
N
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000493:Allopurinol / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D002908:Chronic Disease; D003078:Colchicine / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D006073:Gout / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D006074:Gout Suppressants / Q000627:therapeutic use*; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians'; D051437:Renal Insufficiency / Q000150:complications / Q000209:etiology / Q000473:pathology; D012189:Retrospective Studies
D000894:Anti-Inflammatory Agents, Non-Steroidal; D006074:Gout Suppressants; D000493:Allopurinol; D003078:Colchicine