title: Hyperuricemia is associated with increased hospitalization risk and healthcare costs: Evidence from an administrative database in Italy.
abstract: Chronic hyperuricemia is responsible for a relevant burden of articular diseases and cardio-nephrometabolic disorders. We evaluated the effect of high serum uric acid (SUA) levels on hospitalization risk and mortality and on healthcare costs in a real-life setting.
  
  
  
  We conducted a retrospective analysis using a large administrative database and a clinical registry among 112,170 subjects from three Italian local health units. Individuals were divided into four groups according to their SUA levels: <6 mg/dL (66.5%), >6 mg/dL and ≤7 mg/dL (19.3%), >7 mg/dL and ≤8 mg/dL (8.7%), and >8 mg/dL (5.5%). Compared to those with SUA level of <6 mg/dL, the risk of hospitalization related to gout and/or nephrolithiasis was higher in the three groups of patients with higher SUA levels (1.51, P = 0.100; 2.21, P = 0.005; and 1.17, P = 0.703, respectively). A similar trend was also observed for hospitalization due to chronic kidney disease (CKD) (1.31, P < 0.001; 1.40, P < 0.001; and 2.18, P < 0.001, respectively) and cardiovascular disease (CVD) (1.08, P < 0.001; 1.23, P < 0.001; and 1.67, P < 0.001, respectively) and for all-cause mortality (0.97, P = 0.309; 1.21, P < 0.001; and 2.15, P < 0.001). The mean annual healthcare costs were higher in patients with higher SUA level (€2752, €2957, €3386, and €4607, respectively) mainly because of a progressive increase in hospitalization costs per patient (from € 1515 for SUA <6 mg/dL to € 3096 for SUA >8 mg/dL).
  
  
  
  Increased SUA levels are associated with an increased risk of hospitalizations related to hyperuricemia, CKD, and CVDs and total mortality, and consequently with higher total healthcare costs and hospitalization costs per patient.
authors.affiliation: CliCon S.r.l. Health, Economics & Outcomes Research, Ravenna, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Degli Esposti
authors.affiliation: Geriatric Unit, Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy. Electronic address: giovambattista.desideri@univaq.it.
authors.forename: G
authors.initials: G
authors.lastname: Desideri
authors.affiliation: CliCon S.r.l. Health, Economics & Outcomes Research, Ravenna, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Saragoni
authors.affiliation: CliCon S.r.l. Health, Economics & Outcomes Research, Ravenna, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Buda
authors.affiliation: Department of Internal Medicine, University of Genoa and IRCCS Azienda Ospedaliera Universitaria San Martino-IST, Genoa, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Pontremoli
authors.affiliation: Department of Internal Medicine Unit, Aging and Kidney Disease, University of Bologna, Bologna, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Borghi
mesh_terms: D000067575:Administrative Claims, Healthcare; D000368:Aged; D015415:Biomarkers / Q000097:blood; D016208:Databases, Factual; D003695:Delivery of Health Care / Q000191:economics*; D005260:Female; D017721:Hospital Costs; D006760:Hospitalization / Q000191:economics*; D006801:Humans; D033461:Hyperuricemia / Q000175:diagnosis / Q000191:economics* / Q000401:mortality / Q000628:therapy*; D007558:Italy; D008297:Male; D008875:Middle Aged; D018803:Models, Economic; D012042:Registries; D012189:Retrospective Studies; D015854:Up-Regulation; D014527:Uric Acid / Q000097:blood
chemical_list: D015415:Biomarkers; D014527:Uric Acid
keywords: Gout; Healthcare costs; Hospitalization risk; Hyperuricemia