To examine trends in hospital length of stay, total costs and comorbidities in chronic Gout patients with and without tophus.

METHODS: The latest available 2016 National Inpatient Sample (NIS) data set from the Healthcare Cost and Utilization Project was utilized in order to determine the number of hospital admissions for patients with chronic gout (w/o tophus). Propensity score matched analysis was conducted to compare hospital LOS and costs in patients w/o tophus . Thirty comorbidities were assessed using Elixhauser scoring. Multivariate logistic regression was conducted to assess predictor variables for LOS and costs.

RESULTS:

In 2016, there were an estimated 40,065 hospitalizations with a diagnosis of chronic gout, of which 20.5% were with tophus . The mean age was 70.5 (SD 13.1) and 69.5 (SD 14.1), and 25.5% and 31.3% were female in chronic gout with and without tophus, respectively. The overall co-morbidity index in all chronic gout patients (with or without tophus) was 4.88 (SD 2.22). Most common comorbidities (more than 20%) were congestive heart failure (40.4%), cardiac arrhythmias (39.1%), hypertension (37.6%), chronic pulmonary disease (26.8%), diabetes with complications (24.5%), renal failure (51.2%) and obesity (23.2%). The propensity score matched hospital LOS was 6.4 and 5.2, with a statistically significant difference of 1.2 days (SE 0.27, P<0.05), in chronic gout with and without tophus, respectively. The propensity score matched hospital charges were $61,116 and $48,592, with a statistically significant difference of $12,524 (SE $4554, P<0.05), in chronic gout with and without tophus, respectively.

CONCLUSIONS: Chronic gout patients with or without tophus suffer from high rate of comorbidities leading to long hospital length of stay and high costs. The chronic gout patients with tophus have relatively more burden of hospitalizations compared to patients without tophus.