Postoperative Recurrent Gout Flares: A Cross-sectional Study From China

Area of Science:

• Rheumatology
• Surgical Patient Care
• Gout Management

Background:

• Postoperative recurrent gout flares (PRGFs) represent a significant clinical challenge.
• Understanding the incidence, characteristics, and risk factors of PRGFs is crucial for improving patient outcomes.

Purpose of the Study:

• To investigate the morbidity, clinical characteristics, and risk factors associated with postoperative recurrent gout flares (PRGFs).

Main Methods:

• A cross-sectional study was conducted on surgical patients from 2010-2018.
• Data on demographics, gout history, clinical variables, medications, and PRGF occurrence were extracted from medical records.
• Forward stepwise multivariable logistic regression was employed for statistical analysis.

Main Results:

• Of 474 analyzed patients with gout, 40.3% experienced PRGFs, often severe (pain score ≥7) and polyarticular.
• Serum urate levels decreased postoperatively, with a greater reduction observed in patients receiving postoperative total parenteral nutrition (PTPN).
• Independent risk factors for PRGFs included a significant serum urate decrease, prior ankle flares, lack of colchicine prophylaxis, and abdominal surgery.

Conclusions:

• PRGFs are frequent and severe postoperatively, particularly in patients undergoing abdominal surgery.
• Key preventive strategies include vigilant postsurgical serum urate monitoring, colchicine prophylaxis, and cautious use of PTPN.
• These interventions are vital for mitigating PRGFs in high-risk surgical populations.