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The Burden of Cardiac Arrhythmias in Gout: A National Representative Database Study
Mohammed Mhanna1, Ahmad Jabri2, Yazan Abu Omar3
1Division of Cardiology, Department of Medicine, University of Iowa, Iowa City, Iowa.
Insights
Gout patients with arrhythmias face higher mortality and longer hospital stays. Early detection and treatment of heart rhythm issues in gout patients can improve outcomes.
Area of Science:
- Cardiology
- Rheumatology
- Epidemiology
Background:
- The association between gout and cardiac arrhythmias is understudied.
- Arrhythmias may hold prognostic value in gout patients.
Purpose of the Study:
- To examine the burden, patterns, and outcomes of arrhythmias in hospitalized gout patients.
- To assess the impact of arrhythmias on mortality, length of stay, and costs in gout.
Main Methods:
- Retrospective cohort study using the US National Inpatient Sample (2015-2019).
- Multivariable logistic and linear regression models were employed.
- Analysis included incidence, trends, and predictors of mortality.
Main Results:
- Approximately one-fourth of gout hospitalizations (60,360 admissions) involved arrhythmias.
- Atrial fibrillation was the most common arrhythmia (88%).
- Gout patients with arrhythmias had higher mortality (aOR 2.06), longer LOS (4.3 vs 3.7 days), and increased costs ($33,057 vs $28,384).
Conclusions:
- Incident arrhythmias significantly increase mortality risk in gout patients.
- Hospitalized gout patients with concurrent arrhythmias experience worse outcomes.
- Early identification and management of arrhythmias are crucial for improving outcomes in gout.
Abstract:
The association between gout and arrhythmias has not been thoroughly examined. This study discusses the underappreciated burden, patterns, and outcomes of several arrhythmias, which may have prognostic value in patients with gout. This is a retrospective cohort study that used the US National Inpatient Sample for 2015-2019. Complex samples multivariable logistic and linear regression models were used to assess the incidence and trends in gout-related arrhythmia and consequential inpatient mortality, hospital length of stay (LOS), hospitalization charges, and predictors of mortality. Hospitalizations that included a diagnosis of gout accounted for 60,360 admissions. Arrhythmias affected roughly one-fourth of those. When compared to individuals without arrhythmia, those who experienced arrhythmias were older. Arrhythmias were found to be equally common in both men and women. The most common subtype was AF (88%), followed by atrial flutter (6.2%), conduction disorders (4.7%), and ventricular tachycardia (3.2%). In individuals with gout, there was a rising trend in arrhythmia-related hospital admissions and mortality. The gout-arrhythmia group had more traditional cardiac comorbidities. After adjusting for baseline variables, the arrhythmia group had significantly greater mortality (693 vs 77 per 100,000 hospitalizations), mean LOS (4.3 vs 3.7 days), and hospital costs ($33,057 vs $28,384). In gout, incident arrhythmia dramatically raised the risk of death (adjusted odds ratio, 2.06; 95% CI, 1.95-2.16; P < 0.001). Gout patients who are hospitalized with concurrent arrhythmia have a likelihood of longer stays in the hospital and higher mortality. Early identification and treatment of arrhythmia may benefit outcomes in gout patients.
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