Postoperative Recurrent Gout Flares: A Cross-sectional Study From China.
J Clin Rheumatol
; 26(5): 197-203, 2020 Aug.
Article
em En
| MEDLINE
| ID: mdl-31483351
ABSTRACT
OBJECTIVES:
To investigate the morbidity, clinical characteristics, and risk factors for postoperative recurrent gout flares (PRGFs).METHODS:
This cross-sectional study included all surgical patients at 2 academic institutions between 2010 and 2018. Data including demographics, prior history of gout, clinical variables, medications, and the occurrence of PRGFs were abstracted from medical records. Forward stepwise multivariable logistic regression analysis was used in the statistical analyses.RESULTS:
Among the 518 (0.5% [518/114,760]) surgical patients with a prior diagnosis of gout, 474 had sufficient documentation for analysis. Of these, 191 (40.3%) had experienced a PRGF. Most PRGFs (54.4%) were polyarticular gout; 79.6% had a pretreatment pain score of PRGFs ≥7, and 59.2% required combination pharmacologic therapy. The mean (SD) serum urate (SU) level decreased postoperatively (500.33 [122.77] vs. 380.15 [118.35] µmol/L; p = 0.000), with an average decrease of 125.86 µmol/L. The decrease in the postsurgical SU level was greater in patients who received postoperative total parenteral nutrition (PTPN) than in those who did not (p = 0.009), and it was correlated with the duration of PTPN (r = 0.156, p = 0.031). Factors independently associated with PRGFs were decrease in the postsurgical SU level by ≥126 µmol/L, previous flares involving the ankle, failure to take prophylactic colchicine therapy, and abdominal surgery.CONCLUSIONS:
Recurrent gout flares often occur postoperatively and are severe. For high-risk patients, especially those undergoing abdominal surgeries, timely monitoring of postsurgical SU level, colchicine prophylaxis, and avoiding the overuse of PTPN may help prevent PRGFs.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Supressores da Gota
/
Gota
Tipo de estudo:
Diagnostic_studies
/
Observational_studies
/
Prevalence_studies
/
Risk_factors_studies
Limite:
Humans
País/Região como assunto:
Asia
Idioma:
En
Ano de publicação:
2020
Tipo de documento:
Article