Table 2.
Outcomes during hospitalizations for gout flares, comparing the pre- and post-implementation cohorts
| Outcome | Pre-implementation, n (%) (n = 119) | Post-implementation, n (%) (n = 108) | Odds ratio (95% CI) | P-value |
|---|---|---|---|---|
| Rheumatology input during hospitalization | 65 (54.6) | 82 (75.9) | 2.48 (1.37, 4.52) | 0.003 |
| Serum urate level performed | 79 (66.4) | 100 (92.6) | 6.32 (2.75, 14.5) | <0.001 |
| Joint aspiration performed | 23 (19.3) | 51 (47.2) | 3.44 (1.88, 6.27) | <0.001 |
| Flare treatment prescribed | 111 (93.3) | 106 (98.1) | 4.46 (0.91, 21.8) | 0.065 |
| NSAIDs | 38 (31.9) | 34 (31.5) | 1.18 (0.61, 2.28) | 0.63 |
| Colchicine | 74 (62.2) | 86 (79.6) | 2.30 (1.23, 4.31) | 0.009 |
| Corticosteroids | 25 (21.0) | 40 (37.0) | 2.20 (1.21, 4.02) | 0.010 |
| Multiple flare treatments prescribed | 21 (17.6) | 49 (45.4) | 4.10 (2.20, 7.67) | <0.001 |
| Intra-articular steroid injection | 2 (1.7) | 9 (8.3) | 5.53 (1.15, 26.7) | 0.033 |
| Disease education documented prior to discharge | 27 (22.7) | 24 (22.2) | 1.00 (0.53, 1.90) | 0.99 |
| ULT initiated and/or titrated during hospitalization | 21 (17.6) | 67 (62.0) | 7.69 (4.12, 14.4) | <0.001 |
| Gout recommendations documented on discharge | 70 (58.8) | 93 (86.1) | 4.33 (2.21, 8.48) | <0.001 |
| Recommendation to initiate and/or titrate ULT after discharge | 18 (15.1) | 42 (38.9) | 3.26 (1.71, 6.19) | <0.001 |
| Recommendation for prophylaxis while titrating ULT | 23 (19.3) | 13 (12.0) | 0.54 (0.26, 1.15) | 0.11 |
| Recommendation for target serum urate level | 13 (10.9) | 28 (25.9) | 2.56 (1.23, 5.36) | 0.012 |
| Recommendation for primary care follow-up | 53 (44.5) | 43 (39.8) | 0.82 (0.48, 1.41) | 0.47 |
| Recommendation for rheumatology/gout clinic follow-up | 11 (9.2) | 73 (67.6) | 19.8 (9.34, 42.0) | <0.001 |
Odds ratios from logistic regression models are shown, with adjustment for age and sex. ULT: urate-lowering therapy.