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Dr Mats Dehlin
M
ats Dehlin, MD, of the Sahlgrenska
Academy at the University of Gothenburg,
Sweden, explained that gout is the most
common arthritic disease in the world, and inci-
dence and prevalence are increasing. An increase
in hospitalization for gout has been shown over
the last two decades in North America.
“It is important to collect these data from different
parts of the world as gout prevalence will vary as
well as the course of the disease, due to cultural,
ethnic and genetic factors,” Dr Dehlin said.
Dr Dehlin and colleagues set out to assess
hospitalization trends for gout using data from
the healthcare consumption register from 2001
through 2012 in the Western Swedish Health Care
Region, an area of the country believed to repre-
sent the whole of Sweden. Patients aged 18 years
and older who were hospitalized during the study
period with a principal ICD-10 diagnosis of gout at
discharge were included.
Dr Dehlin and coinvestigators calculated annual
population rates for hospitalization for gout.
Inflation-adjusted healthcare costs for gout
hospitalizations were calculated using the Cost-
Per-Patient register. Dispensation of urate-lowering
therapy, including allopurinol and probenecid, was
identified using the Swedish Prescribed Drug
Register within 6 months prior to hospitalization.
A total of 1873 hospitalizations for gout were
recorded (mean patient age 75.0–77.6 years,
61–74% men) between 2000 and 2012.
Demographic characteristics were similar over
the study period.
From 2000 to 2012, the annual hospitalization rate
for gout in western Sweden increased from 12.2
to 16.7 per 100,000 adults (P = 0.0038). This rise
was most pronounced over the last 3 years of
the study in males aged 65 years and older. In
addition, the length of hospitalization increased
from a median of 3 to 5 days in 2000 and 2012,
respectively (P = 0.021). The increase was exac-
erbated by widespread failure to treat.
The findings are in marked contrast to the over-
all trend in hospitalization across the Western
Swedish Health Care Region. Over the same
decade, the number of days of inpatient care due
to physical conditions in the region decreased
by 9% from 2002 to 2012 (1,267,900 days, mean
duration 5.7 vs 1,151,630 days, mean duration 4.9
days, respectively).
From 2009 to 2012, inflation-adjusted healthcare
costs for gout hospitalization increased from
$521,000 to $815,000. Only a minority of patients,
19% to 27%, received urate-lowering therapy in
the 6 months preceding hospitalisation, with no
obvious cyclical or seasonal trend.
Dr Dehlin concluded, “The incidence of hospitaliza-
tion for primary gout has increased substantially in
Sweden over the last decade, and this is reflected
in associated healthcare costs. Though we would
expect more hospitalizations due to the increasing
incidence of gout among an aging population, the
Failure to prescribe
urate-lowering
treatment exacerbates
hospitalisation for gout
Hospitalisation for gout has risen over the last
decade, with a resultant increase in healthcare
costs, in a major region of Sweden. Many patients
admitted to hospital had not been receiving the
recommended urate-lowering treatment, finds a
population-based registry study.
PRACTICEUPDATE CONFERENCE SERIES • EULAR CONGRESS 2017
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