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Treatment of Acute Gout in Hospitalized Patients
DANIELLE PETERSEL and NAOMI SCHLESINGER
ABSTRACT. Methods. We performed a retrospective chart review of hospitalized patients diagnosed with gout. Results. Seventy-nine (43%) patients were diagnosed with acute gout during their hospitalization. Fifty-eight (73%) patients with acute gout were found to have a reduction in their glomerular filtration rate. Twenty patients (25%) underwent arthrocentesis. The most widely used drugs for acute gout were colchicine, n = 42 (53%), and nonsteroidal antiinflammatory drugs (NSAID), n = 40 (51%). Combination therapy was used in 52% of patients with acute gout. Thiry-six (86%) patients treated with colchicine and 32 (80%) patients treated with NSAID had renal failure. Discussion. Crystal analysis, the gold standard for diagnosing gout, was performed in only 25% of patients suspected of acute gout. Combination antiinflammatory agents are used in over 50% of patients despite the absence of evidence to support use of such combinations. Renal failure was present in 73% of patients with acute gout. Colchicine and NSAID should therefore be used with caution in these patients. Practice patterns vary widely and often appear to be in conflict with recommended diagnostic and treatment measures for acute gout. (First Release June 15 2007; J Rheumatol 2007;34:1566-8) Key Indexing Terms:
GOUT
From the Rheumatology Division, Department of Medicine, University of Medicine and Dentistry of New Jersey/Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA. D. Petersel, MD, Former Fellow; N. Schlesinger, MD, Associate Professor of Medicine, Chief, Division of Rheumatology, Department of Medicine, UMDNJ/RWJMS. Address reprint requests to Dr. N. Schlesinger, Division of Rheumatology, Department of Medicine, UMDNJ-Robert Wood Johnson Medical School, One Robert Wood Johnson Pl., PO Box 19, New Brunswick, NJ 08903-0019. E-mail: schlesna@umdnj.edu Accepted for publication March 9, 2007. |
