Gout Increases Length Of Stay In Patients Hospitalized For Heart Failure Exacerbation

Background: It is unclear whether patients with a history of gout have longer hospitalizations in general, or only when suffering a flare. This study examines the effect of gout diagnosis and gout flare on the length of stay (LoS) in patients admitted for heart failure (HF) exacerbation. Methods: We conducted a matched retrospective cohort study and searched electronic medical records for patients admitted for HF with a prior diagnosis of gout from 1 July 2012 to 30 June 2017 and matched them to patients admitted for HF without gout. Cases who had a gout flare during the admission were identified. The log of the length of stay (log LoS) was utilized for normalization of the data. We used a linear mixed-effect model to compare the adjusted LoS of gout patient with flare, gout patient without flare, and controls. Results: A total of 978 admissions for HF exacerbation in 738 patients, including 246 individual with gout and 492 matched controls, were identified and included in the analysis. The log LoS was significantly longer in cases (1.86 +/- 0.95) compared with controls (1.72 +/- 0.94; p=0.0278). The log LoS was significantly longer in those with gout who flared (2.41 +/- 0.96) compared to those without gout (1.72 +/- 0.94, p< 0.0001). After adjusting for potential confounders, the log LoS of patients who flared (p < 0.0001) remained significantly longer than controls, as well as those who did not flare (p= 0.0421, but to a lesser extent. Conclusion: HF patients with gout had significantly longer hospitalizations than those without gout, a finding driven primarily by gout flare during hospitalization.