Aims: To explore characteristics, management and length-of-stay across older (age ≥65) and younger in-patients with gout during hospitalisation.
Methods: Retrospective chart review of all patients with primary/secondary gout in a tertiary hospital, 2021.
Results: Amongst 241 patients (gout primary diagnosis in 32.5%, secondary 67.5%), mean age was 67.4 years (SD 17.3), 59.8% (144) were aged ≥65; 75.1% male, 54.8% from CALD background, and median Charlson Comorbidity Index (CCI) 5 (IQR 3-7). Median LOS was 7 days (3-17). Older patients had more medications (8.5 versus 5.3), higher CCI (6 versus 2), and longer LOS (10 versus 4 days) (all p<0.001). Older patients less often had prior history gout (67.1 versus 79.2%, p=0.04) and gout as principal admission diagnosis was less common (p=0.03).
There were no management differences vis-à-vis: initial (73.6 versus 64.5%, p=0.14) or progress urate checks (p=0.4), joint aspiration (24.6 versus 31.3%, p=0.26), or imaging (58.4 versus 49.0%, p=0.15). Colchicine prescription was less common in older people (52.1 versus 71.6%, p=0.003), and colchicine dose was lower (mean 0.90 versus 0.76mg/day, p=0.03); use of other urate-lowering therapies, oral steroids, NSAIDS, paracetamol or intra-articular injection were similar in older/younger patients (all p>0.07). Older people did not often receive rheumatology consult (39.9%), rheumatology follow-up (24.8%) or urate target (8.4%), but often received outpatient gout-management plans (71.3%); patterns were similar for younger patients (all p>0.1).
Conclusions: Older and younger patients commonly received similar gout management. Gaps in terms of some aspects of management were evident in both groups, highlighting areas for future care improvement.