英文摘要 |
Objective. Recurrent attacks of gouty arthritis at Chang Gung Memorial Hospital (CGMH), Kaohsiung, was the most common reason for consultation by a rheumatologist. The purpose of this study was to survey the clinical manifestations and predisposing factors of acute flares for gouty patients hospitalized due to non-gout diseases. Methods. This study reviewed the clinical features and predisposing factors of 216 hospitalized patients (186 males and 30 females) with known previous diagnoses of gout who were admitted to CGMH, Kaohsiung, during a 15-month period between Jan 2003 and Mar 2004. All subjects were categorized into two groups. Group I comprised patients who developed a recunent attack of gouty arthritis during hospitalization. Group 2 (control) consisted of subjects with a gout history and without a flare-up during admission. Each group 1 patient was age- (±5 years) and sex-matched with 2 control subjects. Results. Patient mean age was 59.1 ±14.7 years and the male-to-female ratio was 6.2: 1 in group I. The leading cause of recunent attack in group 1 compared with group 2 was lack of antigout medication (adjusted odds ratio 4.6, 95% confidence intervals 2.34-9.06). During recurrent attacks 69.4% of patients developed monoarthritis, 48.5% bad hyperuricemia, and 32.3% developed fever. Ankles were the joints affected most during recurrent attacks. Conclusion. Lack of antigout medication was a significant factor in the development of acute attacks of gouty arthritis in hospitalized patients admitted due to non-gout diseases. Education of patients and physicians to continue antigout therapy is strongly recommended to prevent recurrent attacks of gouty arthritis in hospitalized patients. |