Abstract
BackgroundHeart failure is a clinical syndrome with significant morbidity, mortality, and financial burden. These factors are magnified in patients with associated comorbidities. Therefore, addressing such conditions is critical in decreasing healthcare costs and improving patient outcomes.Gout is a major comorbidity in patients with heart failure. Acute gout flares that occur in the context of acute heart failure exacerbations (AHFE) form an independent risk factor for increased readmissions or death. In this study, we characterized the frequency and outcomes of acute gout flares in patients treated with intravenous (IV) bumetanide for AHFE.MethodsThis single-center retrospective cohort study included 130 adult patients admitted in a tertiary-care hospital between August 2016 and June 2018. Chart review identified patients who were hospitalized for AHFE with International Classification of Diseases, Tenth Revision (ICD-10) diagnosis code I50, received IV bumetanide, and developed an acute gout flare. Data were analyzed using the chi-square test for categorical variables and the two-sample t-test for continuous variables.ResultsThe annualized frequency of acute gout while receiving IV bumetanide for AHFE was 7.17%. Chronic gout patients who were on colchicine and/or allopurinol while hospitalized were less likely to develop acute gout while receiving IV bumetanide for AHFE compared with those taking neither medication (p-value =0.002). There was no significant difference in length of stay or 30-day readmissions between those who developed acute gout and those who did not.ConclusionsAcute gout flares occur with a notable frequency in patients hospitalized for AHFE who are administered IV bumetanide. It is important to continue patients’ outpatient gout regimens in an effort to mitigate acute gout flares during this time.
Highlights
Heart failure is a prevalent and ever-increasing public health concern that affects over five million people nationwide and is projected to cost $53 billion in healthcare expenditures by 2030 [1,2]
Chronic gout patients who were on colchicine and/or allopurinol while hospitalized were less likely to develop acute gout while receiving IV bumetanide for acute heart failure exacerbations (AHFE) compared with those taking neither medication (p-value =0.002)
Acute gout flares occur with a notable frequency in patients hospitalized for AHFE who are administered IV bumetanide
Summary
Heart failure is a prevalent and ever-increasing public health concern that affects over five million people nationwide and is projected to cost $53 billion in healthcare expenditures by 2030 [1,2]. In one study consisting of 1,269 patients with heart failure, 81% were found to have at least one or more comorbid conditions [4] This was associated with significantly higher healthcare expenses, and with longer hospitalization and higher mortality rates [5]. Identifying and addressing comorbidities in the context of heart failure is critical in decreasing healthcare costs and improving patient outcomes. Flares of acute gout during heart failure exacerbations form an independent risk factor for increased readmissions or death [8]. Heart failure is a clinical syndrome with significant morbidity, mortality, and financial burden These factors are magnified in patients with associated comorbidities. Acute gout flares that occur in the context of acute heart failure exacerbations (AHFE) form an independent risk factor for increased readmissions or death. We characterized the frequency and outcomes of acute gout flares in patients treated with intravenous (IV) bumetanide for AHFE
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