Gout, allopurinol intake and clinical outcomes in the hospitalized multimorbid elderly

Carlotta Franchi, Francesco Salerno, Alessio Conca, Codjo D. Djade, Mauro Tettamanti, Luca Pasina, Salvatore Corrao, Alessandra Marengoni, Maura Marcucci, Pier Mannuccio Mannucci, Alessandro Nobili, Eleonora Sparacio, Stefania Alborghetti, Rosa Di Costanzo, Domenico Prisco, Elena Silvestri, Caterina Cenci, Tommaso Barnini, Giuseppe Delitala, Stefano CartaSebastiana Atzori, Gianfranco Guarnieri, Michela Zanetti, Annalisa Spalluti, Maria Grazia Serra, Maria Antonietta Bleve, Massimo Vanoli, Giulia Grignani, Gianluca Casella, Laura Gasbarrone, Giorgio Maniscalco, Massimo Gunelli, Daniela Tirotta, Antonio Brucato, Silvia Ghidoni, Paola Di Corato, Mauro Bernardi, Silvia Li Bassi, Luca Santi, Giancarlo Agnelli, Alfonso Iorio, Emanuela Marchesini, Elmo Mannarino, Graziana Lupattelli, Pamela Rondelli, Francesco Paciullo, Fabrizio Fabris, Michela Carlon, Francesca Turatto, Maria Cristina Baroni, Marianna Zardo, Roberto Manfredini, Christian Molino, Marco Pala, Fabio Fabbian, Ranuccio Nuti, Roberto Valenti, Martina Ruvio, Silvia Cappelli, Giuseppe Paolisso, Maria Rosaria Rizzo, Maria Teresa Laieta, Teresa Salvatore, Ferdinando Carlo Sasso, Riccardo Utili, Emanuele Durante Mangoni, Daniela Pinto, Oliviero Olivieri, Anna Maria Stanzial, Renato Fellin, Stefano Volpato, Sioulis Fotini, Mario Barbagallo, Ligia Dominguez, Lidia Plances, Daniela D'Angelo, Giovanbattista Rini, Pasquale Mansueto, Ilenia Pepe, Giuseppe Licata, Luigi Calvo, Maria Valenti, Claudio Borghi, Enrico Strocchi, Elisa Rebecca Rinaldi, Marco Zoli, Elisa Fabbri, Donatella Magalotti, Alberto Auteri, Anna Laura Pasqui, Luca Puccetti, Franco Laghi Pasini, Pier Leopoldo Capecchi, Maurizio Bicchi, Carlo Sabbà, Francesco Saverio Vella, Alessandro Marseglia, Chiara Valentina Luglio, Giuseppe Palasciano, Maria Ester Modeo, Annamaria Aquilino, Pallante Raffaele, Stefania Pugliese, Caterina Capobianco, Alfredo Postiglione, Maria Rosaria Barbella, Francesco De Stefano, Luigi Fenoglio, Chiara Brignone, Christian Bracco, Alessia Giraudo, Giuseppe Musca, Olga Cuccurullo, Luigi Cricco, Alessandra Fiorentini, Maria Domenica Cappellini, Giovanna Fabio, Sonia Seghezzi, Margherita Migone De Amicis, Silvia Fargion, Paola Bonara, Mara Bulgheroni, Rosa Lombardi, Fabio Magrini, Ferdinando Massari, Tatiana Tonella, Flora Peyvandi, Alberto Tedeschi, Raffaella Rossio, Guido Moreo, Barbara Ferrari, Luisa Roncari, Valter Monzani, Valeria Savojardo, Christian Folli, Maria Magnini, Daniela Mari, Paolo Dionigi Rossi, Sarah Damanti, Silvia Prolo, Maria Sole Lilleri, Giuliana Micale, Mauro Podda, Carlo Selmi, Francesca Meda, Silvia Accordino, Valentina Monti, Gino Roberto Corazza, Emanuela Miceli, Marco Vincenzo Lenti, Donatella Padula, Carlo L. Balduini, Giampiera Bertolino, Stella Provini, Federica Quaglia, Giovanni Murialdo, Marta Bovio, Franco Dallegri, Luciano Ottonello, Alessandra Quercioli, Alessandra Barreca, Maria Beatrice Secchi, Davide Ghelfi, Wu Sheng Chin, Laura Carassale, Silvia Caporotundo, Luigi Anastasio, Lucia Sofia, Maria Carbone, Giancarlo Traisci, Lucrezia De Feudis, Silvia Di Carlo, Giovanni Davì, Maria Teresa Guagnano, Simona Sestili, Elisabetta Bergami, Emanuela Rizzioli, Carlo Cagnoni, Luca Bertone, Antonio Manucra, Alberto Buratti, Tiziana Tognin, Nicola Lucio Liberato, Giordano Bernasconi, Barbara Nardo, Giovanni Battista Bianchi, Giampiero Benetti, Michela Quagliolo, Giuseppe Riccardo Centenaro, Francesco Purrello, Antonino Di Pino, Salvatore Piro, Gerardo Mancuso, Daniela Calipari, Mosè Bartone, Francesco Gullo, Michele Cortellaro, Marina Magenta, Francesca Perego, Maria Rachele Meroni, Marco Cicardi, Antonio Gidaro Marina Magenta, Andrea Sacco, Antonio Bonelli, Gaetano Dentamaro, Renzo Rozzini, Lina Falanga, Alessandro Giordano, Paolo Cavallo Perin, Bartolomeo Lorenzati, Gabriella Gruden, Graziella Bruno, Giuseppe Montrucchio, Elisabetta Greco, Pietro Tizzani, Giacomo Fera, Maria Loreta Di Luca, Donatella Renna, Antonio Perciccante, Alessia Coralli, Rodolfo Tassara, Deborah Melis, Lara Rebella, Giorgio Menardo, Stefania Bottone, Elsa Sferrazzo, Claudio Ferri, Rinaldo Striuli, Rosa Scipioni, Raffaella Salmi, Piergiorgio Gaudenzi, Susanna Gamberini, Franco Ricci, Cosimo Morabito, Roberto Fava, Andrea Semplicini, Lucia Gottardo, Gianluigi Vendemiale, Gaetano Serviddio, Roberta Forlano, Luigi Bolondi, Leonardo Rasciti, Ilaria Serio, Cesare Masala, Antonio Mammarella, Valeria Raparelli, Filippo Rossi Fanelli, Massimo Delfino, Antonio Amoroso, Francesco Violi, Stefania Basili, Ludovica Perri, Pietro Serra, Vincenzo Fontana, Marco Falcone, Raffaele Landolfi, Antonio Grieco, Antonella Gallo, Giuseppe Zuccalà, Francesco Franceschi, Guido De Marco, Cordischi Chiara, Sabbatini Marta, Martino Bellusci, Donatella Setti, Filippo Pedrazzoli, Giuseppe Romanelli, Caterina Pirali, Claudia Amolini, Enrico Agabiti Rosei, Damiano Rizzoni, Luana Castoldi, Antonio Picardi, Umberto Vespasiani Gentilucci, Chiara Mazzarelli, Paolo Gallo, Luigina Guasti, Luana Castiglioni, Andrea Maresca, Alessandro Squizzato, Sara Contini, Marta Molaro, Giorgio Annoni, Maurizio Corsi, Sara Zazzetta, Marco Bertolotti, Chiara Mussi, Roberto Scotto, Maria Alice Ferri, Francesca Veltri, Franco Arturi, Elena Succurro, Giorgio Sesti, Umberto Gualtieri, Francesco Perticone, Angela Sciacqua, Michele Quero, Chiara Bagnato, Paola Loria, Maria Angela Becchi, Gianfranco Martucci, Alessandra Fantuzzi, Mauro Maurantonio, Roberto Corinaldesi, Roberto De Giorgio, Mauro Serra, Valentina Grasso, Eugenio Ruggeri, Lorenzo Mauro Carozza, Fabio Pignatti

Research output: Contribution to journalArticle

Abstract

Background: Increased serum uric acid has been considered a cardiovascular risk factor but no study has assessed its relation with hospital mortality or length of stay. On the basis of data obtained from a prospective registry, the prevalence of gout/hyperuricemia and its association with these and other clinical parameters was evaluated in an Italian cohort of elderly patients acutely admitted to internal medicine or geriatric wards. Methods: While the prevalence of gout was calculated by counting patients with this diagnosis hyperuricemia was inferred in patients taking allopurinol at hospital admission or discharge, on the assumption that this drug was only prescribed owing to the finding of high serum levels of uric acid. A series of clinical and demographic variables were evaluated for their association with gout/hyperuricemia. Results: Of 1380 patients, 139 (10%) had a diagnosis of gout or were prescribed allopurinol. They had more co-morbidities (7.0 vs 5.6; P <0.0001) and consumed more drugs (6.8 vs 5.0; <b 0.0001). The CIRS (co-morbidity index) was worse in these patients (OR 1.28 95% CI 1.15-1.41). Multivariable regression analysis showed that only renal and heart failures were independently associated with gout/allopurinol intake. Moreover, this combined event was associated with an increased risk of adverse events during hospitalization (OR 1.66, 95% CI 1.16-2.36), but not with the risk of re-hospitalization, length of hospital stay or death. Conclusions: Gout/allopurinol intake has a high prevalence in elderly patients acutely admitted to hospital and are associated with renal and cardiovascular diseases, an increased rate of adverse events and a high degree of drug consumption. In contrast, this finding did not affect the length of hospitalization nor hospital mortality.

Original languageEnglish
Pages (from-to)847-852
Number of pages6
JournalEuropean Journal of Internal Medicine
Volume25
Issue number9
DOIs
Publication statusPublished - Nov 1 2014

Keywords

  • Allopurinol
  • Comorbidities
  • Elderly
  • Gout
  • Hyperuricemia
  • Outcomes

ASJC Scopus subject areas

  • Internal Medicine
  • Medicine(all)

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    Franchi, C., Salerno, F., Conca, A., Djade, C. D., Tettamanti, M., Pasina, L., Corrao, S., Marengoni, A., Marcucci, M., Mannucci, P. M., Nobili, A., Sparacio, E., Alborghetti, S., Di Costanzo, R., Prisco, D., Silvestri, E., Cenci, C., Barnini, T., Delitala, G., ... Pignatti, F. (2014). Gout, allopurinol intake and clinical outcomes in the hospitalized multimorbid elderly. European Journal of Internal Medicine, 25(9), 847-852. https://doi.org/10.1016/j.ejim.2014.09.019