Filling gaps in female gout: a cross-sectional study of comorbidities in 192 037 hospitalised patients

OBJECTIVE: There is room for improvement in the knowledge of female gout, often noted at risk of gender blindness. This study aims to compare the prevalence of comorbidities in women versus men hospitalised with gout in Spain. METHODS: This is an observational, multicentre, cross-sectional study in public and private Spanish hospitals analysing the minimum basic data set from 192 037 hospitalisations in people with gout (International Classification of Diseases, Ninth Revision (ICD-9) coding) from 2005 to 2015. Age and several comorbidities (ICD-9) were compared by sex, with a subsequent stratification of comorbidities by age group. The association between each comorbidity and sex was assessed using multivariable logistic regression. A clinical decision tree algorithm was constructed to predict the sex of patients with gout based on age and comorbidities alone. RESULTS: Women with gout (17.4% of the sample) were significantly older than men (73.9±13.7 years vs 64.0±14.4 years, p<0.001). Obesity, dyslipidaemia, chronic kidney disease, diabetes mellitus, heart failure, dementia, urinary tract infection and concurrent rheumatic disease were more common in women. Female sex was strongly associated with increasing age, heart failure, obesity, urinary tract infection and diabetes mellitus, while male sex was associated with obstructive respiratory diseases, coronary disease and peripheral vascular disease. The decision tree algorithm built showed an accuracy of 74.4%. CONCLUSIONS: A nationwide analysis of inpatients with gout in 2005–2015 confirms a different comorbidity profile between men and women. A different approach to female gout is needed to reduce gender blindness.