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Risk Factors for Postsurgical Gout Flares after Thoracolumbar Spine Surgeries

Gouty arthritis is the most common form of inflammatory arthritis and flares frequently after surgeries. Such flares impede early patient mobilization and lengthen hospital stays; however, little has been reported on gout flares after spinal procedures. This study reviewed a database of 6439 adult p...

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Autores principales: Chen, Kuan-Jung, Huang, Yen-Chun, Yao, Yu-Cheng, Hsiung, Wei, Chou, Po-Hsin, Wang, Shih-Tien, Chang, Ming-Chau, Lin, Hsi-Hsien
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9267449/
https://www.ncbi.nlm.nih.gov/pubmed/35807031
http://dx.doi.org/10.3390/jcm11133749
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author Chen, Kuan-Jung
Huang, Yen-Chun
Yao, Yu-Cheng
Hsiung, Wei
Chou, Po-Hsin
Wang, Shih-Tien
Chang, Ming-Chau
Lin, Hsi-Hsien
author_facet Chen, Kuan-Jung
Huang, Yen-Chun
Yao, Yu-Cheng
Hsiung, Wei
Chou, Po-Hsin
Wang, Shih-Tien
Chang, Ming-Chau
Lin, Hsi-Hsien
author_sort Chen, Kuan-Jung
collection PubMed
description Gouty arthritis is the most common form of inflammatory arthritis and flares frequently after surgeries. Such flares impede early patient mobilization and lengthen hospital stays; however, little has been reported on gout flares after spinal procedures. This study reviewed a database of 6439 adult patients who underwent thoracolumbar spine surgery between January 2009 and June 2021, and 128 patients who had a history of gouty arthritis were included. Baseline characteristics and operative details were compared between the flare-up and no-flare groups. Multivariate logistic regression was used to analyze predictors and construct a predictive model of postoperative flares. This model was validated using a receiver operating characteristic (ROC) curve analysis. Fifty-six patients (43.8%) had postsurgical gout flares. Multivariate analysis identified gout medication use (odds ratio [OR], 0.32; 95% confidence interval [CI], 0.14–0.75; p = 0.009), smoking (OR, 3.23; 95% CI, 1.34–7.80; p = 0.009), preoperative hemoglobin level (OR, 0.68; 95% CI, 0.53–0.87; p = 0.002), and hemoglobin drop (OR, 1.93; 95% CI, 1.25–2.96; p = 0.003) as predictors for postsurgical flare. The area under the ROC curve was 0.801 (95% CI, 0.717–0.877; p < 0.001). The optimal cut-off point of probability greater than 0.453 predicted gout flare with a sensitivity of 76.8% and specificity of 73.2%. The prediction model may help identify patients at an increased risk of gout flare.
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spelling pubmed-92674492022-07-09 Risk Factors for Postsurgical Gout Flares after Thoracolumbar Spine Surgeries Chen, Kuan-Jung Huang, Yen-Chun Yao, Yu-Cheng Hsiung, Wei Chou, Po-Hsin Wang, Shih-Tien Chang, Ming-Chau Lin, Hsi-Hsien J Clin Med Article Gouty arthritis is the most common form of inflammatory arthritis and flares frequently after surgeries. Such flares impede early patient mobilization and lengthen hospital stays; however, little has been reported on gout flares after spinal procedures. This study reviewed a database of 6439 adult patients who underwent thoracolumbar spine surgery between January 2009 and June 2021, and 128 patients who had a history of gouty arthritis were included. Baseline characteristics and operative details were compared between the flare-up and no-flare groups. Multivariate logistic regression was used to analyze predictors and construct a predictive model of postoperative flares. This model was validated using a receiver operating characteristic (ROC) curve analysis. Fifty-six patients (43.8%) had postsurgical gout flares. Multivariate analysis identified gout medication use (odds ratio [OR], 0.32; 95% confidence interval [CI], 0.14–0.75; p = 0.009), smoking (OR, 3.23; 95% CI, 1.34–7.80; p = 0.009), preoperative hemoglobin level (OR, 0.68; 95% CI, 0.53–0.87; p = 0.002), and hemoglobin drop (OR, 1.93; 95% CI, 1.25–2.96; p = 0.003) as predictors for postsurgical flare. The area under the ROC curve was 0.801 (95% CI, 0.717–0.877; p < 0.001). The optimal cut-off point of probability greater than 0.453 predicted gout flare with a sensitivity of 76.8% and specificity of 73.2%. The prediction model may help identify patients at an increased risk of gout flare. MDPI 2022-06-28 /pmc/articles/PMC9267449/ /pubmed/35807031 http://dx.doi.org/10.3390/jcm11133749 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Chen, Kuan-Jung
Huang, Yen-Chun
Yao, Yu-Cheng
Hsiung, Wei
Chou, Po-Hsin
Wang, Shih-Tien
Chang, Ming-Chau
Lin, Hsi-Hsien
Risk Factors for Postsurgical Gout Flares after Thoracolumbar Spine Surgeries
title Risk Factors for Postsurgical Gout Flares after Thoracolumbar Spine Surgeries
title_full Risk Factors for Postsurgical Gout Flares after Thoracolumbar Spine Surgeries
title_fullStr Risk Factors for Postsurgical Gout Flares after Thoracolumbar Spine Surgeries
title_full_unstemmed Risk Factors for Postsurgical Gout Flares after Thoracolumbar Spine Surgeries
title_short Risk Factors for Postsurgical Gout Flares after Thoracolumbar Spine Surgeries
title_sort risk factors for postsurgical gout flares after thoracolumbar spine surgeries
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9267449/
https://www.ncbi.nlm.nih.gov/pubmed/35807031
http://dx.doi.org/10.3390/jcm11133749
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