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Studies describing seasonal variations in acute gouty arthritis note seasonal variation, but disagree on timing, with most showing a peak in spring months while others show peaks later in the year.
Acute gout/gout
flare is a disabling inflammatory arthritis causing intense pain. It mostly
involves a single joint, but occasionally involves two or more joints.
According to this study, the seasonal disparity has been known to effect the
acute gouty conditions.
Studies
describing seasonal variations in acute gouty arthritis note seasonal
variation, but disagree on timing, with most showing a peak in spring months
while others show peaks later in the year. Various theories on the effect of
weather and immune system changes on the chronobiology of monosodium urate
crystals’ equilibrium and precipitation have been proposed. We aimed to shed
light on this question by examining the seasonal variation in the incidence of
acute gouty arthritis in the USA using a large inpatient database.
We used the
Nationwide Inpatient Sample (NIS) database to identify patients aged ≥18 years
with primary diagnosis of acute gouty arthritis (International Classification
of Diseases, 9th Revision, Clinical Modification code 274.01) from 2009–2011
during hospitalization. We used the Edwards recognition and estimation of
cyclic trend method to study the seasonal variation of the incidence of acute
gout and z-test to compare the seasonal incidences.
A total of 28,172
hospitalizations with primary diagnosis of acute gouty arthritis were reported
in the USA from 2009–2011. The peak incidence of acute gout was seen in
November (peak/low ratio 1.34, 95 % CI 1.29–1.38, p < 0.05). The highest
number of hospitalizations was observed in autumn months while the lowest
incidence was observed in spring (28.12 vs. 23.13 %, p < 0.001).
The peak
incidence of acute gout seems to be in the fall with its peak in the month of
November. This seasonality may shed light into the pathophysiology of acute
attacks and better management of patients with gout who are at risk of acute
attacks.
Clin Rheumatology
Seasonal variation in acute gouty arthritis: data from Nationwide Inpatient Sample
Paras Karmacharya et al.
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