Cesar Diaz-Torne (1), Daniel Martinez-Laguna (2), Jose Luis Estebanez (3), Angeles Conesa (2), Jordi Hoyo (4) , Cristina Carbonell (5), Meritxell Aivar (6), Carlen Reyes (7), Raquel Gayarre (8), Maria Antonia Pou (8)
Affiliation(s):
1. Hospital de la Santa Creu I Sant Pau,
2. Cap Sant MartÃ,
3. Cap Vila de Gracia,
4. Cap Numà ncia,
5. EAP Via Roma,
6. Cap Sants,
7. Idiap Jordi Gol,
8. Eap Encants
Objective: To determine the percentage of patients with a diagnosis of gout in their primary care (PC) medical records who meet the EULAR/ACR 2105 criteria.
Material and methods: Cross-sectional observational study carried out in seven PC teams in an urban area. Individuals aged at least 15 years with a diagnosis of gout (ICD-10 CM: M10.0 or M1A.0 and subcategories) made between the years 2011 to 2021 were randomly selected. We studied if patienta met the EULAR/ACR 2015 criteria for gout classification using data from their medical record and telephone interview. The following variables were collected: 1) Demographic (Age and sex); 2) Clinical (date of diagnosis, number and location of flares, glomerular filtration rate and uricemia at diagnosis and last available, alcohol consumption (no enol, low consumption and high risk), uricemia-lowering treatment (drug and dose), presence of tophi, imaging studies (plain radiology, ultrasound and DECT) and synovial fluid study. A sample of 289 individuals was calculated to be necessary to estimate with 95% confidence and a precision of ≥5 percentage units a population percentage that was predicted to be around 75%.
Results: 289 users were included. The mean age at diagnosis was 71.6 ±12.2 years and 235 (81.3%) were male. Fifty (23.6%) had a glomerular filtration rate <60 ml/mn/m2. Seventy-nine (9.5%) were high-risk drinkers and 140 (57.9%) had low alcohol consumption. One hundred and ninety (65.7%) patients had podagra and 45 (15.6%) had midfoot or ankle swelling. In 8 (2.6%) patients tophi were described. Mean uricemia at diagnosis was 8.1±1.7mg/dl and 6.7±1.8mg/dl at the time of evaluation. In 72% any uricemia >6.8mg/dl was collected in the medical record. 71% (205) of subjects with a diagnosis of gout met EULAR/ACR 2015 diagnostic criteria. When combining the diagnosis of gout in the HC with the presence of hyperuricemia in any record the percentage increased to 78.4%.
Conclusions: 71% of those with a diagnosis of gout in the computerized Primary Care medical record met EULAR/ACR 2015 criteria for gout. Combining the diagnosis of gout with the presence of hyperuricemia in at least one record increased the percentage to 78.4%.