Jatuworapruk et al reported a model for predicting a flare of gout in a hospitalized patient. These can help to identify a patient who may benefit from a pre-flare intervention. The authors are from the University of Otago (Wellington), Thammasat University (Pathumthani, Thailand), and University of Auckland.
Patient selection: inpatient with a history of gout
Parameters:
(1) pre-admission urate lowering therapy
(2) adjustment of urate-lowering regimen
(3) adjustments of diuretics
(4) preadmission urate in mmol/L
(5) tophi
(6) pre-admission gout prophylaxis
(7) gout prophylaxis started or increased
(8) acute kidney injury
(9) surgery
Parameter
Finding
Points (with Shrinkage)
pre-admission urate lowering drugs
no
1.318
yes
0
adjustment of urate-lowering regimen
no
0
yes
0.989
adjustment of diuretics
no
0
yes
0.952
preadmission urate
<= 0.36 mmol/L
0
> 0.36 mmol/L
1.079
tophi
no
0
yes
1.301
pre-admission gout prophylaxis
no
1.898
yes
0
gout prophylaxis started or increased
no
0
yes
2.540
acute kidney injury
no
0
yes
0.752
surgery
no
0
yes
0.543
value of X =
= SUM(points for the parameters) - 5.393
probability of a gout flare =
= 1 / (1 + EXP((-1) * X))
Performance:
• The area under the ROC curve is 0.80.
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