Are there rural-urban disparities in cardiovascular disease hospitalization and other outcomes in people with gout? A nationwide U.S. study.

Abstract

The objective of this study was to assess whether rural vs urban patient residence is associated with the risk of myocardial infarction (MI) hospitalization and other outcomes in people with gout. We used the 2016-2019 U.S. National Inpatient Sample (NIS) database to assess whether rural patient residence is associated with a higher risk of MI hospitalizations in gout, while adjusting for demographics (age, sex, race), comorbidity, median household income, insurance payer, and hospital characteristics (location and teaching status, bed size, hospital control, and hospital region). We calculated adjusted odds ratios (aORs) and 95% CIs (CIs). We found that, compared with urban residents, people living in the rural areas had higher crude rates of MI, 2640 vs 3145 per 100 000 area-specific gout hospitalizations. In multivariable-adjusted analyses, compared with urban residents with gout, the rural area residents with gout were significantly more likely to have a MI hospitalization, with an odds ratio of 1.70 (95% CI, 1.61-1.79; P < 0.001). The association was confirmed in multiple sensitivity analyses. We demonstrated significant rural-urban disparities in the risk of MI hospitalization in people with gout. Policymakers and hospital systems need to design and implement interventions to reduce these disparities.