Acute gout attacks during the perioperative period and risk factors of recurrence after orthopedic surgery among untreated gout patients

Abstract

Background This study aimed to explore the clinical characteristics of perioperative acute gout attacks in patients with varying uric acid levels undergoing orthopedic surgery, identify the risk factors for gout recurrence within the first postoperative year, and provide a disease prevention and diagnostic reference. Methods This hospital-based retrospective study was conducted between January 2018 and December 2020. According to the blood uric acid levels at admission, the patients were grouped into either the normal uric acid level group or the hyperuricemia group. Patient comorbidities, serum uric acid levels, inflammatory indicators, follow-up recurrence rates, and other indicators were compared. Result The uric acid decline ratio and the inflammatory indexes (white blood cell count and C-reactive protein level) at the time of the attack were significantly higher in the normal uric acid level group than in the hyperuricemia group (P < 0.05). Patients in the hyperuricemia group with diabetes and tophi and those administered diuretics were more prone to acute gout attacks than those in the normal uric acid level group (P < 0.05). In the normal uric acid level group, 22 patients (84.6%) exhibited single joint involvement, whereas only 18 patients (47.4%) in the hyperuricemia group demonstrated single joint involvement (P < 0.05). After 1 year of follow-up, the gout recurrence rate in the hyperuricemia group was 44.7%, which was significantly higher that the recurrence rate in the normoglycemic group (11.5%; P < 0.05). Presenting tophi in perioperative orthopedic surgery patients was found to be an independent risk factor for gout recurrence within 1 year (RR = 4.80; P = 0.029). Conclusion The recurrence rate of gout in patients with hyperuricemia during perioperative period increased 1 year after operation. Therefore, it is crucial to monitor the uric acid level to prevent acute gout attacks during the perioperative period and recurrence during the 1-year follow-up period. Moreover, the risk of an acute gout recurrence 1 year after operation increased in patients who presented tophi; therefore, it is necessary to maintain appropriate blood uric acid level during perioperative period among patients undergoing orthopedic surgery.

Ionic liquids revolutionizing biomedicine: recent advances and emerging opportunities

“…IL-based sensors could be used to diagnose gout as they can enable more sensitive detection of uric acid (UA) in human blood and urine, which is highly beneficial for early disease diagnosis. 222,223 Abbas et al developed an electrochemical sensor for the real-time monitoring of UA using benzimidazolium-1-acetate to modify the electrode, which increased the intrinsic conductivity and thermal stability, due to the availability of high p-electron density from availability of carboxyl functional groups and aromatic rings. The sensor exhibited a highly sensitive and selective response, excellent anti-interference ability, a linear range of 2-1050 mM, as well as a detection limit of 1.27 mM, and was effective in monitoring UA from blood of gout patients and healthy individuals.…”