Gout in Native Hawaiian Patients in Hawaiʻi: Clinical Characteristics and Disparities

Abstract

ObjectiveTo investigate differences in clinical characteristics and healthcare utilization of Native Hawaiian and White gout patientsMethodsWe performed a retrospective chart review of Native Hawaiian and White gout patients treated from 2011‐2017 within a large healthcare system in Hawai'i. We compared demographic characteristics, clinical outcomes, and risk factors for gout. We used multivariable logistic regression to identify predictive factors of emergency department visits.ResultsWe identified 270 Native Hawaiian gout patients and 239 White patients. The Native Hawaiian patients were younger on average (54.0 vs. 64.0, p<0.0001) and had an earlier onset of disease (50.0 vs. 57.0, p<0.0001). Native Hawaiian gout patients had higher mean (7.58 vs. 6.87, p<0.0001) and maximum (10.30 vs. 9.50, p<0.0001) serum urate levels as compared to White gout patients. Native Hawaiian gout patients also had a greater number of tophi (median 2.00 vs. 1.00, p<0.0001). Native Hawaiians gout patients were 2.7 times more likely to have frequent (≥ 1) emergency department visits than White gout patients. Native Hawaiian gout patients were less likely to have a therapeutic serum urate ≤ 6.0 and had lower rates of rheumatology specialty care.ConclusionNative Hawaiian patients have a higher disease burden of gout, with earlier disease onset and more tophi. Native Hawaiian gout patients are more likely to use emergency services for gout, had lower rates of rheumatology specialty care compared to white patients. Future studies are needed to promote culturally appropriate preventive care and management of gout in Native Hawaiians.This article is protected by copyright. All rights reserved.