Analysis of risk factors of fever in hospitalized patients with acute gout
Objective:To investigate the risk factors of fever in hospitalized patients with acute gout.Methods:The data of 185 hospi-talized patients with acute gout meeting the inclusion criteria were retrospectively analyzed and divided into moderate and high fever group(n=25),low fever group(n=25)and no fever group(n=135)according to body temperature.The clinical data,inflammatory indi-cators and medication data were compared.Then the two groups were divided into knee pain group(n=69)and pain free group(n=116)according to the presence or absence of knee pain.The risk factors of hospitalized gout fever were analyzed by binary Logistic regression.Results:The white blood cell count in 3 groups was(9.2±2.3 vs.8.6±3.3 vs.7.7±2.5,P=0.022),neutrophil percentage(77.7±4.0 vs.70.5±10.6 vs.67.7±12.1,P=0.001),pain VAS score[3(3.0,4.0)vs.2(2.0,3.0)vs.2(1.5,3.0),P=0.001],c-reactive protein(102(49,137)vs.36(22,83)vs.15(5,53),P=0.001)and ESR levels50(41,66)vs.28(16,45)vs.27(14,46),P=0.001]were statistically significant.The white blood cell count and neutrophil percentage in the high fever group were higher than those in the no-fever group(P=0.012,P=0.001).The pain VAS score,CRP and ESR in moderate and high fever group were higher than those in no fever group and low fever group(P=0.001,P=0.001,P=0.001 and P=0.014,P=0.033,P=0.011).The proportion of NSAIDS used in low-fever group was higher than that in no-fever group(92％vs.68.1％,P=0.015)and medium-high fever group(92％vs.60.0％,P=0.008).In the three groups,knee pain(56.0％vs 48.0％vs.31.9％,P=0.036),first toe joint pain(6.0％vs.0.0％vs.25.9％,P=0.007),upper limb joint pain(40.0％vs.16.0％vs.17.8％,P=0.034)and multiple joint involvement(56.0％vs.24.0％vs.25.9％,P=0.008)were statistically significant.Proportion of ESR[43(21,56)vs.25(14,41),P=0.001],CRP[45(11,115)vs.17(5,49),P=0.001]and local treatment of joint cavity in patients with knee pain[(58.0％vs.6.9％),P=0.001]were higher than those without knee joint involvement.Logistic regression analysis showed that leu-kocytes(OR=1.171,95％CI=1.037-1.323,P=0.011),neutrophil percentage(OR=1.053,95％CI=1.020-1.087,P=0.002),CRP(OR=1.015,95％CI=1.008～1.021,P=0.001),ESR(OR=1.023,95％CI=1.008-1.039,P=0.003),pain VAS score(OR=1.674,95％CI=1.228-2.282,P=0.001),knee pain(2.428,95％CI=1.252-4.709,P=0.009)was a risk factor for hospitalized gout fever.First toe joint pain(OR=0.233,95％CI=0.068-0.804,P=0.021)was a protective factor for hospitalized gout fever.The increase of CRP level(OR=1.011,95％CI=1.005-1.018,P=0.001)and pain VAS score(OR=1.446,95％CI=1.035-2.019,P=0.031)were independent risk factors for hospitalized gout fever.Conclusion:The proportion of hospitalized acute gout patientss with fever was 27％(50/185),and patients with fever had higher inflammation levels and pain scores,a higher proportion of knee pain and multi-joint pain,and lower rates of first toe joint pain,which required stronger anti-inflammatory and analgesic therapy.In particular,high CRP level andhigh pain VAS score were independent risk factors for hospitalized gout fever.
万方数据
维普
