Rural-Urban Disparities in cardiovascular disease hospitalizations and its outcomes in gout: a nationwide U.S. study.

Abstract

Objective: To assess whether patient residence is associated with the risk of myocardial infarction (MI) hospitalizations in people with gout.

Methods: 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 (aOR) and 95% confidence intervals (CI).

Results: We found that compared with urban residents, people living in the rural areas had higher crude rates of MI, 2,640 vs 3,145 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 an MI with an odds ratio of 1.70 (95% CI, 1.61-1.79; p< 0.001). The association was confirmed in multiple sensitivity analyses.

Conclusions: We demonstrated a significant rural-urban disparity in the risk of MI hospitalizations in people with gout. Policymakers and hospital systems need to design and implement interventions to reduce these disparities.