Evaluate patient demographic, care encounter, comorbidity, and clinical differences in Hmong and non-Hmong gout patients.
Using retrospective chart review, all inpatient encounters (Hmong vs non-Hmong) were reviewed from 2014 to 2017. Acute or chronic gout was the primary or secondary diagnosis for the encounter.
Hmong gout patients were on average 11 years younger than non-Hmong patients, but after adjustment for age, sex, and type of encounter, had similar rates of hypertension, diabetes, and heart disease. Hmong patients had significantly decreased renal function at time of presentation; the odds ratio of CKD for Hmong patients was 2.33 vs. 1.48 for non-Hmong patients (p<0.05), mean creatinine 3.3 mg/dL vs. 2.0 mg/dL (beta = 1.35, p<0.001) and GFR 44.8 mL/min vs 49.3 mL/min (beta = -6.95, p<0.001). Hmong gout patients were more likely to use emergency care vs. elective/ urgent care, less likely to be using medications for the treatment of gout prior to admission (32.3% vs. 58.2%), and the length of hospital stay was increased (8.8 vs. 5.2 days, p<0.05).
Hmong gout patients who had a tertiary care encounter were 11 years younger than non-Hmong patients with similar rates of comorbidities, but had worse renal function despite the age differences. They were more likely to use emergency services, be insured through Medicaid, and not use preventive medications for gout prior to their encounter. Intensive efforts are needed in the Hmong population for culturally-appropriate preventive care management of gout along with diabetes, hypertension, heart disease, and kidney disease.