{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T22:43:28Z","timestamp":1790981008054,"version":"4.1.0"},"reference-count":43,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,5,24]],"date-time":"2026-05-24T00:00:00Z","timestamp":1779580800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,5,24]],"date-time":"2026-05-24T00:00:00Z","timestamp":1779580800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100019746","name":"Sunnybrook Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100019746","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthritis Care &amp;amp; Research"],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>We characterized emergency department (ED) gout visits and identified patient characteristics and health services patterns contributing to ED presentations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a population\u2010based study of ED gout visits in Ontario, Canada, between 2014 and 2023. We assessed patient characteristics, encounter rate trends (cumulatively and stratified by age and sex), and health care use surrounding ED visits. Among individuals aged \u226566 years old, gout\u2010related medication use was examined.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>From 2014 to 2023, 125,505 ED gout visits occurred, including 86,824 (69.2%) incident ED cases. Mean age was 59.7 years, with 77.5% men. Individuals with ED gout visits were more likely to live in materially marginalized and less racially diverse neighborhoods. Comorbidity burden was high, driven by hypertension (57.7%) and diabetes (24.0%). ED gout encounters peaked in 2018, with an annual crude rate of 0.99 visits per 1,000 persons (95% confidence interval [CI] 0.97\u20131.01) and a male\u2010specific rate of 1.56 (95% CI 1.53\u20131.59). Older adults (aged 75\u201384 years) had the highest rates at 3.01 (95% CI 2.89\u20133.15) visits per 1,000 persons in 2015 across study years. Within 30 days of ED discharge, 21.3% had gout\u2010specific follow\u2010up visits, 28.3% of patients aged \u226566 years old received flare medications, and 10.3% filled an opioid prescription. By six months, 38.1% underwent outpatient serum urate testing. Within 90 days, repeat ED visits occurred in 29.9%, with 9.4% specifically for gout.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Gout contributes to a high burden of ED visits, with suboptimal treatment, poor follow\u2010up, and frequent representations. Quality improvement efforts are needed to prevent acute care presentations for gout and improve post\u2010ED management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/acr.80086","type":"journal-article","created":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T13:14:13Z","timestamp":1778505253000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Health Care Use Among Patients Presenting to Emergency Department for Gout Flares in Ontario, Canada: A Population\u2010Based Health Systems Analysis"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0354-4794","authenticated-orcid":false,"given":"Timothy S. H.","family":"Kwok","sequence":"first","affiliation":[{"name":"Division of Rheumatology, Department of Medicine University of Toronto  Toronto Ontario Canada"},{"name":"Holland Bone and Joint Program, Sunnybrook Research Institute  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5808-0179","authenticated-orcid":false,"given":"Samantha","family":"Morais","sequence":"additional","affiliation":[{"name":"Institute for Clinical Evaluative Sciences  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4133-7369","authenticated-orcid":false,"given":"William K.","family":"Silverstein","sequence":"additional","affiliation":[{"name":"Division of General Internal Medicine, Department of Medicine University of Toronto  Ontario Canada"},{"name":"Integrated Community Care, Sunnybrook Research Institute  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7236-5522","authenticated-orcid":false,"given":"Clare L.","family":"Atzema","sequence":"additional","affiliation":[{"name":"Institute for Clinical Evaluative Sciences  Toronto Ontario Canada"},{"name":"Integrated Community Care, Sunnybrook Research Institute  Toronto Ontario Canada"},{"name":"Division of Emergency Medicine, Department of Medicine University of Toronto  Ontario Canada"},{"name":"Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto  Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory","family":"Choy","sequence":"additional","affiliation":[{"name":"Division of Rheumatology, Department of Medicine University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-2260-4079","authenticated-orcid":false,"given":"Priyanka","family":"Chandratre","sequence":"additional","affiliation":[{"name":"Division of Rheumatology, Department of Medicine University of Ottawa  Ontario Canada"},{"name":"Ottawa Hospital Research Institute  Ottawa Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ping","family":"Li","sequence":"additional","affiliation":[{"name":"Institute for Clinical Evaluative Sciences  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7464-0460","authenticated-orcid":false,"given":"Jessica","family":"Widdifield","sequence":"additional","affiliation":[{"name":"Holland Bone and Joint Program, Sunnybrook Research Institute  Toronto Ontario Canada"},{"name":"Institute for Clinical Evaluative Sciences  Toronto Ontario Canada"},{"name":"Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto  Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,24]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.21837"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.201392"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.171320"},{"issue":"10","key":"e_1_2_7_5_1","doi-asserted-by":"crossref","first-page":"1379","DOI":"10.1002\/acr.25380","article-title":"Adherence and treat\u2010to\u2010target benchmarks in older adults with gout initiating urate\u2010lowering therapy in Ontario, Canada: a population\u2010based study","volume":"76","author":"Kwok TSH","year":"2024","journal-title":"Arthritis Care Res (Hoboken)"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.25167"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.151432"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.semarthrit.2016.08.006"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.52879"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1017\/cem.2017.365"},{"key":"e_1_2_7_11_1","unstructured":"Ontario Marginalization Index (ON\u2010Marg).Public Health Ontario. 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