{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T20:48:55Z","timestamp":1778014135834,"version":"3.51.4"},"reference-count":34,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2023,6,9]],"date-time":"2023-06-09T00:00:00Z","timestamp":1686268800000},"content-version":"unspecified","delay-in-days":8,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["RMD Open"],"accepted":{"date-parts":[[2023,5,24]]},"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>There is room for improvement in the knowledge of female gout, often noted at risk of gender blindness. This study aims to compare the prevalence of comorbidities in women versus men hospitalised with gout in Spain.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This is an observational, multicentre, cross-sectional study in public and private Spanish hospitals analysing the minimum basic data set from 192\u2009037 hospitalisations in people with gout (International Classification of Diseases, Ninth Revision (ICD-9) coding) from 2005 to 2015. Age and several comorbidities (ICD-9) were compared by sex, with a subsequent stratification of comorbidities by age group. The association between each comorbidity and sex was assessed using multivariable logistic regression. A clinical decision tree algorithm was constructed to predict the sex of patients with gout based on age and comorbidities alone.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Women with gout (17.4% of the sample) were significantly older than men (73.9\u00b113.7 years vs 64.0\u00b114.4 years, p&lt;0.001). Obesity, dyslipidaemia, chronic kidney disease, diabetes mellitus, heart failure, dementia, urinary tract infection and concurrent rheumatic disease were more common in women. Female sex was strongly associated with increasing age, heart failure, obesity, urinary tract infection and diabetes mellitus, while male sex was associated with obstructive respiratory diseases, coronary disease and peripheral vascular disease. The decision tree algorithm built showed an accuracy of 74.4%.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>A nationwide analysis of inpatients with gout in 2005\u20132015 confirms a different comorbidity profile between men and women. A different approach to female gout is needed to reduce gender blindness.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/rmdopen-2023-003191","type":"journal-article","created":{"date-parts":[[2023,6,9]],"date-time":"2023-06-09T10:03:14Z","timestamp":1686304994000},"page":"e003191","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":14,"title":["Filling gaps in female gout: a cross-sectional study of comorbidities in 192 037 hospitalised patients"],"prefix":"10.1136","volume":"9","author":[{"given":"Enrique","family":"Rodr\u00edguez-Sosa","sequence":"first","affiliation":[{"name":"Clinical Medicine, Miguel Hernandez University of Elche, Sant Joan D'Alacant, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5146-1964","authenticated-orcid":false,"given":"Eugenio","family":"De Miguel","sequence":"additional","affiliation":[{"name":"Rheumatology, Hospital Universitario La Paz, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fernando","family":"Borr\u00e1s","sequence":"additional","affiliation":[{"name":"Statistics, Mathematics and Informatics, Miguel Hernandez University of Elche, Sant Joan D'Alacant, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0219-9055","authenticated-orcid":false,"given":"Mariano","family":"Andr\u00e9s","sequence":"additional","affiliation":[{"name":"Clinical Medicine, Miguel Hernandez University of Elche, Sant Joan D'Alacant, Spain"},{"name":"Rheumatology, Dr. Balmis General University Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL), Alicante, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2023,6,9]]},"reference":[{"key":"2025090312274647000_9.2.e003191.1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199107253250408"},{"key":"2025090312274647000_9.2.e003191.2","doi-asserted-by":"crossref","first-page":"693","DOI":"10.1016\/j.rdc.2020.07.008","article-title":"Gender and ethnic inequities in gout burden and management","volume":"46","author":"Guill\u00e9n","year":"2020","journal-title":"Rheum Dis Clin North Am"},{"key":"2025090312274647000_9.2.e003191.3","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(65)90048-3"},{"key":"2025090312274647000_9.2.e003191.4","doi-asserted-by":"publisher","DOI":"10.1159\/000321074"},{"key":"2025090312274647000_9.2.e003191.5","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2014-206410"},{"key":"2025090312274647000_9.2.e003191.6","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.170806"},{"key":"2025090312274647000_9.2.e003191.7","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2013-203779"},{"key":"2025090312274647000_9.2.e003191.8","doi-asserted-by":"crossref","first-page":"1358","DOI":"10.1093\/rheumatology\/key096","article-title":"Comorbidity clusters in people with gout: an observational cohort study with linked medical record review","volume":"57","author":"Bevis","year":"2018","journal-title":"Rheumatology"},{"key":"2025090312274647000_9.2.e003191.9","doi-asserted-by":"crossref","DOI":"10.1111\/eci.13090","article-title":"Differential risk group of developing stroke among older women with Gouty arthritis: a latent transition analysis","volume":"49","author":"Huang","year":"2019","journal-title":"Eur J Clin Invest"},{"key":"2025090312274647000_9.2.e003191.10","doi-asserted-by":"crossref","first-page":"825","DOI":"10.1007\/s10067-018-3983-8","article-title":"Temporal trends and regional disparity in rheumatoid arthritis and gout hospitalizations in Sweden, 1998\u20132015","volume":"37","author":"Kiadaliri","year":"2018","journal-title":"Clin Rheumatol"},{"key":"2025090312274647000_9.2.e003191.11","doi-asserted-by":"crossref","unstructured":"O\u2019Dell JR , Brophy MT , Pillinger MH , et al . Comparative effectiveness of allopurinol and Febuxostat in gout management. NEJM Evid 2022;1. doi:10.1056\/evidoa2100028","DOI":"10.1056\/EVIDx2200180"},{"key":"2025090312274647000_9.2.e003191.12","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2016-209707"},{"key":"2025090312274647000_9.2.e003191.13","doi-asserted-by":"publisher","DOI":"10.1002\/acr.24180"},{"key":"2025090312274647000_9.2.e003191.14","unstructured":"NICE guideline [NG219] . Gout: diagnosis and management. 2022. Available: https:\/\/www.nice.org.uk\/guidance\/ng219\/chapter\/Recommendations"},{"key":"2025090312274647000_9.2.e003191.15","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2006.051649"},{"key":"2025090312274647000_9.2.e003191.16","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.200113"},{"key":"2025090312274647000_9.2.e003191.17","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1186\/s12891-017-1465-9","article-title":"Sex differences in gout characteristics: tailoring care for women and men","volume":"18","author":"Harrold","year":"2017","journal-title":"BMC Musculoskelet Disord"},{"key":"2025090312274647000_9.2.e003191.18","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.1991.00400040074016"},{"key":"2025090312274647000_9.2.e003191.19","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2011.200523"},{"key":"2025090312274647000_9.2.e003191.20","doi-asserted-by":"crossref","first-page":"802856","DOI":"10.3389\/fmed.2022.802856","article-title":"Incident gout: risk of death and cause-specific mortality in Western Sweden: a prospective, controlled inception cohort study","volume":"9","author":"Dehlin","year":"2022","journal-title":"Front Med"},{"key":"2025090312274647000_9.2.e003191.21","doi-asserted-by":"crossref","DOI":"10.1038\/s41598-021-92673-3","article-title":"Healthcare-related impact of gout in hospitalized patients in Spain","volume":"11","author":"Benavent","year":"2021","journal-title":"Sci Rep"},{"key":"2025090312274647000_9.2.e003191.22","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2016-210357"},{"key":"2025090312274647000_9.2.e003191.23","doi-asserted-by":"publisher","DOI":"10.9778\/cmajo.20160128"},{"key":"2025090312274647000_9.2.e003191.24","doi-asserted-by":"publisher","DOI":"10.9778\/cmajo.20210170"},{"key":"2025090312274647000_9.2.e003191.25","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1007\/978-1-4419-7046-6_19","article-title":"Decision tree and ensemble learning algorithms with their applications in Bioinformatics","volume":"696","author":"Che","year":"2011","journal-title":"Adv Exp Med Biol"},{"key":"2025090312274647000_9.2.e003191.26","doi-asserted-by":"crossref","unstructured":"Merriman TR . An update on the genetic architecture of hyperuricemia and gout. Arthritis Res Ther 2015;17. doi:10.1186\/s13075-015-0609-2","DOI":"10.1186\/s13075-015-0609-2"},{"key":"2025090312274647000_9.2.e003191.27","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2009.109884"},{"key":"2025090312274647000_9.2.e003191.28","doi-asserted-by":"crossref","first-page":"816","DOI":"10.1002\/art.42393","article-title":"Association of gout polygenic risk score with age at disease onset and Tophaceous disease in European and Polynesian men with gout","volume":"75","author":"Sumpter","year":"2023","journal-title":"Arthritis Rheumatol"},{"key":"2025090312274647000_9.2.e003191.29","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCRESAHA.119.313572"},{"key":"2025090312274647000_9.2.e003191.30","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/kew293"},{"key":"2025090312274647000_9.2.e003191.31","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2011.09.033"},{"key":"2025090312274647000_9.2.e003191.32","doi-asserted-by":"crossref","DOI":"10.1186\/ar4425","article-title":"Veterans affairs databases are accurate for gout-related health care utilization: a validation study","volume":"15","author":"Singh","year":"2013","journal-title":"Arthritis Res Ther"},{"key":"2025090312274647000_9.2.e003191.33","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2019-215315"},{"key":"2025090312274647000_9.2.e003191.34","doi-asserted-by":"crossref","DOI":"10.3389\/fmed.2020.00560","article-title":"Gout is prevalent but under-registered among patients with cardiovascular events: a field study","volume":"7","author":"Calabuig","year":"2020","journal-title":"Front Med (Lausanne)"}],"container-title":["RMD Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/rmdopen-2023-003191","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,3]],"date-time":"2025-09-03T19:27:53Z","timestamp":1756927673000},"score":1,"resource":{"primary":{"URL":"https:\/\/rmdopen.bmj.com\/lookup\/doi\/10.1136\/rmdopen-2023-003191"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,6]]},"references-count":34,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2023,6,9]]},"published-print":{"date-parts":[[2023,6]]}},"alternative-id":["10.1136\/rmdopen-2023-003191"],"URL":"https:\/\/doi.org\/10.1136\/rmdopen-2023-003191","relation":{},"ISSN":["2056-5933"],"issn-type":[{"value":"2056-5933","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,6]]}}}