Clinical survey of 354 patients with gout.

Between the years 1958 and 1967, 354 patients with gout were examined personally at Hammersmith Hospital (257 cases seen between 1958 and 1967), and more recently at the Charing Cross and West London Hospitals (97 cases seen during 1966 and 1967). This paper describes a retrospective computer-assisted analysis of these patients. Some of them were followed for considerable periods of time by ourselves or our colleagues, whereas others were seen on one or two occasions only. The study does not therefore trace the course of the disorder over a period of time in individual patients. Method For the purpose of the survey gout was defined as recurrent acute episodes of arthritis in the presence of hyperuricaemia. Most of the serum urate values had been estimated with the use of the Technicon Auto-Analyzer; the upper limit of normal for serum uric acid was taken to be 6 mg./100 ml. for males and postmenopausal women and 5 mg./100 ml. for premenopausal women. These figures had previously been obtained by duplicate sampling with sera from the population survey of Popert and Hewitt (1962). The presence of urate crystals in synovial fluid or of tophaceous changes was taken as confirming the Jiag-nosis but these were not necessary criteria. The information for the survey was abstracted from the patients' case notes and recorded on a proforma with 100 slots which permitted 65 separate items of data to be assembled for each patient. These items were punched and fed into the Elliott computer at the Royal Postgraduate Medical School of London. Every item was cross-referenced with each of the others, thus demonstrating any association between one feature in relation to another.