Elevated risk of mortality among gout patients: A comparison with the National Population in Taiwan

Kuo, Chang‐Fu; Yu, Kuang‐Hui; See, Lai‐Chu; Chou, I-Jun; Tseng, Wen-Yi; Chang, Hsiao-Chun; Shen, Yu-Ming; Luo, Shue‐Fen

doi:10.1016/j.jbspin.2011.01.007

Cited by 32 publications

(46 citation statements)

References 21 publications

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“…This finding is in line with findings from a study on mortality in patients with gout that had specified causes of death, other than cardiovascular death 32 . This retrospective cohort study that used the National Death Registry in Taiwan showed that women with gout had an excess mortality due to infectious diseases (standardized mortality ratio 2.25) compared to women without gout.…”

Section: Discussionsupporting

confidence: 89%

Risk of infections in patients with gout: a population-based cohort study

Spaetgens

Vries

Driessen

et al. 2017

Sci Rep

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To investigate the risk of various types of infections (pneumonia and urinary tract infection (UTI)), and infection-related mortality in patients with gout compared with population-based controls. A retrospective cohort study was conducted using data from the UK Clinical Practice Research Datalink (CPRD). All patients with a first diagnosis of gout and aged >40 years between January 1987-July 2014, were included and matched with up to two controls. Time-varying Cox proportional hazards models were used to estimate the risk of infections and mortality. 131,565 patients and 252,763 controls (mean age: 64 years, 74% males, mean follow-up of 6.7 years) were included in the full cohort. After full statistical adjustment, the risk of pneumonia was increased (adj. HR 1.27, 95% CI 1.18 to 1.36), while the risk of UTI (adj. HR 0.99, 95% CI 0.97 to 1.01) was similar in patients compared to controls. No differences between patients and controls were observed for infection-related mortality due to pneumonia (adj. HR 1.03, 95% CI 0.93 to 1.14) or UTI (adj. HR 1.16, 95% CI 0.98 to 1.37). In conclusion, patients with gout did not have decreased risks of pneumonia, UTI or infection-related mortality compared to population-based controls.

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Section: Discussionsupporting

confidence: 89%

Risk of infections in patients with gout: a population-based cohort study

Spaetgens

Vries

Driessen

et al. 2017

Sci Rep

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“…A Taiwanese study comparing 6631 subjects with gout with the general population reported standardised mortality ratios for fatal renal disease of 3.54 and 3.10 in women and men, respectively. 25 These fi gures are comparable to our risk estimates from the subpopulation without a selfreported history of physician-diagnosed CHD or stroke. It is diffi cult to ascertain if hyperuricaemia preceded chronic kidney disease or the reverse.…”

Section: Discussionsupporting

confidence: 78%

Mortality due to coronary heart disease and kidney disease among middle-aged and elderly men and women with gout in the Singapore Chinese Health Study

et al. 2011

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Objectives Whether the link between gout and mortality is causal or confounded by lifestyle factors or comorbidities remains unclear. Studies in Asia are warranted due to the rapid modernisation of the locale and ageing of the population. Methods The association between gout and mortality was examined in a prospective cohort, the Singapore Chinese Health Study, comprising 63 257 Singapore Chinese individuals, aged 45–74 years during the enrolment period of 1993–8. All enrollees were interviewed in person on lifestyle factors, current diet and medical histories. All surviving cohort members were contacted by telephone during 1999–2004 to update selected exposure and medical histories (follow-up I interview), including the history of physician-diagnosed gout. Cause-specific mortality in the cohort was identified via record linkage with the nationwide death registry, up to 31 December 2009. Results Out of 52 322 participants in the follow-up I interview, 2117 (4.1%) self-reported a history of physician-diagnosed gout, with a mean age at diagnosis of 54.7 years. After a mean follow-up period of 8.1 years, there were 6660 deaths. Relative to non-gout subjects, subjects with gout had a higher risk of death (HR 1.18; 95% CI 1.06 to 1.32), and specifi cally from death due to coronary heart disease (CHD) (HR 1.38, 95% CI 1.10 to 1.73) and kidney disease (HR 5.81, 95% CI 3.61 to 9.37). All gout–mortality risk associations were present in both genders but the risk estimates appeared higher for women. Conclusion Gout is an independent risk factor for mortality, and specifically for death due to CHD and kidney disease.

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“…Historically, the burden of comorbidities in gout has translated into higher mortality rates . This excess mortality among gout patients has been previously attributed mainly to CV causes . It is unclear whether women have similar risks to men, as most studies have mostly or exclusively included men, and thus precise estimates in women are lacking .…”

Section: Introductionmentioning

confidence: 99%

Cause‐Specific Mortality in Gout: Novel Findings of Elevated Risk of Non–Cardiovascular‐Related Deaths

Vargas-Santos

Neogi

Pinheiro

et al. 2019

Arthritis & Rheumatology

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Objective To examine cause‐specific mortality beyond cardiovascular diseases (CVDs) in patients with gout compared to the general population. Methods We included all residents of Skåne (Sweden) age ≥18 years in the year 2002. Using the Skåne Healthcare Register, we identified subjects with a new diagnosis of gout (2003–2013) and matched each person with gout with 10 comparators free of gout, by age and sex. We used information on the underlying cause of death from the Swedish Cause of Death Register (through December 31, 2014) to estimate hazard ratios (HRs, with 95% confidence intervals [95% CIs]) of mortality for specific causes of death in a multi‐state Cox model, with adjustment for potential confounders. Results Among 832,258 persons, 19,497 had a new diagnosis of gout (32% women) and were matched with 194,947 comparators. Subjects with gout had higher prevalence of chronic kidney disease, metabolic disease, and CVD. Gout was associated with 17% increased hazard of all‐cause mortality overall (HR 1.17 [95% CI 1.14–1.21]), 23% in women (HR 1.23 [95% CI 1.17–1.30]), and 15% in men (HR 1.15 [95% CI 1.10–1.19]). In terms of cause‐specific mortality, the strongest associations were seen in the relationship of gout to the risk of death due to renal disease (HR 1.78 [95% CI 1.34–2.35]), diseases of the digestive system (HR 1.56 [95% 1.34–1.83]), CVD (HR 1.27 [95% CI 1.22–1.33]), infections (HR 1.20 [95% CI 1.06–1.35]), and dementia (HR 0.83 [95% CI 0.72–0.97]). Conclusion Several non‐CV causes of mortality are increased in persons with gout, emphasizing the need for improved management of comorbidities.

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Elevated risk of mortality among gout patients: A comparison with the National Population in Taiwan

Cited by 32 publications

References 21 publications

Risk of infections in patients with gout: a population-based cohort study

Risk of infections in patients with gout: a population-based cohort study

Mortality due to coronary heart disease and kidney disease among middle-aged and elderly men and women with gout in the Singapore Chinese Health Study

Cause‐Specific Mortality in Gout: Novel Findings of Elevated Risk of Non–Cardiovascular‐Related Deaths

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