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

Research output: Contribution to journalArticle

Abstract

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.

Details

Authors
Organisations
External organisations
  • State University of Rio de Janeiro
  • Boston University
  • Skåne University Hospital
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Public Health, Global Health, Social Medicine and Epidemiology
  • Rheumatology and Autoimmunity
Original languageEnglish
Pages (from-to)1935-1942
Number of pages8
JournalArthritis and Rheumatology
Volume71
Issue number11
Publication statusPublished - 2019 Nov 1
Publication categoryResearch
Peer-reviewedYes