RT Journal Article
SR Electronic
T1 Predictors of Mortality in People with Recent-onset Gout: A Prospective Observational Study
JF The Journal of Rheumatology
JO J Rheumatol
FD The Journal of Rheumatology
SP 368
OP 373
DO 10.3899/jrheum.160596
VO 44
IS 3
A1 Zoë L. Vincent
A1 Greg Gamble
A1 Meaghan House
A1 Julie Knight
A1 Anne Horne
A1 William J. Taylor
A1 Nicola Dalbeth
YR 2017
UL http://www.jrheum.org/content/44/3/368.abstract
AB Objective. To determine mortality rates and predictors of death at baseline in people with a recent onset of gout.Methods. People with gout disease duration < 10 years were recruited from primary and secondary care settings. Comprehensive clinical assessment was completed at baseline. Participants were prospectively followed for at least 1 year. Information about death was systematically collected from primary and secondary health records. Standardized mortality ratios (SMR) were calculated and risk factors for mortality were analyzed using Cox proportional hazard regression models.Results. The mean (SD) followup duration was 5.1 (1.6) years (a total 1511 patient-yrs accrued). Of the 295 participants, 43 (14.6%) had died at the time of censorship (SMR 1.96, 95% CI 1.44–2.62). In the reduced Cox proportional hazards model, these factors were independently associated with an increased risk of death from all causes: older age (70–80 yrs: HR 9.96, 95% CI 3.30–30.03; 80–91 yrs: HR 9.39, 95% CI 2.68–32.89), Māori or Pacific ethnicity (HR 2.48, 95% CI 1.17–5.29), loop diuretic use (HR 3.99, 95% CI 2.15–7.40), serum creatinine (per 10 µmol/l change; HR 1.04, 95% CI 1.00–1.07), and the presence of subcutaneous tophi (HR 2.85, 95% CI 1.49–5.44). The presence of subcutaneous tophi was the only baseline variable independently associated with both cardiovascular (CV) cause of death (HR 3.13, 95% CI 1.38–7.10) and non-CV cause of death (HR 3.48, 95% CI 1.25–9.63).Conclusion. People with gout disease duration < 10 years have an increased risk of death. The presence of subcutaneous tophi at baseline is an independent predictor of mortality, from both CV and non-CV causes.