Zoë L Vincent1,2, Greg Gamble1,2, Meaghan House1,2, Julie Knight1,2, Anne Horne1,2, William J Taylor1,2, Nicola Dalbeth3,4. 1. From the Bone and Joint Research Group, Department of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland; Department of Medicine, University of Otago Wellington, Wellington, New Zealand. 2. Z.L. Vincent, PhD, Bone and Joint Research Group, Department of Medicine, Faculty of Medical and Health Sciences, University of Auckland; G. Gamble, MSc, Bone and Joint Research Group, Department of Medicine, Faculty of Medical and Health Sciences, University of Auckland; M. House, MPH, Bone and Joint Research Group, Department of Medicine, Faculty of Medical and Health Sciences, University of Auckland; J. Knight, BA, Bone and Joint Research Group, Department of Medicine, Faculty of Medical and Health Sciences, University of Auckland; A. Horne, MBChB, Bone and Joint Research Group, Department of Medicine, Faculty of Medical and Health Sciences, University of Auckland; W.J. Taylor, PhD, FRACP, Department of Medicine, University of Otago Wellington; N. Dalbeth, MD, FRACP, Bone and Joint Research Group, Department of Medicine, Faculty of Medical and Health Sciences, University of Auckland. 3. From the Bone and Joint Research Group, Department of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland; Department of Medicine, University of Otago Wellington, Wellington, New Zealand. n.dalbeth@auckland.ac.nz. 4. Z.L. Vincent, PhD, Bone and Joint Research Group, Department of Medicine, Faculty of Medical and Health Sciences, University of Auckland; G. Gamble, MSc, Bone and Joint Research Group, Department of Medicine, Faculty of Medical and Health Sciences, University of Auckland; M. House, MPH, Bone and Joint Research Group, Department of Medicine, Faculty of Medical and Health Sciences, University of Auckland; J. Knight, BA, Bone and Joint Research Group, Department of Medicine, Faculty of Medical and Health Sciences, University of Auckland; A. Horne, MBChB, Bone and Joint Research Group, Department of Medicine, Faculty of Medical and Health Sciences, University of Auckland; W.J. Taylor, PhD, FRACP, Department of Medicine, University of Otago Wellington; N. Dalbeth, MD, FRACP, Bone and Joint Research Group, Department of Medicine, Faculty of Medical and Health Sciences, University of Auckland. n.dalbeth@auckland.ac.nz.
Abstract
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.
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.
Authors: Irvin J Huang; Jean W Liew; Meredith B Morcos; Silu Zuo; Carol Crawford; Alison M Bays Journal: Rheumatol Int Date: 2019-05-30 Impact factor: 2.631
Authors: Sarah Stewart; Keith Rome; Alastair Eason; Meaghan E House; Anne Horne; Anthony J Doyle; Julie Knight; William J Taylor; Nicola Dalbeth Journal: Clin Rheumatol Date: 2018-04-21 Impact factor: 2.980
Authors: Fernando Pérez Ruiz; Pascal Richette; Austin G Stack; Ravichandra Karra Gurunath; Ma Jesus García de Yébenes; Loreto Carmona Journal: RMD Open Date: 2019-10-13