Comorbidities in patients with gout prior to and following diagnosis: case-control study

OBJECTIVES: To determine the burden of comorbidities in patients with gout at diagnosis and the risk of developing new comorbidities post diagnosis. METHODS: There were 39 111 patients with incident gout and 39 111 matched controls identified from the UK Clinical Practice Research Data-link. The...

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Main Authors: Kuo, Chang-Fu, Grainge, Matthew J., Mallen, Christian, Zhang, Weiya, Doherty, Michael
Format: Article
Published: BMJ Publishing Group 2016
Subjects:
Online Access:https://eprints.nottingham.ac.uk/41930/
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author Kuo, Chang-Fu
Grainge, Matthew J.
Mallen, Christian
Zhang, Weiya
Doherty, Michael
author_facet Kuo, Chang-Fu
Grainge, Matthew J.
Mallen, Christian
Zhang, Weiya
Doherty, Michael
author_sort Kuo, Chang-Fu
building Nottingham Research Data Repository
collection Online Access
description OBJECTIVES: To determine the burden of comorbidities in patients with gout at diagnosis and the risk of developing new comorbidities post diagnosis. METHODS: There were 39 111 patients with incident gout and 39 111 matched controls identified from the UK Clinical Practice Research Data-link. The risk of comorbidity before (ORs) and after the diagnosis of gout (HRs) were estimated, adjusted for age, sex, diagnosis year, body mass index, smoking and alcohol consumption. RESULTS: Gout was associated with adjusted ORs (95% CIs) of 1.39 (1.34 to 1.45), 1.89 (1.76 to 2.03) and 2.51 (2.19 to 2.86) for the Charlson index of 1-2, 3-4 and >/=5, respectively. Cardiovascular and genitourinary diseases, in addition to hyperlipidaemia, hypothyroidism, anaemia, psoriasis, chronic pulmonary diseases, osteoarthritis and depression, were associated with a higher risk for gout. Gout was also associated with an adjusted HR (95% CI) of 1.41 (1.34 to 1.48) for having a Charlson index >/=1. Median time to first comorbidity was 43 months in cases and 111 months in controls. Risks for incident comorbidity were higher in cardiovascular, genitourinary, metabolic/endocrine and musculoskeletal diseases, in addition to liver diseases, hemiplegia, depression, anaemia and psoriasis in patients with gout. After additionally adjusting for all comorbidities at diagnosis, gout was associated with a HR (95% CI) for all-cause mortality of 1.13 (1.08 to 1.18; p<0.001). CONCLUSIONS: The majority of patients with gout have worse pre-existing health status at diagnosis and the risk of incident comorbidity continues to rise following diagnosis. The range of associated comorbidities is broader than previously recognised and merits further evaluation.
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spelling nottingham-419302024-08-15T15:17:40Z https://eprints.nottingham.ac.uk/41930/ Comorbidities in patients with gout prior to and following diagnosis: case-control study Kuo, Chang-Fu Grainge, Matthew J. Mallen, Christian Zhang, Weiya Doherty, Michael OBJECTIVES: To determine the burden of comorbidities in patients with gout at diagnosis and the risk of developing new comorbidities post diagnosis. METHODS: There were 39 111 patients with incident gout and 39 111 matched controls identified from the UK Clinical Practice Research Data-link. The risk of comorbidity before (ORs) and after the diagnosis of gout (HRs) were estimated, adjusted for age, sex, diagnosis year, body mass index, smoking and alcohol consumption. RESULTS: Gout was associated with adjusted ORs (95% CIs) of 1.39 (1.34 to 1.45), 1.89 (1.76 to 2.03) and 2.51 (2.19 to 2.86) for the Charlson index of 1-2, 3-4 and >/=5, respectively. Cardiovascular and genitourinary diseases, in addition to hyperlipidaemia, hypothyroidism, anaemia, psoriasis, chronic pulmonary diseases, osteoarthritis and depression, were associated with a higher risk for gout. Gout was also associated with an adjusted HR (95% CI) of 1.41 (1.34 to 1.48) for having a Charlson index >/=1. Median time to first comorbidity was 43 months in cases and 111 months in controls. Risks for incident comorbidity were higher in cardiovascular, genitourinary, metabolic/endocrine and musculoskeletal diseases, in addition to liver diseases, hemiplegia, depression, anaemia and psoriasis in patients with gout. After additionally adjusting for all comorbidities at diagnosis, gout was associated with a HR (95% CI) for all-cause mortality of 1.13 (1.08 to 1.18; p<0.001). CONCLUSIONS: The majority of patients with gout have worse pre-existing health status at diagnosis and the risk of incident comorbidity continues to rise following diagnosis. The range of associated comorbidities is broader than previously recognised and merits further evaluation. BMJ Publishing Group 2016-01-01 Article PeerReviewed Kuo, Chang-Fu, Grainge, Matthew J., Mallen, Christian, Zhang, Weiya and Doherty, Michael (2016) Comorbidities in patients with gout prior to and following diagnosis: case-control study. Annals of the Rheumatic Diseases, 75 (1). pp. 210-217. ISSN 1468-2060 Aged Case-control studies Comorbidity Databases Factual Female Follow-up studies Gout/epidemiology Humans Male Middle aged Retrospective studies United Kingdom/epidemiology Cardiovascular disease Epidemiology Gout http://ard.bmj.com/content/75/1/210.info doi:10.1136/annrheumdis-2014-206410 doi:10.1136/annrheumdis-2014-206410
spellingShingle Aged
Case-control studies
Comorbidity
Databases
Factual
Female
Follow-up studies
Gout/epidemiology
Humans
Male
Middle aged
Retrospective studies
United Kingdom/epidemiology
Cardiovascular disease
Epidemiology
Gout
Kuo, Chang-Fu
Grainge, Matthew J.
Mallen, Christian
Zhang, Weiya
Doherty, Michael
Comorbidities in patients with gout prior to and following diagnosis: case-control study
title Comorbidities in patients with gout prior to and following diagnosis: case-control study
title_full Comorbidities in patients with gout prior to and following diagnosis: case-control study
title_fullStr Comorbidities in patients with gout prior to and following diagnosis: case-control study
title_full_unstemmed Comorbidities in patients with gout prior to and following diagnosis: case-control study
title_short Comorbidities in patients with gout prior to and following diagnosis: case-control study
title_sort comorbidities in patients with gout prior to and following diagnosis: case-control study
topic Aged
Case-control studies
Comorbidity
Databases
Factual
Female
Follow-up studies
Gout/epidemiology
Humans
Male
Middle aged
Retrospective studies
United Kingdom/epidemiology
Cardiovascular disease
Epidemiology
Gout
url https://eprints.nottingham.ac.uk/41930/
https://eprints.nottingham.ac.uk/41930/
https://eprints.nottingham.ac.uk/41930/