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

Annals of the rheumatic diseases, 2016-01, Vol.75 (1), p.210-217 [Peer Reviewed Journal]

Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing ;Copyright: 2015 Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing ;Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/ 2015 ;ISSN: 0003-4967 ;EISSN: 1468-2060 ;DOI: 10.1136/annrheumdis-2014-206410 ;PMID: 25398375 ;CODEN: ARDIAO

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  • Title:
    Comorbidities in patients with gout prior to and following diagnosis: case-control study
  • Author: Kuo, Chang-Fu ; Grainge, Matthew J ; Mallen, Christian ; Zhang, Weiya ; Doherty, Michael
  • Subjects: Aged ; Anemia ; Arthritis ; Case-Control Studies ; Clinical and Epidemiological Research ; Comorbidity ; Databases, Factual ; Female ; Follow-Up Studies ; Gout - epidemiology ; Health risk assessment ; Humans ; Hypothyroidism ; Liver diseases ; Male ; Medical records ; Middle Aged ; Mortality ; Patients ; Registration ; Retrospective Studies ; Rheumatism ; Rheumatology ; Studies ; United Kingdom - epidemiology
  • Is Part Of: Annals of the rheumatic diseases, 2016-01, Vol.75 (1), p.210-217
  • Description: ObjectivesTo determine the burden of comorbidities in patients with gout at diagnosis and the risk of developing new comorbidities post diagnosis.MethodsThere 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.ResultsGout 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).ConclusionsThe 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.
  • Publisher: England: BMJ Publishing Group LTD
  • Language: English
  • Identifier: ISSN: 0003-4967
    EISSN: 1468-2060
    DOI: 10.1136/annrheumdis-2014-206410
    PMID: 25398375
    CODEN: ARDIAO
  • Source: BMJ Open Access Journals
    MEDLINE
    ProQuest Central
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