Related Experiment Video
Updated: Sep 30, 2025
Inverse Probability of Treatment Weighting Propensity Score using the Military Health System Data Repository and National Death Index
Published on: January 8, 2020
Incident Gout: Risk of Death and Cause-Specific Mortality in Western Sweden: A Prospective, Controlled Inception
Mats Dehlin1, Tatiana Zverkova Sandström1, Lennart Th Jacobsson1
1Department of Rheumatology and Inflammation Research, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Insights
Gout patients, particularly women, face an elevated mortality risk from cardiovascular, renal, and digestive diseases. However, gout is linked to decreased dementia mortality, suggesting potential therapeutic implications.
Area of Science:
- Rheumatology
- Epidemiology
- Public Health
Background:
- Gout's association with cardiovascular disease (CVD) mortality is established.
- Declining CVD mortality rates necessitate re-evaluation of overall and cause-specific mortality in gout patients.
- Temporal trends in gout mortality require investigation.
Purpose of the Study:
- To evaluate overall mortality in gout patients.
- To identify cause-specific mortality risks beyond CVD.
- To analyze temporal trends in gout mortality.
Main Methods:
- Incident gout cases (2006-2015) and population controls in western Sweden were identified.
- Comorbidities were assessed for 5 years prior to the index date.
- Cox regression analysis was used to determine death risk, stratified by sex and adjusted for confounders.
Main Results:
- 22,055 gout cases and 98,946 controls were analyzed.
- Women with gout had a 10% elevated overall mortality risk; men did not.
- Increased mortality from CVD, renal, and digestive diseases was observed in gout patients; decreased mortality from dementia, cancer, and lung diseases was noted.
Conclusions:
- Gout patients exhibit increased risks for cardiovascular, renal, and digestive diseases, underscoring the need for managing CVD risk factors.
- Gout is associated with reduced dementia mortality, potentially impacting urate-lowering therapy strategies and dementia risk.
- No significant changes in overall mortality rates were observed between 2006-2010 and 2011-2015 for gout patients.
Background:
Excess mortality in gout has been attributed to cardiovascular diseases (CVD). Considering the decline in CVD mortality in the general population, we wanted to evaluate overall mortality in gout and cause-specific contributions to mortality beyond CVD and temporal trends.
Methods:
All incident cases of gout between 2006 and 2015 in western Sweden and 5 population controls per case matched for age, sex, and county were identified. Comorbidities were identified for 5 years preceding the index date. Follow-up ended at death, migration, or end of study on December 2017. Effect of gout on death risk was calculated using COX regression on the whole population and stratified by sex, adjusted for demographics, and comorbidities. Death incidence rates were compared between the two time periods, 2006-2010 and 2011-2015.
Results:
We identified 22,055 cases of incident gout and 98,946 controls, median age (Q1, Q3) 69-68 (57, 79/56, 78) years and 67.6-66.5% males. Except for dementia, all comorbidities were significantly more common at baseline among gout cases. Overall, the risk for death in incident gout was neither increased overall nor in men, but women had a 10% elevated risk. In adjusted models for cause-specific mortality, death from CVD, renal disease, and digestive system diseases were significantly increased in the total gout population while death from dementia, cancer, and lung diseases were significantly decreased. There were no significant differences in overall incident death rate ratios between cases and controls in the two time periods examined.
Conclusions:
An increased risk for CVD, renal disease, and diseases of the digestive system in patients with gout highlights the importance of addressing CVD risk factors in gout management. Gout was associated with reduced mortality from dementia, which may have implications on urate lowering therapy and possible effects on dementia risk.
Related Concept Videos
01:23Types of Biopharmaceutical Studies: Controlled and Non-Controlled Approaches
Non-controlled studies, commonly employed for initial exploration, lack a control group, rendering them susceptible to biases and external influences. In contrast,...
01:29Bias in Epidemiological Studies
01:12Relative Risk
01:26Factors Affecting the Risk of Infection
The integrity and count of the white blood cells help the body resist pathogens and fight infection. When impaired, it reduces the body's resistance to pathogens. The acidic pH levels of the gastrointestinal, genitourinary tracts, and skin...
01:20Study Designs in Epidemiology
Observational studies are those where the researcher does not intervene but rather observes natural variations. They include cross-sectional, cohort, and...
01:27Confounding in Epidemiological Studies