Comorbidity Drives Risk of Death in Gout Patients Save

A study of men with gout from the US Veteran’s Health Administration (VHA) shows that excess mortality in gout could be attributed to comorbidities.

A matched cohort study done between 1999 - 2015, compared gout and non-gout patients, looking at clinical variables and mortality rates. 

Nearly a half million gout patients were matched with over 5 million non-gout controls (mean age of 67 years).  This included 246,291 gout deaths and 2,000,000 non-gout deaths.

Gout patients demonstrated an increased risk of death (HR 1.09; 95% CI 1.08-1.09), which was no longer present after adjusting for comorbidities (HR 0.98; 95% CI 0.97-0.98).

The gout - mortality association was strongest with genitourinary conditions (HR 1.50; 95% CI 1.47-1.54).

Yet, there were certain comorbidities in gout patients that were associated with a lower risk of death, including neurologic (Alzheimer’s, Parkinson’s; HR 0.63) and and mental health (HR 0.66) conditions.

While other factors, including urate burden and chronic inflammation can augment the mortality risk in gout patients, the comorbidity burden not only adds to the morbidity, but also the mortality, seen in gout.