All-cause and specific mortality in patients with gout: A systematic review and meta-analysis

Abstract

Objectives: This meta-analysis aims to examine the general mortality risk and specific mortality risk of gout, as the incidence of the condition is on the rise but information on mortality rates remains uncertain.

Method: The researchers conducted a search of published cohort studies on gout and mortality using Medical subject headings and keywords in PubMed, EMBASE, and Cochrane Library databases from inception to September 2022. The quality of study was evaluated using the NOS scale. Statistical analysis was performed using STATA software (version 16.0). Publication bias was assessed using funnel plots and Egger's test.

Result: This meta-analysis included 11 cohort studies (2010-2022), covering 14,854,490 people with a follow-up time of 1.66-16 years. The pooled analysis shows increased risk of overall mortality [HR=1.23, 95 % CI (1.13-1.35), I²=96.4 %, P<0.001], cardiovascular mortality [HR=1.29, 95 % CI (1.13-1.48), I²=98.5 %, P<0.001], infection mortality [HR=1.24, 95 % CI (1.04-1.47), I²=88.5 %, P = 0.019], and digestive system disease mortality [HR=1.42, 95 % CI (1.13-1.80), I²=91.7 %, P = 0.003] in gout. Sensitivity and subgroup analysis support the findings, and publication bias was not evident.

Conclusion: The findings from our meta-analysis indicate that gout is associated with an increased risk of all-cause mortality, as well as mortality related to cardiovascular disease, infections, and digestive system diseases. This has important implications for clinical practice, nursing care of patients with gout, and guidance on lifestyle modifications to prevent adverse outcomes such as cardiovascular events, infections, and digestive disorders.

Keywords: Cardiovascular; Digestive disease; Gout; Infection; Meta-analysis; Mortality.