Background/Purpose: Patients with gout have several coexisting conditions that impact mortality. Studies on clinical features and mortality of female patients with gout are limited, as gout is far more prevalent in male patients than in females. We analyzed the differences in clinical manifestations and mortality among Korean patients with gout and compared the causes of death based on sex. Furthermore, we identified the risk factors contributing to overall mortality.

Methods: This study was based on patient data collected from the Korean National Health Insurance Service-National Sample Cohort database. We included individuals aged ≥20 years who were diagnosed with gout and received urate-lowering therapy (ULT). Clinical features and mortality rate were compared according to sex, and multivariate Cox regression was performed to calculate hazard ratio (HR) for overall mortality with covariates.

Results: Female patients were older at the start of ULT (60.40 ± 14.87 vs 51.23 ± 14.59) and had more comorbidities. The most common cause of death among patients with gout was chronic kidney disease; however, the order of common causes of death differed by sex. Multivariate Cox analysis showed age at initiation of ULT (HR: 1.10), current smoking (HR: 1.26), diabetes (HR: 1.37), chronic kidney disease (HR: 1.97), cerebrovascular disease (HR: 1.28), and malignancy (HR: 1.88) as significant risk factors for overall mortality. Overall mortality based on sex in multivariate analysis was not statistically different.

Conclusion: The clinical features and mortality pattern were different between male and female patients with gout, suggesting that treatment strategies for gout should be established differently depending on sex.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/sex-differences-in-clinical-features-and-mortality-in-gout-a-nationwide-retrospective-cohort-study/