Higher Rates of Mortality in Gout Patients With Concurrent Arrhythmias

Patients diagnosed with gout are at a higher risk of mortality, largely due to the increased likelihood of a range of comorbidities. The comorbidities often associated with gout include stroke, obesity, hyperlipidemia, type 2 diabetes mellitus, chronic kidney disease, hypertension, and myocardial infarction. In addition, gout patients suffer from recurrent flares of pain, redness, and swelling in the joints.

Many of the indicators for cardiac arrhythmias (irregular or abnormal heartbeats) are also commonly seen in those with gout. Despite this fact, research regarding the association between gout and arrhythmias is still being explored.

A study, published in Current Problems in Cardiology, investigated the prognostic value of the burden, patterns, and outcomes of several arrhythmias in patients with gout.

Utilizing data from the US National Inpatient Sample, researchers conducted a retrospective cohort study comprising a total of 60,360 hospitalizations carrying a primary or secondary diagnosis of gout. Of the study population, 25% had concomitant discharge diagnoses of arrhythmias.

To assess the incidence and trends in gout-related arrhythmia and consequential inpatient mortality, hospital length of stay (LOS), hospitalization charges, and predictors of mortality, researchers employed multivariable logistic and linear regression models.

Comparing gout patients with and without arrhythmia, those who had experienced arrhythmias tended to be older (mean age, 73 vs 65 years). There were no significant differences between the incidence of arrythmia when comparing men and women. The most common types of arrhythmias were atrial fibrillation (88%), atrial flutter (6.2%), conduction disorders (4.7%), and ventricular tachycardia (3.2%).

After adjusting for baseline variables, the researchers noted that patients in the arrhythmia group had significantly greater mortality (693 vs 77 per 100,000 hospitalizations). The mean LOS and total hospital costs in patients with arrhythmias were 4.3 days and $33,057, respectively. The mean LOS and hospital costs for patients without arrhythmias were 3.7 days and $28,384, respectively, and were considered significantly lower than the arrhythmia group. Researchers also found that incident arrhythmia dramatically raised the risk of death in patients with gout.

“Arrhythmias affect nearly one-fourth of gout patients during hospitalization, which is a major source of concern for health care providers,” the researchers wrote. “The observed rising prevalence, increased hospital LOS, costs, and fatality rates among hospitalized gout patients with arrhythmia emphasize the need for increased surveillance in this cohort of patients.”