Singh J A, Strand V
Minneapolis VA Medical Center, Rheumatology (111R), One Veteran's Drive, Minneapolis, MN 55417, USA.
Ann Rheum Dis. 2008 Sep;67(9):1310-6. doi: 10.1136/ard.2007.081604. Epub 2008 Jan 4.
To better understand the impact of gout on functional status, health-related quality of life (HRQoL), mortality and healthcare utilisation in US veterans.
All veterans seen in Veterans Integrated Service Network-13 from 1 October 1996 to 31 March 1998 received mailed surveys asking about demographic characteristics; performance of activities of daily living and HRQoL by Short Form-36 (SF-36) for Veterans. Administrative data included demographics; inpatient/outpatient healthcare utilisation; ICD-9 codes for gout, medical comorbidities and arthritis excluding gout-"arthritic comorbidity" and 1-year mortality. Multivariable estimates compared results between veterans with/without gout using least means squared.
with gout were significantly older, retired, not married, current non-smokers, with more comorbidities. Multivariable-adjusted bodily pain was somewhat worse (49.7 vs 47.1, p<0.01) and mental health (66.7 vs 68.6, p<0.01) domain scores somewhat better in patients with gout, both differences significant but not clinically meaningful (less than threshold of 5-10 points); other SF-36 domain and summary scores and functional limitations were similar. Medical or arthritic comorbidities predicted clinically/statistically lower adjusted scores in all SF-36 domains and physical domains (physical component summary), respectively. Patients with gout had significantly more annual primary care visits (3.5 vs 2.7, p<0.001) and admissions to hospital (18.3% vs 15.1%, p<0.01), fewer mental health visits (10.1% vs 13.7%, p<0.01) and similar mortality (2.6% vs 2.2%, p = 0.23).
Gout is independently associated with higher medical and arthritic comorbidity, primary care and inpatient utilisation. Poorer HRQoL, functional limitation and higher mortality noted in univariate analyses in patients with gout were attributable to higher comorbidity and sociodemographic characteristics.
更好地了解痛风对美国退伍军人功能状态、健康相关生活质量（HRQoL）、死亡率和医疗保健利用的影响。
1996年10月1日至1998年3月31日在退伍军人综合服务网络13就诊的所有退伍军人都收到了邮寄的调查问卷，询问其人口统计学特征；通过退伍军人简式36（SF - 36）评估日常生活活动表现和HRQoL。行政数据包括人口统计学；住院/门诊医疗保健利用情况；痛风、合并症和排除痛风的关节炎（“关节炎合并症”）的国际疾病分类第九版（ICD - 9）编码以及1年死亡率。多变量估计使用最小均方比较有/无痛风退伍军人之间的结果。
患有痛风的退伍军人明显年龄更大、已退休、未婚、当前不吸烟且合并症更多。多变量调整后的身体疼痛在痛风患者中略差（49.7对47.1，p<0.01），心理健康领域得分略高（66.7对68.6，p<0.01），两者差异均显著但在临床上无意义（低于5 - 10分的阈值）；其他SF - 36领域和汇总得分以及功能受限情况相似。合并症或关节炎合并症分别在所有SF - 36领域和身体领域（身体成分汇总）预测了临床上/统计学上较低的调整得分。痛风患者每年的初级保健就诊次数显著更多（3.5对2.7，p<0.001），住院率更高（18.3%对15.1%，p<0.01），心理健康就诊次数更少（10.1%对13.7%，p<0.01），死亡率相似（2.6%对2.2%，p = 0.23）。
痛风与更高的合并症和关节炎合并症、初级保健和住院利用独立相关。痛风患者单变量分析中指出的较差的HRQoL、功能受限和更高的死亡率归因于更高的合并症和社会人口统计学特征。
