Division of Cardiology, Department of Medicine, University of Iowa, Iowa City, Iowa.
Department of Cardiology, Case Western Reserve University/MetroHealth Medical Center, Cleveland, Ohio.
Curr Probl Cardiol. 2023 Jan;48(1):101437. doi: 10.1016/j.cpcardiol.2022.101437. Epub 2022 Sep 30.
The association between gout and arrhythmias has not been thoroughly examined. This study discusses the underappreciated burden, patterns, and outcomes of several arrhythmias, which may have prognostic value in patients with gout. This is a retrospective cohort study that used the US National Inpatient Sample for 2015-2019. Complex samples multivariable logistic and linear regression models were used 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. Hospitalizations that included a diagnosis of gout accounted for 60,360 admissions. Arrhythmias affected roughly one-fourth of those. When compared to individuals without arrhythmia, those who experienced arrhythmias were older. Arrhythmias were found to be equally common in both men and women. The most common subtype was AF (88%), followed by atrial flutter (6.2%), conduction disorders (4.7%), and ventricular tachycardia (3.2%). In individuals with gout, there was a rising trend in arrhythmia-related hospital admissions and mortality. The gout-arrhythmia group had more traditional cardiac comorbidities. After adjusting for baseline variables, the arrhythmia group had significantly greater mortality (693 vs 77 per 100,000 hospitalizations), mean LOS (4.3 vs 3.7 days), and hospital costs ($33,057 vs $28,384). In gout, incident arrhythmia dramatically raised the risk of death (adjusted odds ratio, 2.06; 95% CI, 1.95-2.16; P < 0.001). Gout patients who are hospitalized with concurrent arrhythmia have a likelihood of longer stays in the hospital and higher mortality. Early identification and treatment of arrhythmia may benefit outcomes in gout patients.
痛风与心律失常之间的关联尚未得到充分研究。本研究讨论了几种心律失常的被低估的负担、模式和结果,这些结果可能对痛风患者具有预后价值。这是一项回顾性队列研究,使用了 2015 年至 2019 年美国国家住院患者样本。采用复杂样本多变量逻辑回归和线性回归模型,评估与痛风相关的心律失常以及随之而来的住院死亡率、住院时间(LOS)、住院费用和死亡率预测因素的发生率和趋势。包含痛风诊断的住院治疗占 60360 例入院。大约四分之一的患者出现心律失常。与没有心律失常的患者相比,发生心律失常的患者年龄更大。男女心律失常的发生率相同。最常见的亚型是房颤(88%),其次是心房扑动(6.2%)、传导障碍(4.7%)和室性心动过速(3.2%)。在痛风患者中,与心律失常相关的住院和死亡率呈上升趋势。痛风-心律失常组有更多的传统心脏合并症。在调整基线变量后,心律失常组的死亡率显著更高(每 100000 例住院患者中有 693 例 vs 77 例),平均 LOS(4.3 天 vs 3.7 天)和住院费用(33057 美元 vs 28384 美元)。在痛风中,心律失常的发生显著增加了死亡的风险(调整后的优势比,2.06;95%CI,1.95-2.16;P<0.001)。同时患有心律失常的痛风住院患者住院时间更长,死亡率更高。早期识别和治疗心律失常可能有益于痛风患者的预后。