Association Between Gout and Injury Risk: A National Retrospective Cohort Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Data Collection
2.2. Study Design
2.3. Data Analysis
3. Results
3.1. Sample Size
3.2. Baseline Characteristics
3.3. Differences in Injuries between Groups CFG and C at the End of Follow-Up
3.4. Risk Factors for the Occurrence of Injuries
3.5. Factors for the Occurrence of Injuries by Cox Regression Analysis
3.6. Relationship between the Occurrence of Subgroup Injuries and Gout
3.7. Difference in the Occurrence of Injuries in Group CFG with Medication (M) and without Medication (NM)
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Conflicts of Interest
References
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Gout | Total | Group CFG | Group C | p Value | ||||
---|---|---|---|---|---|---|---|---|
Variables | n | % | n | % | n | % | ||
Total | 257,442 | 85,814 | 33.33 | 171,628 | 66.67 | |||
Sex | 0.999 | |||||||
Male | 206,907 | 80.37 | 68,969 | 80.37 | 137,938 | 80.37 | ||
Female | 50,535 | 19.63 | 16,845 | 19.63 | 33,690 | 19.63 | ||
Age (Years) (Mean ± SD) | 64.15 ± 16.69 | 63.90 ± 16.13 | 64.28 ± 16.97 | 0.041 | ||||
Season | <0.001 | |||||||
Spring (March–May) | 62,939 | 24.45 | 19,672 | 22.92 | 43,267 | 25.21 | ||
Summer (June–August) | 64,590 | 25.09 | 21,974 | 25.61 | 42,616 | 24.83 | ||
Autumn (September–November) | 68,327 | 26.54 | 24,952 | 29.08 | 43,375 | 25.27 | ||
Winter (December–February) | 61,586 | 23.92 | 19,216 | 22.39 | 42,370 | 24.69 | ||
Location | <0.001 | |||||||
Northern Taiwan | 101,639 | 39.48 | 32,547 | 37.93 | 69,092 | 40.26 | ||
Central Taiwan | 73,304 | 28.47 | 24,929 | 29.05 | 48,375 | 28.19 | ||
Southern Taiwan | 64,734 | 25.15 | 21,637 | 25.21 | 43,097 | 25.11 | ||
Eastern Taiwan | 16,564 | 6.43 | 6208 | 7.23 | 10,356 | 6.03 | ||
Outlying islands | 1201 | 0.47 | 493 | 0.57 | 708 | 0.41 | ||
Insured Premium (NT$) | 0.001 | |||||||
<15,840 | 253,900 | 98.62 | 84,517 | 98.49 | 169,383 | 98.69 | ||
15,841–25,000 | 2832 | 1.10 | 1077 | 1.26 | 1755 | 1.02 | ||
≥25,001 | 710 | 0.28 | 220 | 0.26 | 490 | 0.29 | ||
Diabetes Mellitus (DM) | <0.001 | |||||||
Without | 212,846 | 82.68 | 69,797 | 81.34 | 143,049 | 83.35 | ||
With | 44,596 | 17.32 | 16,017 | 18.66 | 28,579 | 16.65 | ||
Hypertension | <0.001 | |||||||
Without | 197,472 | 76.71 | 56,906 | 66.31 | 140,566 | 81.90 | ||
With | 59,970 | 23.29 | 28,908 | 33.69 | 31,062 | 18.10 | ||
Stroke | <0.001 | |||||||
Without | 233,003 | 90.51 | 77,098 | 89.84 | 155,905 | 90.84 | ||
With | 24,441 | 9.49 | 8718 | 10.16 | 15,723 | 9.16 | ||
Chronic Renal Disease | <0.001 | |||||||
Without | 248,622 | 96.57 | 82,486 | 96.12 | 166,136 | 96.80 | ||
With | 8820 | 3.43 | 3328 | 3.88 | 5492 | 3.20 | ||
Coronary Artery Disease (CAD) | <0.001 | |||||||
Without | 230,456 | 89.52 | 75,336 | 87.79 | 155,120 | 90.38 | ||
With | 26,986 | 10.48 | 10,478 | 12.21 | 16,508 | 9.62 |
Gout | Total | Group CFG | Group C | p Value | ||||
---|---|---|---|---|---|---|---|---|
Variables | n | % | n | % | n | % | ||
Total | 257,442 | 85,814 | 33.33 | 171,628 | 66.67 | |||
Injury | <0.001 | |||||||
Without | 210,610 | 81.81 | 69,576 | 81.08 | 141,034 | 82.17 | ||
With | 46,832 | 18.19 | 16,238 | 18.92 | 30,594 | 17.83 | ||
Cause of injury | <0.001 | |||||||
Traffic Injuries | 6615 | 14.12 | 2141 | 13.19 | 4474 | 14.62 | ||
Poisoning | 586 | 1.25 | 234 | 1.44 | 352 | 1.15 | ||
Falls | 10,044 | 21.45 | 3322 | 20.46 | 6722 | 21.97 | ||
Burns and Fires | 73 | 0.16 | 19 | 0.12 | 54 | 0.18 | ||
Drowning | 9 | 0.02 | 3 | 0.02 | 6 | 0.02 | ||
Suffocation | 217 | 0.46 | 68 | 0.42 | 149 | 0.49 | ||
Crushing/Cutting/Piercing | 1452 | 3.10 | 512 | 3.15 | 940 | 3.07 | ||
Excessive Heat | 12 | 0.03 | 4 | 0.02 | 8 | 0.03 | ||
Injury Caused by Animals | 96 | 0.03 | 44 | 0.05 | 52 | 0.03 | ||
Electric Current Injury | 21 | 0.04 | 4 | 0.02 | 17 | 0.06 | ||
Other Unintentional Injuries | 9472 | 20.23 | 3768 | 23.20 | 5704 | 18.64 | ||
Suicide | 555 | 1.19 | 179 | 1.10 | 376 | 1.23 | ||
Homicide/Abuse | 449 | 0.96 | 140 | 0.86 | 309 | 1.01 | ||
Intention Unknown | 305 | 0.65 | 110 | 0.68 | 195 | 0.64 | ||
No Provided E-Code | 16,926 | 36.14 | 5690 | 35.04 | 11,236 | 36.73 | ||
Injury Severity Score (ISS) ≥ 16 | <0.001 | |||||||
Without | 257,056 | 99.85 | 85,631 | 99.79 | 171,425 | 99.88 | ||
With | 386 | 0.15 | 183 | 0.21 | 203 | 0.12 |
Variables | Crude HR | 95% CI | 95% CI | p | Adjusted HR | 95% CI | 95% CI | p |
---|---|---|---|---|---|---|---|---|
Gout | ||||||||
Without | Reference | Reference | ||||||
With | 1.992 | 1.953 | 2.031 | <0.001 | 2.034 | 1.995 | 2.074 | <0.001 |
Sex | ||||||||
Male | 0.912 | 0.892 | 0.932 | <0.001 | 0.889 | 0.869 | 0.909 | <0.001 |
Female | Reference | Reference | ||||||
Age (Years) | 0.989 | 0.988 | 0.990 | <0.001 | 0.993 | 0.992 | 0.994 | <0.001 |
Diabetes Mellitus (DM) | ||||||||
Without | Reference | Reference | ||||||
With | 0.856 | 0.836 | 0.876 | <0.001 | 0.894 | 0.873 | 0.916 | <0.001 |
Hypertension | ||||||||
Without | Reference | Reference | ||||||
With | 0.751 | 0.735 | 0.768 | <0.001 | 0.787 | 0.769 | 0.806 | <0.001 |
Stroke | ||||||||
Without | Reference | Reference | ||||||
With | 0.618 | 0.596 | 0.642 | <0.001 | 0.649 | 0.626 | 0.674 | <0.001 |
Chronic Renal Disease | ||||||||
Without | Reference | Reference | ||||||
With | 1.484 | 1.422 | 1.548 | <0.001 | 1.302 | 1.247 | 1.360 | <0.001 |
Coronary Artery Disease (CAD) | ||||||||
Without | Reference | Reference | ||||||
With | 0.612 | 0.592 | 0.633 | <0.001 | 0.661 | 0.639 | 0.685 | <0.001 |
Season | ||||||||
Spring (March–May) | Reference | Reference | ||||||
Summer (June–August) | 0.944 | 0.920 | 0.968 | <0.001 | 0.932 | 0.909 | 0.956 | <0.001 |
Autumn (September–November) | 0.813 | 0.792 | 0.834 | <0.001 | 0.803 | 0.783 | 0.824 | <0.001 |
Winter (December–February) | 0.911 | 0.887 | 0.935 | <0.001 | 0.919 | 0.896 | 0.943 | <0.001 |
Location | ||||||||
Northern Taiwan | Reference | Reference | ||||||
Central Taiwan | 1.228 | 1.201 | 1.256 | <0.001 | 1.169 | 1.143 | 1.196 | <0.001 |
Southern Taiwan | 1.215 | 1.186 | 1.243 | <0.001 | 1.184 | 1.156 | 1.212 | <0.001 |
Eastern Taiwan | 1.314 | 1.268 | 1.361 | <0.001 | 1.201 | 1.159 | 1.245 | <0.001 |
Outlying Islands | 1.313 | 1.156 | 1.492 | <0.001 | 1.174 | 1.033 | 1.334 | 0.014 |
Insured premium (NT$) | ||||||||
<15,840 | Reference | Reference | ||||||
15,841–25,000 | 0.980 | 0.903 | 1.063 | 0.622 | 0.899 | 0.828 | 0.975 | 0.010 |
≥25,001 | 0.718 | 0.572 | 0.902 | 0.004 | 0.622 | 0.495 | 0.782 | <0.001 |
Gout | Group CFG | Group C | Ratio | Adjusted HR | 95%CI | 95%CI | p | |||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Variables | Event | PYs | Rate (per 105 PYs) | Event | PYs | Rate (per 105 PYs) | ||||||
Total | 16,238 | 150,342.08 | 10,800.70 | 30,594 | 322,350.39 | 9490.91 | 1.138 | 2.034 | 1.995 | 2.074 | <0.0011 | |
Sex | ||||||||||||
Male | 12,534 | 118,736.14 | 10,556.18 | 23,960 | 256,463.93 | 9342.44 | 1.130 | 2.021 | 1.976 | 2.066 | <0.001 | |
Female | 3704 | 31,605.94 | 11,719.32 | 6634 | 65,886.46 | 10,068.84 | 1.164 | 2.077 | 1.993 | 2.165 | <0.001 | |
Diabetes mellitus (DM) | ||||||||||||
Without | 13,201 | 116,597.02 | 11,321.90 | 24,862 | 254,643.69 | 9763.45 | 1.160 | 2.082 | 2.037 | 2.127 | <0.001 | |
With | 3037 | 33,745.06 | 8999.84 | 5732 | 67,706.70 | 8465.93 | 1.063 | 1.834 | 1.753 | 1.919 | <0.001 | |
Hypertension | ||||||||||||
Without | 11,736 | 98,684.39 | 11,892.46 | 24,703 | 238,757.71 | 10,346.47 | 1.149 | 2.000 | 1.955 | 2.045 | <0.001 | |
With | 4502 | 51,657.69 | 8715.06 | 5891 | 83,592.68 | 7047.27 | 1.237 | 2.184 | 2.097 | 2.274 | <0.001 | |
Stroke | ||||||||||||
Without | 15,258 | 134,176.20 | 11,371.61 | 28,531 | 284,544.60 | 10,026.90 | 1.134 | 2.060 | 2.019 | 2.103 | <0.001 | |
With | 980 | 16,165.88 | 6062.15 | 2063 | 37,805.79 | 5456.84 | 1.111 | 1.667 | 1.542 | 1.802 | <0.001 | |
Chronic renal disease | ||||||||||||
Without | 15,325 | 143,313.20 | 10,693.36 | 29,281 | 307,574.55 | 9519.97 | 1.123 | 2.076 | 2.035 | 2.119 | <0.001 | |
With | 913 | 7028.89 | 12,989.25 | 1313 | 14,775.84 | 8886.13 | 1.462 | 1.492 | 1.368 | 1.627 | <0.001 | |
Coronary artery disease (CAD) | ||||||||||||
Without | 14,873 | 129,957.13 | 11,444.54 | 28332 | 284,501.30 | 9958.48 | 1.149 | 2.039 | 1.998 | 2.082 | <0.001 | |
With | 1365 | 20,384.95 | 6696.12 | 2262 | 37,849.09 | 5976.37 | 1.120 | 1.940 | 1.810 | 2.079 | <0.001 | |
Season | ||||||||||||
Spring (March–May) | 3967 | 33,203.35 | 11,947.59 | 7760 | 75,299.86 | 10,305.46 | 1.159 | 2.061 | 1.981 | 2.143 | <0.001 | |
Summer (June–August) | 4271 | 37,283.12 | 11,455.59 | 7792 | 80,649.66 | 9661.54 | 1.186 | 2.096 | 2.016 | 2.178 | <0.001 | |
Autumn (September–November) | 4326 | 45,283.44 | 9553.16 | 7590 | 89,206.10 | 8508.39 | 1.123 | 1.985 | 1.910 | 2.063 | <0.001 | |
Winter (December–February) | 3674 | 34,572.18 | 10,627.04 | 7452 | 77,194.77 | 9653.50 | 1.101 | 1.999 | 1.919 | 2.082 | <0.001 | |
Location | ||||||||||||
Northern Taiwan | 5326 | 55,338.61 | 9624.38 | 10,761 | 127,610.68 | 8432.68 | 1.141 | 2.074 | 2.004 | 2.145 | <0.001 | |
Central Taiwan | 5147 | 44,678.27 | 11,520.14 | 9259 | 91,204.09 | 10,151.96 | 1.135 | 2.082 | 2.010 | 2.156 | <0.001 | |
Southern Taiwan | 4277 | 37,643.40 | 11,361.89 | 8075 | 79,540.46 | 10,152.07 | 1.119 | 1.967 | 1.894 | 2.043 | <0.001 | |
Eastern Taiwan | 1391 | 11,782.55 | 11,805.59 | 2357 | 21,562.39 | 10,931.07 | 1.080 | 1.932 | 1.804 | 2.069 | <0.001 | |
Outlying Islands | 97 | 899.26 | 10,786.65 | 142 | 2432.78 | 5836.94 | 1.848 | 1.779 | 1.358 | 2.330 | <0.001 | |
Insured premium (NT$) | ||||||||||||
<15,840 | 15,975 | 147,884.48 | 10,802.35 | 30,197 | 317,543.94 | 9509.55 | 1.136 | 2.029 | 1.989 | 2.069 | <0.001 | |
15,841–25,000 | 238 | 2122.27 | 11,214.41 | 348 | 4087.90 | 8512.93 | 1.317 | 2.539 | 2.136 | 3.020 | <0.001 | |
≥25,001 | 25 | 335.33 | 7455.34 | 49 | 718.56 | 6819.19 | 1.093 | 2.946 | 1.695 | 5.121 | <0.001 |
Gout | Group CFG | Group C | Ratio | Adjusted HR | 95%CI | 95%CI | p | |||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Subgroups of Injury | Event | PYs | Rate (per 10 5 PYs) | Event | PYs | Rate (per 10 5 PYs) | ||||||
Total | 16,238 | 150,342.08 | 10,800.70 | 30,594 | 322,350.39 | 9,490.91 | 1.138 | 2.034 | 1.995 | 2.074 | <0.001 | |
Cause of injury | ||||||||||||
Traffic injuries | 2141 | 150,342.08 | 1424.09 | 4,74 | 322,350.39 | 1387.93 | 1.026 | 1.575 | 1.494 | 1.861 | <0.001 | |
Poisoning | 234 | 150,342.08 | 155.65 | 352 | 322,350.39 | 109.20 | 1.425 | 1.650 | 1.382 | 1.970 | <0.001 | |
Falls | 3322 | 150,342.08 | 2209.63 | 6722 | 322,350.39 | 2085.31 | 1.060 | 1.743 | 1.670 | 1.820 | <0.001 | |
Burns and fires | 19 | 150,342.08 | 12.64 | 54 | 322,350.39 | 16.75 | 0.754 | 0.637 | 0.215 | 8.189 | 0.721 | |
Drowning | 3 | 150,342.08 | 2.00 | 6 | 322,350.39 | 1.86 | 1.072 | 1.022 | 0.674 | 3.571 | 0.166 | |
Suffocation | 68 | 150,342.08 | 45.23 | 149 | 322,350.39 | 46.22 | 0.979 | 0.942 | 0.328 | 2.554 | 0.402 | |
Crushing/Cutting/Piercing | 512 | 150,342.08 | 340.56 | 940 | 322,350.39 | 291.61 | 1.168 | 1.879 | 1.662 | 2.123 | <0.001 | |
Excessive Heat | 4 | 150,342.08 | 2.66 | 8 | 322,350.39 | 2.48 | 1.072 | 1.145 | 0.976 | 2.447 | 0.435 | |
Injury Caused by Animals | 44 | 150,342.08 | 29.27 | 52 | 322,350.39 | 16.13 | 1.814 | 1.976 | 1.013 | 3.001 | 0.026 | |
Electric Current Injury | 4 | 150,342.08 | 2.66 | 17 | 322,350.39 | 5.27 | 0.504 | 0.976 | 0.432 | 1.434 | 0.556 | |
Other Unintentional Injuries | 3768 | 150,342.08 | 2506.28 | 5704 | 322,350.39 | 1769.50 | 1.416 | 1.511 | 1.126 | 2.138 | <0.001 | |
Suicide | 179 | 150,342.08 | 119.06 | 376 | 322,350.39 | 116.64 | 1.021 | 1.506 | 1.247 | 1.820 | <0.001 | |
Homicide/Abuse | 140 | 150,342.08 | 93.12 | 309 | 322,350.39 | 95.86 | 0.971 | 0.618 | 0.301 | 1.012 | 0.058 | |
Intention Unknown | 110 | 150,342.08 | 73.17 | 195 | 322,350.39 | 60.49 | 1.209 | 1.447 | 1.119 | 1.876 | 0.005 | |
No Provided E-Code | 5690 | 150,342.08 | 3784.70 | 11,236 | 322,350.39 | 3485.65 | 1.086 | 1.473 | 1.426 | 1.552 | <0.001 | |
Injury Severity Score (ISS) ≥16 | ||||||||||||
Without | 16,055 | 150,342.08 | 10,678.98 | 30,391 | 322,350.39 | 9427.94 | 1.133 | 2.025 | 1.986 | 2.066 | <0.001 | |
With | 183 | 150,342.08 | 121.72 | 203 | 322,350.39 | 62.97 | 1.933 | 2.114 | 1.692 | 2.641 | <0.001 |
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Ou, S.-H.; Chou, C.-L.; Lin, C.-W.; Chien, W.-C.; Fang, T.-C.; Lu, K.-C.; Chen, J.-S. Association Between Gout and Injury Risk: A National Retrospective Cohort Study. Int. J. Environ. Res. Public Health 2020, 17, 3679. https://doi.org/10.3390/ijerph17103679
Ou S-H, Chou C-L, Lin C-W, Chien W-C, Fang T-C, Lu K-C, Chen J-S. Association Between Gout and Injury Risk: A National Retrospective Cohort Study. International Journal of Environmental Research and Public Health. 2020; 17(10):3679. https://doi.org/10.3390/ijerph17103679
Chicago/Turabian StyleOu, Shih-Hsiang, Chu-Lin Chou, Chia-Wei Lin, Wu-Chien Chien, Te-Chao Fang, Kuo-Cheng Lu, and Jin-Shuen Chen. 2020. "Association Between Gout and Injury Risk: A National Retrospective Cohort Study" International Journal of Environmental Research and Public Health 17, no. 10: 3679. https://doi.org/10.3390/ijerph17103679