After MI, married people more likely to survive, have shorter hospital stay

Compared with single people, married people were more likely to survive and have a shorter length of hospital stay after an MI, according to findings presented at the British Cardiovascular Society Conference.

Previous research had indicated married people had greater survival rates after MI compared with single people, but the relationship between marital status and length of stay after MI was unknown, according to the study background.

In an email interview with Cardiology Today, researchers Paul Carter, MB, BCh, Nicholas D. Gollop, BSc (Hons), MB, BCh, and Rahul Potluri, MBBS, wrote that, “Marital status is in many ways a proxy for the psychosocial environment after an MI, and as such, our study shows that patients who are married, live together or widowed after having been married seem to have improved mortality and shorter length of stay compared with single patients and divorced patients.”

Rahul Potluri

The researchers analyzed 25,287 patients with new MI (mean age, 67 years; 64% men; 80% white) from hospital databases in northern England between 2000 and 2013.

The breakdown of marital status was as follows: single, 10%; married, 47.2%; divorced, 4.4%; widowed, 15.8%; common-law living, 0.02%; unmarried, 20.5%; separated, 1.1%; and unknown, 1%. Single was defined as not in a relationship or in wedlock at the time of the event; unmarried was defined as being in a relationship but not in wedlock at the time of the event.

After adjustment for age, sex and gender, compared with single people, married people had a nearly 14% lower risk for mortality after MI (OR = 0.863; 95% CI, 0.798-0.933). Compared with single people, the ORs for mortality after MI also were lower in widowed people (OR = 0.959; 95% CI, 0.947-0.971) and unmarried people (OR = 0.973; 95% CI, 0.956-0.991). There was no difference vs. single people in mortality after MI for divorced and separated people, and there were no deaths in the common-law living and unknown groups.

Compared with single people, married people had a shorter mean length of stay after MI (difference, –2.12 days; 95% CI, –1.05 to –3.2; P < .001), as did unmarried people (difference, –2.66 days; 95% CI, –3.34 to 0.96; P < .001), but widowed people had a longer mean length of stay (difference, 1.82 days; 95% CI, 0.58-3.07; P < .001), according to the researchers.

Carter, researcher with the Algorithm for Comorbidities, Associations, Length of Stay and Mortality (ACALM) Study Unit at Aston Medical School, Birmingham, England; Gollop, clinical research fellow in cardiology, University of East Anglia, Norwich, England; and Potluri, founder of the ACALM Study Unit and clinical lecturer at Aston Medical School, wrote Cardiology Today that the study “complements previous research that the ACALM Study Unit has undertaken over the last few years, which shows the significant impact of psychosocial factors on mortality and length of hospital stay across the spectrum of [CVD]. There seems to be something about divorce and the surrounding circumstances/stress [that] has a negative impact on mortality and/or length of stay.”

They wrote that: “In addition to excellent medical care, post-MI management should also focus on finding out and addressing the main psychosocial concerns of patients. The aim of this would be to ensure that patients have an adequate network to address their problems similar to the support naturally experienced by most people in a relationship.” – by Erik Swain

Reference:

Gollop ND, et al. Abstract 1904. Presented at: British Cardiovascular Society Conference; June 6-8, 2016; Manchester, England.

Disclosure: The researchers report no relevant financial disclosures.