Affiliation:
1. Cardiology, Shamir Medical Center Be'er‐Yaakov Israel
2. Sackler School of Medicine Tel‐Aviv University Ramat‐Aviv Israel
3. The Jesselson Integrated Heart Center, Shaare Zedek Medical Center, Faculty of Medicine Hebrew University Jerusalem Israel
4. Cape Cod Hospital, Brigham and Women's Hospital, Harvard Medical School Division of Cardiac Surgery Boston Massachusetts USA
5. Cardiology Department Meir Medical Center Kfar‐Saba Israel
Abstract
AbstractBackgroundConflicting evidence exists regarding the association between marital status and outcomes in patients with heart failure (HF). Further, it is not clear whether type of unmarried status (never married, divorced, or widowed) disparities exist in this context.HypothesisWe hypothesized that marital status will be associated with better outcomes in patients with HF.MethodsThis single‐center retrospective study utilized a cohort of 7457 patients admitted with acute decompensated HF (ADHF) between 2007 and 2017. We compared baseline characteristics, clinical indices, and outcomes of these patients grouped by their marital status. Cox regression analysis was used to explore the independency of the association between marital status and long‐term outcomes.ResultsMarried patients accounted for 52% of the population while 37%, 9%, and 2% were widowed, divorced, and never married, respectively. Unmarried patients were older (79.8 ± 11.5 vs. 74.8 ± 11.1 years; p < 0.001), more frequently women (71.4% vs. 33.2%; p < 0.001), and less likely to have traditional cardiovascular comorbidities. Compared with married patients, all‐cause mortality incidence was higher in unmarried patients at 30 days (14.7% vs. 11.1%, p < 0.001), 1 year, and 5 years (72.9% vs. 68.4%, p < 0.001). Nonadjusted Kaplan‐Meier estimates for 5‐year all‐cause mortality by sex, demonstrated the best prognosis for married women, and by marital status in unmarried patients, the best prognosis was demonstrated in divorced patients while the worst was recorded in widowed patients. After adjustment for covariates, marital status was not found to be independently associated with ADHF outcomes.ConclusionsMarital status is not independently associated with outcomes of patients admitted for ADHF. Efforts for outcomes improvement should focus on other, more traditional risk factors.
Subject
Cardiology and Cardiovascular Medicine,General Medicine