Welcome Guest | My Page | | Login


Home | Affiliates | BCS Conference | Courses & Education | Research | Resources | About | Contact Us
 
Untitled Document

BCS Conference 2017

 

AbstractTitle: THE IMPACT OF MARITAL STATUS ON MORTALITY AND LENGTH OF STAY IN PATIENTS ADMITTED WITH MYOCARDIAL INFARCTION

Submission Date : 01/12/2015 14:43:40

Category
: Acute coronary syndromes

KeyWords

Length of stay, Mortality, Marital status

Abstract Body

Introduction: Ischaemic heart disease is the leading cause of mortality worldwide. The development of surgical and percutaneous interventions has improved survival rates, but the influence of sociodemographic factors on outcomes following MI and their potential use as predictors of such outcomes, are increasingly recognised. Conclusive studies show associations between marriage and lower incidences of IHD in addition to better survival prospects for married individuals suffering MI. There is however, a conflicting evidence base and a lack of literature considering the influence of marital status on LOS, which has been observed to be highly variable in MI patients.


Objectives: From a large patient database, we aimed to investigate the impact of marital status on the prevalence, LOS and crude mortality of MI patients admitted in Northern England, UK.


Methods: We compared marital status variations and associated LOS and mortality data by one way anova and cox regression respectively, using anonymous information on MI patients obtained from hospitals in North England between 1st  January 2000 and 31stMarch 2013. This data was analysed according to the ACALM (Algorithm for Comorbidities, Associations, Length of stay and Mortality) study protocol, which uses ICD-10 and OPCS-4 codes to trace patients and demographics. P values <0.05 were taken as statistically significant.


Results: Amongst 929552 patient admissions recorded during the study period there were 25287 cases involving a new diagnosis of MI. Mean age of MI patients was 66.6 years, 64.2% of the cohort were male and 80.3% were Caucasian. 38.2% of MI patients died and mean LOS was 7.0 days. Crude mortality was highest among widowed patients(62.9%). Logistic regression accounting for age, sex and gender showed that married(OR 0.863), widowed(OR 0.959) and unmarried patients(OR 0.973) had statistically lower mortality rates when compared to single people. LOS was statistically shorter for married patients(2.12 days shorter), and unmarried patients(2.66 days shorter) compared to a mean LOS of 8.2days recorded amongst single patients. Conversely, mean LOS was 1.82 days longer for widowed patients.


Conclusion: Marital status has a clinically important impact on LOS and mortality of MI patients. In particular, single patients show higher mortality rates
and longer LOS compared to married patients. It is reasonable to suggest that these results may be due to reduced social support at home and this should be taken into account when considering the holistic care of patients with MI.


Image/graph I:

 

Marital Status

 

Prevalence

n (%)

Mean LOS (Days)

Difference in mean LOS compared to single patients

(95% confidence intervals)

Crude mortality

n (%)

Odds ratio for mortality compared to single patients

(95% confidence intervals)

Single

2 531

(10.0%)

8.2

-

752

(29.7%)

-

Married

11 933 (47.2%)

6.1

-2.12

(-1.05, -3.20)***

4 098

(34.3%)

0.863

(0.798-0.933) ***

Divorced

1 105

(4.4%)

6.8

-1.38

(-3.14, 0.39)

378

(34.2%)

0.994

(0.934-1.058)

Widowed

4 004
(15.8%)

10.0

1.82

(0.58-3.07) ***

 2 517

(62.9%)

0.959

(0.947-0.971) ***

Common Law Living

5
(0.02%)

7.8

-0.39

(-22.34, 21.55)

0

(0%)

No deaths

Unmarried

5 184

(20.5%)

6.0

-2.66

(-3.34, 0.96) ***

1 830

(35.3%)

0.973

(0.956-0.991) **

Separated

284

 (1.1%)

10.5

2.26

 (-0.80, 5.33)

78

(27.5%)

0.983

(0.945-1.022)

Unknown

241

(1.0%)

7.2

-1.00

(-4.31, 2.30)

0

(0%)

No deaths

* p < 0.05   **  p<0.01    *** p<001

Submitter Details
Dr Nicholas D Gollop

Authors

Names Presenting Author Institution
Dr Nicholas D Gollop No The University of East Anglia
Miss Rosie M Hayes Yes University of Birmingham
Dr Paul R Carter No Royal Free London, NHS Trust
Dr Jennifer E Reynolds No University of Birmingham
Dr Hardeep Uppal No ACALM Study Unit in collaboration with Aston Medical School
Dr Jaydeep Sarma No University Hospital South Manchester
Dr Suresh  Chandran No Department of Acute Medicine, North Western Deanery
Dr Rahul Potluri No ACALM Study Unit in collaboration with Aston Medical School