
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 |
|