Marriage Linked to Favorable Recovery after Heart Surgery

New research finds that being married appears to have significant benefits following cardiac surgery.

Researchers at the Perelman School of Medicine at the University of Pennsylvania discovered patients who are divorced, separated, or widowed had an approximately 40 percent greater chance of dying or developing a new functional disability in the first two years following cardiac surgery than their married peers.

“While it has been established that the chances of survival following major surgery may be better among married versus unmarried persons, it is not known how marriage ‘marries’ with actual postoperative function,” said study co-author Mark Neuman, M.D., M.S.C.E.

“Understanding this may be useful for identifying patients who may be in need of additional support and targeted interventions aimed at improving functional recovery.”

The study by Neuman and co-author Rachel Werner, M.D., Ph.D., appears in JAMA Surgery.

The researchers used a subset of data from the University of Michigan Health and Retirement Study, a database of 29,053 adults age 50 years and older in which study participants have undergone interviews every two years since 1998 about their health, functioning, medical care, and family structure.

The team then analyzed data from the 2004, 2006, 2008, and 2010 interviews and included the 1,576 subjects who reported undergoing cardiac surgery in the interval since the preceding interview and deceased participants for whom a representative reported a cardiac surgery since the last interview.

They collected demographic information including marital status, age, sex, and comorbidities at enrollment and in the last interview before surgery. In addition, they collected information on preoperative dependence in six activities of daily living: dressing, movement ability, bathing, eating, toileting, and getting in and out of bed.

They found that at the time of baseline interview, 65 percent were married, 12 percent were divorced or separated, 21 percent were widowed and two percent were never married.

At their post-surgery interview, 19 percent of the married participants, 29 percent of the divorced or separated subjects, 39 percent of the widowed, and 20 percent of those who had never been married had either died or developed a new disability.

Compared with subjects who were married at baseline, the odds for death or a new functional disability during the first two years following cardiac surgery were 40 percent greater among those who are divorced, separated, or widowed, the researchers found.

Although additional research is needed to explain the differences in outcomes, Neuman and Werner surmise that this may relate to the social support; in particular, support that influences patients’ choice of hospitals and their self-care.

Investigators also note that the findings support prior research that has suggested postoperative survival advantages for married people.

Future research is critically needed to understand and define the mechanisms that link marital status and postoperative outcomes.

Source: University of Pennsylvania