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Marriage and mortality after noncardiac surgery.
Brian C Gulack1, Betsy Hale2, William D White2
1Department of Surgery, Duke University Medical Center, Durham, North Carolina.
The Journal of Surgical Research
|May 2, 2017
Summary
Marriage significantly improves survival after noncardiac surgery, but only for men. Unmarried men face worse outcomes, highlighting the need for social support interventions. This study explores marital status and surgical outcomes.
Area of Science:
- Surgical Outcomes Research
- Social Determinants of Health
- Health Services Research
Background:
- Marriage is linked to societal and economic benefits, and improved outcomes after acute illness.
- The impact of marital status on noncardiac surgical patient outcomes remains unclear.
Purpose of the Study:
- To investigate the association between marital status and survival in patients undergoing noncardiac surgery.
- To determine if being married confers a survival benefit in this patient population.
Main Methods:
- A cohort of 11,588 patients undergoing noncardiac surgery was analyzed over 19 months.
- All-cause mortality at 2 years was assessed by linking patient records to the National Death Index.
- Risk adjustment utilized Cox modeling and the Cleveland Clinic risk stratification index, with analysis stratified by sex due to significant interaction.
Main Results:
- Of 11,588 patients, 68.0% were married at the time of surgery.
- Marital status significantly interacted with sex (P=0.03).
- Among men, not being married was linked to worse survival (HR: 1.31), particularly for divorced (HR: 1.76) and never-married men (HR: 1.53). No significant difference was observed for widowed men.
- Among women, marital status showed no significant association with survival (HR: 0.94).
Conclusions:
- Being married at the time of noncardiac surgery is associated with improved survival exclusively in men.
- The findings suggest a need for targeted social support interventions for unmarried male surgical patients to potentially enhance their outcomes.
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