Marital History and Survival After Stroke
Marital History and Survival After Stroke
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DOI：
10.1161/jaha.116.004647
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发表时间：
2016-12-01
影响因子：
5.4
通讯作者：
Lopes, Renato D.
中科院分区：
文献类型：
--
作者：
Dupre, Matthew E.;Lopes, Renato D.
背景-中风是美国残疾和死亡的主要原因之一，目前有近700万成年人在经历中风后仍然活着。尽管与中风相关的风险已经得到了很好的证实，但我们对婚姻状况如何影响患有这种疾病的成年人的生存率知之甚少。这项研究是第一次前瞻性调查的婚姻史是如何与中风后的生存在美国。方法和结果，数据从一个全国代表性的样本的老年人谁经历了中风（n=2351）被用来检查是否和在何种程度上目前的婚姻状况和过去的婚姻损失与疾病发作后死亡的风险。结果显示，未婚者中风后死亡的风险明显更高（风险比[HR]，1.55; 95% CI，1.15-2.08），再婚（HR，1.22; 95% CI，1.05-1.43），离婚（HR，1.22; 95% CI，1.01-1.50），丧偶（HR，1.32; 95% CI，1.16-1.51）。我们还发现，有多个婚姻损失是特别不利于生存，无论目前的婚姻状况，并占多个社会经济，心理，行为和生理的危险factors. Conclusions婚姻史与中风后的生存显着相关。还需要进一步研究，以进一步研究有助于关联的机制，并更好地了解如何使用这些信息来个性化护理和积极治疗人口中的弱势群体。
Background-Stroke is among the leading causes of disability and death in the United States, and nearly 7 million adults are currently alive after experiencing a stroke. Although the risks associated with having a stroke are well established, we know surprisingly little about how marital status influences survival in adults with this condition. This study is the first prospective investigation of how marital history is related to survival after stroke in the United States.Methods and Results-Data from a nationally representative sample of older adults who experienced a stroke (n=2351) were used to examine whether and to what extent current marital status and past marital losses were associated with risks of dying after the onset of disease. Results showed that the risks of dying following a stroke were significantly higher among the never married (hazard ratio [HR], 1.55; 95% CI, 1.15-2.08), remarried (HR, 1.22; 95% CI, 1.05-1.43), divorced (HR, 1.22; 95% CI, 1.01-1.50), and widowed (HR, 1.32; 95% CI, 1.16-1.51) relative to those who remained continuously married. We also found that having multiple marital losses was especially detrimental to survival-regardless of current marital status and accounting for multiple socioeconomic, psychosocial, behavioral, and physiological risk factors.Conclusions-Marital history is significantly associated with survival after stroke. Additional studies are needed to further examine the mechanisms contributing to the associations and to better understand how this information can be used to personalize care and aggressively treat vulnerable segments of the population.