Stroke case‐fatality and marital status

Objectives Most studies show that marriage conveys a survival advantage. Whether this is valid also for stroke patients is unclear. Results of studies have been inconsistent and conflicting. Material & Methods We studied 1‐week and 1‐month stroke case‐fatality in relation to marital status (marr...

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Bibliographic Details
Published in:Acta neurologica Scandinavica 2018-10, Vol.138 (4), p.377-383
Main Authors: Andersen, K. K., Olsen, T. S.
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Cardiovascular diseases
case‐fatality
Denmark - epidemiology
Divorce
Fatalities
Female
Humans
Life span
Male
Marital Status
Middle Aged
mortality
Mortality - trends
Registries
Regression analysis
Risk assessment
Stroke
Stroke - diagnosis
Stroke - mortality
Stroke - therapy
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Summary:Objectives Most studies show that marriage conveys a survival advantage. Whether this is valid also for stroke patients is unclear. Results of studies have been inconsistent and conflicting. Material & Methods We studied 1‐week and 1‐month stroke case‐fatality in relation to marital status (married, unmarried, divorced, and widowed) in all patients admitted to hospital for incident stroke in Denmark during 2003‐2012. We used information from Danish registries on stroke merged to information on age, sex, marital status, stroke severity, stroke subtype, socioeconomic status, cardiovascular risk profile, and causes of death. We studied deaths due to the index stroke within the first week and month after stroke. Multivariate Cox regression models were applied to estimate cause‐specific hazards and relative risks. Results We included 60507 patients with an incident stroke of which 51.19% were married, 9.47% were unmarried, 13.29% were divorced, and 26.05% were widowers. Death within the first week and first month was caused by stroke in 2110 (3.5%) and 3423 (5.7%) patients, respectively. Compared to married stroke patients, 1‐week/1‐month case‐fatality (by stroke) was lower for the unmarried (HR (hazard ratio):0.69/0.74), divorced (HR:0.69/0.72), and widowed (HR:0.80/0.74) men and the unmarried (HR:0.84/0.86), divorced (HR:0.82/0.80), and widowed (HR:0.87/0.88) women with stroke. Conclusions One‐week and one‐month case‐fatality by stroke was lower among the unmarried, divorced, and widowed than among the married stroke patients. Selection by so‐called mortality displacement linked to shorter life expectancy among divorced, widowed, and singles may explain our findings.
ISSN:0001-6314
1600-0404
DOI:10.1111/ane.12975