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Association of marital/partner status with hospital readmission among young adults with acute myocardial infarction

Author

Listed:
  • Cenjing Zhu
  • Rachel P Dreyer
  • Fan Li
  • Erica S Spatz
  • César Caraballo
  • Shiwani Mahajan
  • Valeria Raparelli
  • Erica C Leifheit
  • Yuan Lu
  • Harlan M Krumholz
  • John A Spertus
  • Gail D’Onofrio
  • Louise Pilote
  • Judith H Lichtman

Abstract

Introduction: Despite evidence supporting the benefits of marriage on cardiovascular health, the impact of marital/partner status on the long-term readmission of young acute myocardial infarction (AMI) survivors is less clear. We examined the association between marital/partner status and 1-year all-cause readmission and explored sex differences among young AMI survivors. Methods: Data were from the VIRGO study (Variation in Recovery: Role of Gender on Outcomes of Young AMI Patients), which enrolled young adults aged 18–55 years with AMI (2008–2012). The primary end point was all-cause readmission within 1 year of hospital discharge, obtained from medical records and patient interviews and adjudicated by a physician panel. We performed Cox proportional hazards models with sequential adjustment for demographic, socioeconomic, clinical, and psychosocial factors. Sex-marital/partner status interaction was also tested. Results: Of the 2,979 adults with AMI (2002 women [67.2%]; mean age 48 [interquartile range, 44–52] years), unpartnered individuals were more likely to experience all-cause readmissions compared with married/partnered individuals within the first year after hospital discharge (34.6% versus 27.2%, hazard ratio [HR] = 1.31; 95% confidence interval [CI], 1.15–1.49). The association attenuated but remained significant after adjustment for demographic and socioeconomic factors (adjusted HR, 1.16; 95% CI, 1.01–1.34), and it was not significant after further adjusting for clinical factors and psychosocial factors (adjusted HR, 1.10; 95%CI, 0.94–1.28). A sex-marital/partner status interaction was not significant (p = 0.69). Sensitivity analysis using data with multiple imputation and restricting outcomes to cardiac readmission yielded comparable results. Conclusions: In a cohort of young adults aged 18–55 years, unpartnered status was associated with 1.3-fold increased risk of all-cause readmission within 1 year of AMI discharge. Further adjustment for demographic, socioeconomic, clinical, and psychosocial factors attenuated the association, suggesting that these factors may explain disparities in readmission between married/partnered versus unpartnered young adults. Whereas young women experienced more readmission compared to similar-aged men, the association between marital/partner status and 1-year readmission did not vary by sex.

Suggested Citation

  • Cenjing Zhu & Rachel P Dreyer & Fan Li & Erica S Spatz & César Caraballo & Shiwani Mahajan & Valeria Raparelli & Erica C Leifheit & Yuan Lu & Harlan M Krumholz & John A Spertus & Gail D’Onofrio & Loui, 2024. "Association of marital/partner status with hospital readmission among young adults with acute myocardial infarction," PLOS ONE, Public Library of Science, vol. 19(1), pages 1-12, January.
    • Handle: RePEc:plo:pone00:0287949
    DOI: 10.1371/journal.pone.0287949
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    1. Molloy, Gerard John & Stamatakis, Emmanuel & Randall, Gemma & Hamer, Mark, 2009. "Marital status, gender and cardiovascular mortality: Behavioural, psychological distress and metabolic explanations," Social Science & Medicine, Elsevier, vol. 69(2), pages 223-228, July.
    2. Joung, Inez M. A. & van de Mheen, H. Dike & Stronks, Karien & van Poppel, Frans W. A. & Mackenbach, Johan P., 1998. "A longitudinal study of health selection in marital transitions," Social Science & Medicine, Elsevier, vol. 46(3), pages 425-435, February.
    3. Noreen Goldman, 1993. "Marriage selection and mortality patterns: Inferences and fallacies," Demography, Springer;Population Association of America (PAA), vol. 30(2), pages 189-208, May.
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