Marital Status Linked to Better Postoperative Functional Recovery

Among more than 1500 adults who underwent cardiac surgery, those who were divorced, separated, or widowed were more likely to have died or develop a new functional disability after the surgery compared with the married participants, according to a study published online by JAMA Surgery (2015; doi:10.1001/jamasurg.2015.3240).

Chances of survival after major surgery may be better among married vs unmarried persons, but little is known regarding the association between marital status and postoperative function. Characterizing the association between marital status and postoperative function may be useful for counseling patients and identifying at-risk groups that may benefit from targeted interventions aimed at improving functional recovery.

Mark D. Neuman, MD, MSc, and Rachel M. Werner, MD, PhD, of the Perelman School of Medicine at the University of Pennsylvania in Philadelphia, used data from the University of Michigan Health and Retirement Study, which has enrolled 29 053 adults age 50 years or older since 1998. The study participants undergo interviews every 2 years regarding health, functioning, medical care, and family structure. The sample for this analysis included surviving participants who reported having undergone cardiac surgery in the interval since the preceding interview and deceased participants for whom proxies reported a cardiac surgery since the last interview.

The study included 1576 participants; at the time of study entry, 65% were married, 12% were divorced or separated, 21% were widowed, and 2% were never married. Married participants were more likely to be male and to demonstrate lower levels of other illnesses and disability before surgery.

At the postsurgery interview, 19% of married participants, 29% of divorced or separated participants, 34% of widowed participants, and 20% of participants who had never been married had either died or developed a new disability (unable to perform independently an activity of daily living such as dressing, walking, eating).

Marital status was significantly associated with death or a new functional disability. Participants who were divorced, separated, or widowed had an approximately 40% greater odds of dying or developing a new functional disability during the first 2 years after cardiac surgery compared with the married participants.

“These findings extend prior work suggesting postoperative survival advantages for married people and may relate to the role of social supports in influencing patients' choices of hospitals and their self-care,” the authors wrote. They added that their findings suggest “that marital status is a predictor of survival and functional recovery after cardiac surgery. Further research is needed to define the mechanisms linking marital status and postoperative outcomes.”

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