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J Gen Intern Med. 2007 May;22(5):572-8.

Living alone, patient sex and mortality after acute myocardial infarction.

Author information

1
Department of Medicine, University of Calgary, Calgary, AB, Canada.

Abstract

BACKGROUND:

Psychosocial factors, including social support, affect outcomes of cardiovascular disease, but can be difficult to measure. Whether these factors have different effects on mortality post-acute myocardial infarction (AMI) in men and women is not clear.

OBJECTIVE:

To examine the association between living alone, a proxy for social support, and mortality postdischarge AMI and to explore whether this association is modified by patient sex.

DESIGN:

Historical cohort study.

PARTICIPANTS/SETTING:

All patients discharged with a primary diagnosis of AMI in a major urban center during the 1998-1999 fiscal year.

MEASUREMENTS:

Patients' sociodemographic and clinical characteristics were obtained by standardized chart review and linked to vital statistics data through December 2001.

RESULTS:

Of 880 patients, 164 (18.6%) were living alone at admission and they were significantly more likely to be older and female than those living with others. Living alone was independently associated with mortality [adjusted hazard ratio (HR) 1.6, 95% confidence interval (CI) 1.0-2.5], but interacted with patient sex. Men living alone had the highest mortality risk (adjusted HR 2.0, 95% CI 1.1-3.7), followed by women living alone (adjusted HR 1.2, 95% CI 0.7-2.2), men living with others (reference, HR 1.0), and women living with others (adjusted HR 0.9, 95% CI 0.5-1.5).

CONCLUSIONS:

Living alone, an easily measured psychosocial factor, is associated with significantly increased longer-term mortality for men following AMI. Further prospective studies are needed to confirm the usefulness of living alone as a prognostic factor and to identify the potentially modifiable mechanisms underlying this increased risk.

PMID:
17443363
PMCID:
PMC1852915
DOI:
10.1007/s11606-007-0106-7
[Indexed for MEDLINE]
Free PMC Article

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