By Andrew M. Seaman

(Reuters Health) – Formerly married people may be at an increased risk of disability or death soon after heart surgery, suggests new U.S. research.

In the two years after their surgery, patients who were divorced, separated or widowed were about 40 percent more likely than married people to die or need help with common activities, researchers reported in JAMA Surgery.

“I think people recognize that social determinants of health are very important, but in terms of surgery very little has been done on how these related to functional outcomes,” said lead author Dr. Mark Neuman, of the Perelman School of Medicine at the University of Pennsylvania in Philadelphia.

He and his colleague Dr. Rachel Werner write that it may be useful to know whether single people are more or less likely to need additional help dressing, eating or bathing after heart surgery.

For the new research, they used data from biennial interviews with almost 30,000 people age 50 years or older. The data were collected from 2004, 2006, 2008 and 2010 interviews.

The participants were asked their marital status, as well as how much help they need getting in and out of bed, getting dressed, moving around, eating, bathing and going to the bathroom.

“These are the basic things that often are needed to care for yourself and live independently,” Neuman told Reuters Health.

Overall, the new study included data from 1,576 people who ended up having heart surgery. About 65 percent were married, about 12 percent were divorced or separated, 21 percent were widowed and 2 percent were never married.

About 3 percent of participants died between their heart surgery and the next biennial interview. Another 21 percent survived, but needed more help in their everyday lives.

Overall, those who were single were more likely than married people to die or need additional help in the two years following their surgery, researchers found. The exception was the small number of never-married patients, whose results were about the same as the marrieds.

The research can’t say why married people are less likely to die or need additional help shortly after heart surgery, Neuman said.

“It could be that people who are married are healthier than people who are not married, but that’s just one of several possible explanations,” he said.

The findings tell people who deliver healthcare to take a look at patients from a holistic perspective and consider the households and communities patients live in and ways to improve outcomes, Neuman said.

“As doctors, we always want to strive to do that and as a healthcare system I think it would be wonderful if that was a goal for the care we provide,” he said.

SOURCE: http://bit.ly/1NCGH7Y JAMA Surgery, online October 29, 2015.

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