Mortality After the Hospitalization of a Spouse

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Mortality After the Hospitalization of a Spouse

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Title: Mortality After the Hospitalization of a Spouse
Author: Allison, Paul D.; Christakis, Nicholas

Note: Order does not necessarily reflect citation order of authors.

Citation: Christakis, Nicholas A. and Paul D. Allison. 2006. Mortality after the hospitalization of a spouse. New England Journal of Medicine 354, no. 7: 719-730.
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Abstract: Background: The illness of a spouse can affect the health of a caregiving partner. We examined the association between the hospitalization of a spouse and a partner’s risk of death among elderly people. Methods: We studied 518,240 couples who were enrolled in Medicare in 1993. We used Cox regression analysis and fixed-effects (case–time–control) methods to assess hospitalizations and deaths during nine years of follow-up. Results: Overall, 383,480 husbands (74 percent) and 347,269 wives (67 percent) were hospitalized at least once, and 252,557 husbands (49 percent) and 156,004 wives (30 percent) died. Mortality after the hospitalization of a spouse varied according to the spouse’s diagnosis. Among men, 6.4 percent died within a year after a spouse’s hospitalization for colon cancer, 6.9 percent after a spouse’s hospitalization for stroke, 7.5 percent after a spouse’s hospitalization for psychiatric disease, and 8.6 percent after a spouse’s hospitalization for dementia. Among women, 3.0 percent died within a year after a spouse’s hospitalization for colon cancer, 3.7 percent after a spouse’s hospitalization for stroke, 5.7 percent after a spouse’s hospitalization for psychiatric disease, and 5.0 percent after a spouse’s hospitalization for dementia. After adjustment for measured covariates, the risk of death for men was not significantly higher after a spouse’s hospitalization for colon cancer (hazard ratio, 1.02; 95 percent confidence interval, 0.95 to 1.09) but was higher after hospitalization for stroke (hazard ratio, 1.06; 95 percent confidence interval, 1.03 to 1.09), congestive heart failure (hazard ratio, 1.12; 95 percent confidence interval, 1.07 to 1.16), hip fracture (hazard ratio, 1.15; 95 percent confidence interval, 1.11 to 1.18), psychiatric disease (hazard ratio, 1.19; 95 percent confidence interval, 1.12 to 1.26), or dementia (hazard ratio, 1.22; 95 percent confidence interval, 1.12 to 1.32). For women, the various risks of death after a spouse’s hospitalization were similar. Overall, for men, the risk of death associated with a spouse’s hospitalization was 22 percent of that associated with a spouse’s death (95 percent confidence interval, 17 to 27 percent); for women, the risk was 16 percent of that associated with death (95 percent confidence interval, 8 to 24 percent). Conclusions: Among elderly people hospitalization of a spouse is associated with an increased risk of death, and the effect of the illness of a spouse varies among diagnoses. Such interpersonal health effects have clinical and policy implications for the care of patients and their families.
Published Version: http://dx.doi.org/10.1056/NEJMsa050196
Other Sources: http://christakis.med.harvard.edu/pages/pubtype.html
Terms of Use: This article is made available under the terms and conditions applicable to Other Posted Material, as set forth at http://nrs.harvard.edu/urn-3:HUL.InstRepos:dash.current.terms-of-use#LAA
Citable link to this page: http://nrs.harvard.edu/urn-3:HUL.InstRepos:3685835

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  • FAS Scholarly Articles [6948]
    Peer reviewed scholarly articles from the Faculty of Arts and Sciences of Harvard University
 
 

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