Contributor: Elise Vo
Being the spouse of a HF patient is challenging. In a recent study, Dunlay and colleagues explored the link between spousal health and HF patient outcomes. Interestingly, spousal health did not correlate with HF patient death or hospitalization. However, spouse caregivers experienced worse outcomes following the death of their HF partner.
Olmsted County residents were screened for HF between 2002-2012 using ICD-9 codes. 905 patients met study criteria, 586 (65%) males with mean age of 73.3, 96% Caucasian, and average LVEF 47.7%. The spousal characteristics were: 584 (65%) female, mean age of 71, and 96% Caucasian. HF patient charts were reviewed for marriage.
The Charlson Comborbidity Index was used to assess overall health of spouses in addition to ADL surveys completed annually and at each hospitalization. Once age, sex, and comorbidity analyses were performed, there was no statistical difference in risk of death or hospitalization among HF patients. However, there was a marked “widow” effect. Spouses had an increased risk of hospitalization (in male widowers) and death (in male and female widowers) following the death of their HF spouse.
No study is perfect. The homogenous nature of Olmsted County, the lack of formalized caregiver burden assessment, and potential outside hospitalizations not captured by the community health system (though likely a very small percentage) may blunt the external validity of this study.
This study is the first to extensively explore the longitudinal relationship of spousal health, its impact on HF patients, and conversely the impact of HF patient health on spousal outcomes (hospitalization and death).