"Living with Significant Other is Associated with Lower Risk for Emerge" by Patricia R.E. Harris and Barbara Drew
 

Living with Significant Other is Associated with Lower Risk for Emergency Readmission after Unstable Angina & Non-ST Elevation Myocardial Infarction [Poster 12064]

Document Type

Presentation

Source

American Heart Association Scientific Sessions 2012

Location

Los Angeles, CA

Publication Date

11-6-2012

Department

Nursing

Abstract

Introduction: Patients who are diagnosed with unstable angina (UA) or non-ST elevation myocardial infarction (non-STEMI) are at risk for repeated acute cardiac episodes resulting in emergent rehospitalization. American Heart Association/American College of Cardiology practice guidelines recommend use of risk stratification prior to hospital discharge; however, the importance of identifying patients’ social support for follow-up planning is not emphasized. Hypothesis: UA and non-STEMI patients who live with significant others are less likely to return to the Emergency Department (ED) for acute cardiac-related events within one year. Methods: Secondary analysis was conducted of data from a prospective clinical trial (IMMEDIATE AIM Study, RO1HL69753), in which patients presenting to the ED with chest pain were enrolled and followed for one year. A total of 166 patients with UA or non-STEMI and 1-year outcome data were included in the present analysis. Hazard over time analyses were performed to assess whether living with a significant other was associated with cardiac-related ED readmission during the follow-up period. Significant other was defined as spouse, partner, child, or other care provider. Results: Multivariate Cox Regression analyses controlling for gender, race, discharge diagnosis, and Thrombolysis in Myocardial Infarction (TIMI) risk score revealed that patients who lived with a significant other were less likely to return to the ED for an acute cardiac event within one follow-up year. Living with a significant other was a significant independent contributor to the statistical model (hazard ratio =.47, 95% confidence interval .29 - .75, p=.002). Overall sensitivity and specificity of the model was 73% (C-statistic=.73). Conclusions: In patients with UA or non-STEMI, living without a significant other confers a 2 times greater relative risk of ED cardiac-related readmittance compared with patients who live with a significant other. Prospective clinical trials are needed to identify what the beneficial “active ingredients” are in living with a significant other and to develop interventions to reduce risk for patients who do not have a significant other living arrangement.

Rights

Copyright © 2012 American Heart Association. All rights reserved.

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