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Acta Cardiologica Feb 2021Traditional risk factors for worse outcome in heart failure (HF) are well-established. However, there are still many unknown risk factors for worse outcome in this... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Traditional risk factors for worse outcome in heart failure (HF) are well-established. However, there are still many unknown risk factors for worse outcome in this population. Several studies have shown that unmarried status is associated with an increased risk of rehospitalization and mortality in HF patients. However, there is no systematic review or meta-analysis to confirm this association. We performed a systematic review and meta-analysis to explore the effect of marital status on outcome regarding mortality and rehospitalization in HF population.
METHODS
We searched the databases of MEDLINE and EMBASE from inception to July 2019. Included studies were published cohort studies or randomised controlled trials reporting rates of mortality and/or rehospitalization in HF patients, married and unmarried. Data from each study were combined using the random-effects model.
RESULTS
Ten studies were included in our meta-analysis. We found that unmarried status is associated with increased risk of mortality (pooled OR = 1.52, 95%CI = 1.30-1.78, < .001), increased risk of rehospitalization (pooled OR = 1.80, 95%CI = 1.18-2.74, = .007), and increased risk of combined endpoint of mortality and rehospitalization (pooled OR = 1.72, 95%CI = 1.36-2.17, < .001).
CONCLUSIONS
Our meta-analysis demonstrated that being unmarried, divorced, and widowed is associated with a worse outcome in HF population regarding mortality and rehospitalization rate.
Topics: Heart Failure; Humans; Marital Status; Patient Readmission; Risk Factors
PubMed: 31838953
DOI: 10.1080/00015385.2019.1699281 -
Journal of the American Medical... Mar 2020Evidence on associations between marital status and frailty is limited. The objectives of this study were to perform a systematic review for associations between marital... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
Evidence on associations between marital status and frailty is limited. The objectives of this study were to perform a systematic review for associations between marital status and physical frailty and to perform a meta-analysis to combine findings.
DESIGN
Systematic review and meta-analysis.
SETTING AND PARTICIPANTS
Community-dwelling older people with mean age ≥60 years.
METHODS
Systematic literature search using 5 databases was conducted in February 2019 to identify longitudinal and cross-sectional studies examining associations between marital status and Fried's phenotype-based frailty status. Additional studies were searched for by reviewing the reference lists of relevant articles and conducting forward citation tracking of included articles. Odds ratio (OR) of marital status and frailty was pooled using a random-effects meta-analysis. Subgroup analysis and analyses stratified by gender and marital status (married, widowed, divorced or separated, and never married) were completed.
RESULTS
A total of 1565 studies were found, from which 3 studies with longitudinal data and 35 studies with cross-sectional data were included. Although longitudinal studies suggested that married men had lower frailty risks than unmarried men while married women had higher frailty risks than widowed women, meta-analysis was not possible because of different methodologies. Meta-analyses of cross-sectional data from 35 studies including 80,754 individuals showed that unmarried individuals were almost twice more likely to be frail than married individuals (pooled odds ratio = 1.88, 95% confidence interval = 1.70-2.07). A high degree of heterogeneity was observed (I = 69%) and was partially explained by reasons for not being married and study location. Stratified analyses showed that pooled risks of frailty in the unmarried compared with the married were not statistically different between women and women (P for difference = .62).
CONCLUSIONS AND IMPLICATIONS
Three and 35 studies, respectively, were found providing longitudinal and cross-sectional data regarding associations between marital status and frailty among community-dwelling older people. A meta-analysis of cross-sectional data showed almost twice higher frailty risk in unmarried individuals compared with married individuals. Marital status should be recognized as an important factor, and more longitudinal studies controlling for potential confounding factors are needed.
Topics: Aged; Cross-Sectional Studies; Female; Frail Elderly; Frailty; Humans; Independent Living; Male; Marital Status; Middle Aged; Risk Factors
PubMed: 31740150
DOI: 10.1016/j.jamda.2019.09.017 -
Death Studies 2021The loss of a loved one is often associated with "death from a broken heart" for the survivor, and there is evidence that shows that widowers and widows are at risk for...
The loss of a loved one is often associated with "death from a broken heart" for the survivor, and there is evidence that shows that widowers and widows are at risk for higher morbidity and mortality than the general population. This systematic review will summarize the physical and physiological health outcomes of spousal bereavement. A systematic database search was conducted, and 38 studies were analyzed. The majority of studies found a statistically significant and positive association between spousal bereavement and adverse physical and physiological health outcomes such as inflammation, cardiovascular risk, chronic pain, and mortality.
Topics: Bereavement; Grief; Humans; Outcome Assessment, Health Care
PubMed: 31535594
DOI: 10.1080/07481187.2019.1661884 -
Death Studies 2021This study systematically reviewed the methodology and findings of 19 peer-reviewed studies on the experience of bereavement among widowed Latinos, including risk and...
This study systematically reviewed the methodology and findings of 19 peer-reviewed studies on the experience of bereavement among widowed Latinos, including risk and protective factors to the health of this vulnerable population. Of these studies, 10 included quantitative data, 3 were qualitative studies, and 6 were narrative reviews. Results emphasized the relevance of cultural beliefs about death, rituals, religion, and Latino values (i.e., , , o) as common themes in the included studies, along with expressions of grief (e.g., somatization) that vary by gender and acculturation. Risk factors associated with diminished well-being in this population included being a male, financial strain, cultural stressors, having an undocumented legal status, experiencing widowhood at a younger age, and having poor physical health. Effective coping strategies identified included having adequate social support primarily from family, religion and religious practices, the use of folk medicine, volunteering, and the use of emotional release strategies. Moreover, the results highlight that researches informing the health needs of widowed Latinos in the US is limited, and studies with enhanced methodological rigor are needed to better understand the complex needs of this vulnerable population.
Topics: Bereavement; Female; Grief; Hispanic or Latino; Humans; Male; Religion; United States; Widowhood
PubMed: 31402785
DOI: 10.1080/07481187.2019.1648328