Health Economics and Policy, School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden.
Center on Aging and Health, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Top Stroke Rehabil. 2021 Sep;28(6):432-442. doi: 10.1080/10749357.2020.1834270. Epub 2020 Oct 13.
BACKGROUND/OBJECTIVES: Spousal concordance for cardiovascular risk factors and lifestyle behaviors may affect prevalence rates of diabetes, hypertension, and stroke. Spouses of stroke survivors, therefore, would be expected to have elevated mortality rates, but this has not been established. Thus, the aim of this study was to investigate whether cohabitant spouses of stroke survivors have higher mortality rates compared to a matched reference cohort.
Data for this population-based cohort study were extracted from Swedish national registries from 2010 to 2016. The national sample consisted of 13,049 spouses of first ever stroke survivors and a reference cohort of 51,685 cohabitant individuals from the general population matched by age, gender, and place of residence. Effects on mortality were analyzed using Cox proportional hazard survival analyses.
Female and male spouses of stroke survivors were found to have 5-year hazard ratios of death of 1.26 (95% confidence interval 1.17, 1.36) and 1.24 (95% confidence interval 1.16, 1.33), respectively, when compared to the reference cohort. Both female and male spouses had higher mortality from diseases in the circulatory system compared to the reference cohort.
Spouses of stroke survivors have higher mortality rates than a matched reference population that persist for a minimum of 5 years. Policy-makers should acknowledge and address the health status of spouses when evaluating and planning the health and social care of stroke survivors.
背景/目的:配偶双方心血管危险因素和生活方式行为的一致性可能会影响糖尿病、高血压和中风的患病率。因此,中风幸存者的配偶预计会有更高的死亡率,但这一点尚未得到证实。因此,本研究的目的是调查中风幸存者的同居配偶的死亡率是否高于匹配的参考队列。
本基于人群的队列研究的数据从 2010 年至 2016 年从瑞典国家登记处提取。全国样本包括 13049 名首次中风幸存者的配偶和 51685 名来自普通人群的同居者,他们通过年龄、性别和居住地相匹配。使用 Cox 比例风险生存分析来分析对死亡率的影响。
与参考队列相比,中风幸存者的女性和男性配偶的 5 年死亡风险比分别为 1.26(95%置信区间 1.17,1.36)和 1.24(95%置信区间 1.16,1.33)。与参考队列相比,女性和男性配偶的循环系统疾病死亡率都更高。
中风幸存者的配偶死亡率高于匹配的参考人群,至少持续 5 年。政策制定者在评估和规划中风幸存者的健康和社会护理时,应该认识到并关注配偶的健康状况。