@article{ref1,
title="The widowhood effect on mortality in older patients with hip fracture",
journal="International journal of general medicine",
year="2022",
author="Zhu, Zhonglun and Wang, Zhicong and Wu, Yuxuan and Chen, Xi and Liu, Hailong and Zhang, Jianjun and Liu, Mozhen and Liu, Yuehong",
volume="15",
number="",
pages="7693-7700",
abstract="OBJECTIVE: Widowed people have increased mortality than married people of the same age, a phenomenon known as the widowhood effect. This study aimed to investigate whether this effect exists in older patients with hip fracture. <br><br>METHODS: Using our own hip fracture database, a total of 1101 hip fracture patients were consecutively included from January 2014 to December 2021. Marital status was stratified as married (n = 793) and widowed (n = 308). Patients survival status was obtained from medical records or telephone follow-ups, and the outcomes were all-cause mortality at 30 days, 1 year and at latest follow-up. Univariate and multivariate Cox proportional hazard models were used to assess the association between marital status and mortality, and subgroup analyses according to sex were also conducted. <br><br>RESULTS: Compared with married patients, widowed patients were more likely to be older, female and intertrochanteric fracture, and were less likely to be urban area, smoking, drinking, and surgical treatment (P < 0.05). After a median follow-up of 37.1 months, the 30-day mortality was 4.3% (n = 47), 1-year mortality was 19.3% (n = 178), and total mortality was 34.2% (n = 376). Multivariate Cox analysis showed that widowed marital status remained an independent risk factor for 1-year mortality (HR = 1.437, 95% CI: 1.054-1.959, P = 0.022), and total mortality (HR = 1.296, 95% CI: 1.038-1.618, P = 0.022), whereas this association was not found in 30-day mortality (HR = 1.200, 95% CI: 0.607-2.376, P = 0.599). Moreover, subgroup analyses also found that the widowhood effect on mortality was present in both male and female. <br><br>CONCLUSION: Widowed marital status seems to be an independent risk factor for long-term mortality in older patients with hip fracture.<p /> <p>Language: en</p>",
language="en",
issn="1178-7074",
doi="10.2147/IJGM.S384862",
url="http://dx.doi.org/10.2147/IJGM.S384862"
}