Marital status as a predictor of survival in idiopathic dilated cardiomyopathy: the Washington, DC dilated cardiomyopathy study.

Marital status and other socioeconomic and clinical factors were examined as predictors of survival in idiopathic dilated cardiomyopathy using data from a hospital-based study in Washington, DC. Twenty-five (18.1%) of the cases (n = 138) were single, 66 (47.8%) were married, 25 (18.1%) were divorced or separated, and 22 (15.9%) were widowed. Married patients were more likely to be male, to have an annual household income greater than $15,000, and to live with another person (p < or = 0.01) as compared with those who were single, widowed, divorced or separated. Widowed patients were older on average and more likely to abstain from drinking alcohol. The cumulative survival among widowed patients at 12 and 24 months was 54.6 and 48.5%, respectively, as compared with 75.8 and 59.0% among single patients and 80.0 and 71.2% among married patients. The survival of divorced or separated patients was relatively good with a cumulative survival of 84.0% at both 12 and 24 months. Older age, lower ejection fraction, ventricular arrhythmias, bundle branch block, and marital status were significant predictors of survival in univariate analysis using the proportional hazards model. In multivariable analysis, age, race, ejection fraction, and marital status were statistically significant independent predictors of survival, with single patients with idiopathic dilated cardiomyopathy having a poorer survival than those who were married (adjusted RR = 2.5, 95% CI 1.1-6.2, p < 0.05). The observed association with marital status may be explained by psychosocial factors not examined in the present study such as quality of social network or psychological stress.