Association Between Marital/Partner Status and Patient-reported Outcomes in Stroke Patients: A Systematic Review.

Abstract

Background: The extent to which marital/partner status affects patient-reported outcome measures (PROMs) in stroke patients varies among reported studies. We conducted a systematic review and meta-analysis to clarify this relationship.

Methods: Five databases (Medline, Web of Science, Scopus, EMBASE, and PsycINFO) were searched from inception to April 15, 2024. Peer-reviewed studies that reported the independent association of marital/partner status with defined PROMs for patients who had a stroke were eligible for inclusion. Results for eligible studies were classified into four pre-defined outcome domains (health-related quality of life [HRQoL], functional status, symptoms, and personal recovery outcomes). Study quality was appraised using the Newcastle-Ottawa Scale, and data were synthesized by outcome domains.

Results: We identified 51 studies (n=552,943 participants), of which 10 were included in meta-analyses. Being married/partnered was associated with a lower likelihood of post-stroke depression (pooled OR, 0.62 [95%CI, 0.43 to 0.89], I2=0%) and anxiety (pooled OR, 0.32 [95%CI, 0.21 to 0.49], I2=0%) but was not associated with HRQoL (mixed and insignificant association in physical and mental domains). Qualitative synthesis further suggested that most studies supported better functional and personal recovery outcomes for stroke patients who were married/partnered compared with those who were unpartnered. Data were insufficient to determine whether the association of partner status varied by the sex of the stroke patient.

Conclusions: Our findings highlight the importance of the influence of marital/partner status on PROMs among stroke patients for mental health, but not for HRQoL. Future research should aim to harmonize assessments and standardize reporting to enhance further investigation of these associations, determine whether there are differences by sex, and further explore the association between marital/partner status and poststroke functional outcomes.