The Impact of Marital Status and Sex on Heart Failure Readmissions: A Case Study from Atrium Health Floyd Medical Center

IntroHeart failure is one of the major causes of death in the United States, characterized by high readmission rates annually. Our study sought to analyze de-identified patient data from the Atrium Health Floyd Medical Center to identify differences in readmission rates for patients based on sex and marital status and propose novel solutions to our findings. MethodsIn this retrospective cohort analysis, 1,122 HF patient discharges (obtained by reviewing heart failure specific diagnosis-related group and principal diagnosis codes) between February 1, 2023 - March 30, 2024 were analyzed to describe demographic trends of readmission and total length of stay. Such analyses included a chi-square test of independence and Kruskal Wallis Test alongside the appropriate post-hoc analyses. Univariable logistic regression analyses were used to understand the odds of readmission amongst the different groups of marital status and sex as well as between different rural/urban statuses. Regressions were visualized with forest plots. ResultsThe heart failure readmission rate was 13.25% (147/1,109). Prior to post-hoc analyses, there was a significant difference in the observed count and expected count of married female readmission (9 vs. 19.161, p=0.020), and two proportion tests revealed a significantly higher readmission rate for single females compared to married females [14.36% (56/390) vs. 6.21% (9/145); p=0.010]. Prior to correction, married females had a statistically longer total length of stay compared to single females (p=0.038). Lastly, univariable logistic regressions revealed that married males, single females, and single males all had significantly higher odds of being readmitted compared to married females (married male: OR=2.248, p=0.045; single female: OR=2.532, p=0.013; single male: OR=2.606, p=0.010). No significant relationship between marital status and sex with length of stay or between geographic classification (metropolitan, micropolitan, rural, small town) with readmission was found. ConclusionsMarried females had the lowest readmission risk, while all others experienced significantly higher odds of readmission, pointing to the potentially protective role of partner-based social support post-discharge. Length of stay was not significantly related to marital or sex groups after correction suggesting that inpatient care delivery may be less sensitive to sociodemographic factors than post-discharge recovery. These findings underscore the need for better transitional care strategies for patients who lack strong support networks at home and stronger research backing to further characterize heart failure readmissions.