Death After Heart Surgery Reduced by Social and Religious Factors

Elderly heart patients are 14 times less likely to die following surgery if they are both socially active and find strength or comfort in their religious faith, found a recent study at the University of Dartmouth Medical School in New Hampshire.

The medical researchers studied 232 patients 55 years or older who were preparing to undergo elective heart surgery to investigate what particular variables might contribute to survival. Six months following surgery 21 of the patients had died.

The most consistent indicator of survival was the amount of strength or comfort the patient said they received from their religious faith. "Those without any strength or comfort from religion had almost three times the risk of death as those with at least some strength and comfort," the researchers stated.

Furthermore, the more religious, the greater the protective effect. Of the 37 patients who described themselves as "deeply religious," none died. Only 5% of those who attended church at least every few months died in the six months following the operation, compared to 12% of those who rarely or never did so.

The more socially active patients also had higher survival rates. Only 4% of the patients who engaged in organized groups such as "local government, a church supper group, a senior center, or a historical society," had died compared to 14% of the uninvolved. Surprisingly, other social support such as having a close "confidant," and involvement with friends and family were not associated with lower death risk. Neither was the patient's own perception of how "adequate" such support was associated with lower death risk.

"It appears there is something unique and life protective about participating in an organized, regular social activity," the researchers stated.

The researchers also investigated whether being active in social groups and being religious were related. However, they found the effects of social involvement and degree of religious commitment were independent and separate effects. A patient with both had the greatest risk reduction. For instance, those who either participated in group activities or received strength or support from religion were three times less likely to die during the six months after surgery than those people who had experienced neither of the two characteristics. Those possessing both positive characteristics were 14 times more likely to survive than those with neither. Only two out of the 72 people died who had both.

Although the study's authors said they were unable to explain precisely how the social and religious factors lead to longer life, they nonetheless recommended that health care professionals should support and encourage such patient behaviors. "Cigarette smoking and hypertension are risk factors for coronary artery disease though still unknown mechanisms, yet physicians recommend reduction," they stated. "Physicians may eventually be advised to make relatively simple inquires about and reinforcement of group participation and religious involvement as routinely as they inquire and advise about cigarette smoking and hypertension."

The researchers concluded that a physician "probably cannot convince a patient to participate privately in religion or publicly in social groups any more than he or she can successfully convince a patient to stop smoking." Yet, encouraging these activities "may improve quality of life and...alter their survival behaviors."

Reference: Oxman, T. E., Freeman, D. H., and Manheimer, E. D. (1995). "Lack of Social Participation or Religious Strength or Comfort as Risk Factors for Death After Cardiac Surgery in the Elderly." Psychosomatic Medicine 57:5-15. 95.4(1)