Androgen Therapy and Rehospitalization in Older Men with Testosterone Deficiency

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Abstract

Objective To assess whether the receipt of androgen therapy is associated with a reduced 30-day rehospitalization rate among older men with testosterone deficiency. Patients and Methods We conducted a retrospective cohort study using a 5% national sample of Medicare beneficiaries. We identified 6372 nonsurgical hospitalizations between January 1, 2007, and December 31, 2012, for male patients aged 66 years and older with a previous diagnosis of testosterone deficiency. Patients who died or lost Medicare coverage in the 30 days after hospital discharge or who were discharged to another inpatient setting were excluded from the analysis. Logistic regression was used to calculate odds ratios (ORs) and 95% CIs for the risk of 30-day hospital readmissions associated with receipt of androgen therapy. Results In older men with testosterone deficiency, receipt of androgen therapy was associated with a reduced risk of rehospitalization (91 of 929 androgen users [9.8%] vs 708 of 5443 non-androgen users [13.0%]; OR, 0.73; 95% CI, 0.58-0.92) in the 30 days after hospital discharge. In a logistic regression analysis adjusting for multiple demographic, clinical, and health service variables, the OR was similar (OR, 0.75; 95% CI, 0.59-0.95). The adjusted OR for unplanned 30-day hospital readmissions was 0.62 (95% CI, 0.47-0.83). Each of these findings persisted across a range of propensity score analyses - including adjustment, stratification, and inverse probability treatment weighting - and several sensitivity analyses. Conclusion Androgen therapy may reduce the risk of rehospitalization in older men with testosterone deficiency. Given the high rates of early hospital readmission among older adults, further exploration of this intervention holds broad clinical and public health relevance.

Original languageEnglish (US)
Pages (from-to)587-595
Number of pages9
JournalMayo Clinic Proceedings
Volume91
Issue number5
DOIs
StatePublished - May 1 2016

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Androgens
Testosterone
Patient Readmission
Odds Ratio
Medicare
Logistic Models
Therapeutics
Propensity Score
Health Services
Inpatients
Hospitalization
Cohort Studies
Retrospective Studies
Public Health
Regression Analysis
Demography

ASJC Scopus subject areas

  • Medicine(all)

Cite this

@article{c076b4503315419e9f82ec0989a8d427,
title = "Androgen Therapy and Rehospitalization in Older Men with Testosterone Deficiency",
abstract = "Objective To assess whether the receipt of androgen therapy is associated with a reduced 30-day rehospitalization rate among older men with testosterone deficiency. Patients and Methods We conducted a retrospective cohort study using a 5{\%} national sample of Medicare beneficiaries. We identified 6372 nonsurgical hospitalizations between January 1, 2007, and December 31, 2012, for male patients aged 66 years and older with a previous diagnosis of testosterone deficiency. Patients who died or lost Medicare coverage in the 30 days after hospital discharge or who were discharged to another inpatient setting were excluded from the analysis. Logistic regression was used to calculate odds ratios (ORs) and 95{\%} CIs for the risk of 30-day hospital readmissions associated with receipt of androgen therapy. Results In older men with testosterone deficiency, receipt of androgen therapy was associated with a reduced risk of rehospitalization (91 of 929 androgen users [9.8{\%}] vs 708 of 5443 non-androgen users [13.0{\%}]; OR, 0.73; 95{\%} CI, 0.58-0.92) in the 30 days after hospital discharge. In a logistic regression analysis adjusting for multiple demographic, clinical, and health service variables, the OR was similar (OR, 0.75; 95{\%} CI, 0.59-0.95). The adjusted OR for unplanned 30-day hospital readmissions was 0.62 (95{\%} CI, 0.47-0.83). Each of these findings persisted across a range of propensity score analyses - including adjustment, stratification, and inverse probability treatment weighting - and several sensitivity analyses. Conclusion Androgen therapy may reduce the risk of rehospitalization in older men with testosterone deficiency. Given the high rates of early hospital readmission among older adults, further exploration of this intervention holds broad clinical and public health relevance.",
author = "Jacques Baillargeon and Deer, {Rachel R.} and Kuo, {Yong Fang} and Dong Zhang and Goodwin, {James S.} and Elena Volpi",
year = "2016",
month = "5",
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T1 - Androgen Therapy and Rehospitalization in Older Men with Testosterone Deficiency

AU - Baillargeon, Jacques

AU - Deer, Rachel R.

AU - Kuo, Yong Fang

AU - Zhang, Dong

AU - Goodwin, James S.

AU - Volpi, Elena

PY - 2016/5/1

Y1 - 2016/5/1

N2 - Objective To assess whether the receipt of androgen therapy is associated with a reduced 30-day rehospitalization rate among older men with testosterone deficiency. Patients and Methods We conducted a retrospective cohort study using a 5% national sample of Medicare beneficiaries. We identified 6372 nonsurgical hospitalizations between January 1, 2007, and December 31, 2012, for male patients aged 66 years and older with a previous diagnosis of testosterone deficiency. Patients who died or lost Medicare coverage in the 30 days after hospital discharge or who were discharged to another inpatient setting were excluded from the analysis. Logistic regression was used to calculate odds ratios (ORs) and 95% CIs for the risk of 30-day hospital readmissions associated with receipt of androgen therapy. Results In older men with testosterone deficiency, receipt of androgen therapy was associated with a reduced risk of rehospitalization (91 of 929 androgen users [9.8%] vs 708 of 5443 non-androgen users [13.0%]; OR, 0.73; 95% CI, 0.58-0.92) in the 30 days after hospital discharge. In a logistic regression analysis adjusting for multiple demographic, clinical, and health service variables, the OR was similar (OR, 0.75; 95% CI, 0.59-0.95). The adjusted OR for unplanned 30-day hospital readmissions was 0.62 (95% CI, 0.47-0.83). Each of these findings persisted across a range of propensity score analyses - including adjustment, stratification, and inverse probability treatment weighting - and several sensitivity analyses. Conclusion Androgen therapy may reduce the risk of rehospitalization in older men with testosterone deficiency. Given the high rates of early hospital readmission among older adults, further exploration of this intervention holds broad clinical and public health relevance.

AB - Objective To assess whether the receipt of androgen therapy is associated with a reduced 30-day rehospitalization rate among older men with testosterone deficiency. Patients and Methods We conducted a retrospective cohort study using a 5% national sample of Medicare beneficiaries. We identified 6372 nonsurgical hospitalizations between January 1, 2007, and December 31, 2012, for male patients aged 66 years and older with a previous diagnosis of testosterone deficiency. Patients who died or lost Medicare coverage in the 30 days after hospital discharge or who were discharged to another inpatient setting were excluded from the analysis. Logistic regression was used to calculate odds ratios (ORs) and 95% CIs for the risk of 30-day hospital readmissions associated with receipt of androgen therapy. Results In older men with testosterone deficiency, receipt of androgen therapy was associated with a reduced risk of rehospitalization (91 of 929 androgen users [9.8%] vs 708 of 5443 non-androgen users [13.0%]; OR, 0.73; 95% CI, 0.58-0.92) in the 30 days after hospital discharge. In a logistic regression analysis adjusting for multiple demographic, clinical, and health service variables, the OR was similar (OR, 0.75; 95% CI, 0.59-0.95). The adjusted OR for unplanned 30-day hospital readmissions was 0.62 (95% CI, 0.47-0.83). Each of these findings persisted across a range of propensity score analyses - including adjustment, stratification, and inverse probability treatment weighting - and several sensitivity analyses. Conclusion Androgen therapy may reduce the risk of rehospitalization in older men with testosterone deficiency. Given the high rates of early hospital readmission among older adults, further exploration of this intervention holds broad clinical and public health relevance.

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JF - Mayo Clinic Proceedings

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