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.
Abbreviations and Acronyms:
IPTW (inverse probability treatment weighting), OR (odds ratio)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: April 06, 2016
Footnotes
Grant Support: This study was supported by grants UL1TR001439 and 5P30AG024832 from the National Institutes of Health and grant R24H5022134 from the Agency for Healthcare Research and Quality.
Identification
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© 2016 Mayo Foundation for Medical Education and Research.
