Healthcare News & Insights

Testosterone therapy may cut readmissions in older men

Hospitals looking to get a handle on their readmission rates must look at all possible strategies to make an impact, even those that may not be the most obvious at first glance. New research finds a link between lower readmission rates and the use of testosterone therapy in elderly men. 

ThinkstockPhotos-465364305Much of the focus on lowering readmissions looks at older patients with illnesses like heart failure and diabetes. And statistically, male patients with these chronic diseases are more likely to experience a testosterone deficiency.

Past studies have found that low testosterone levels are associated with an increased risk of functional decline – which can negatively affect a patient’s recovery after a hospital stay.

Because testosterone therapy has been linked to several positive results in patients with declining levels of the hormone (including improved physical strength and health), researchers at the University of Texas Medical Branch at Galveston decided to examine the outcomes for patients receiving testosterone therapy, and their results were published in Mayo Clinic Proceedings.

Link between hormone & outcomes

According to a news release, the University of Texas researchers used Medicare data to identify over 6,000 men over the age of 66 who had low testosterone levels and visited the hospital over a five-year period from 2007 to 2012. They compared the ones who were receiving testosterone therapy to boost their hormone levels to the ones who weren’t.

Their findings: Older men who were being treated for their low testosterone levels were less likely to return to the hospital. Overall, 30-day readmission rates were 9.8% for men who used testosterone, compared to 13% for those who didn’t.

Emergency department readmissions also were lower among men receiving testosterone therapy (6.2%) – those who weren’t using testosterone had ED readmission rates of 10%.

It’s speculated that testosterone makes a big difference in helping older male patients retain their muscle mass and exercise capacity, which keeps them active and less likely to suffer the effects of “post-hospital syndrome,” where the body is weakened and vulnerable to illness or injury in the immediate weeks after discharge. That could keep them from being readmitted within 30 days of their initial hospital stay.

Pros and cons

Many providers may be hesitant to prescribe testosterone therapy for older male patients with lower levels of the hormone because it’s been linked to increased cardiovascular issues in the past. Hospitals are currently being judged by their performance in preventing negative outcomes for heart attacks and other cardiovascular problems, so clinicians might not want to increase the likelihood of a cardiovascular event.

However, in this analysis, University of Texas researchers found no link between an increased risk of adverse cardiovascular problems and the use of testosterone therapy. And previous studies have even suggested that testosterone therapy might boost patients’ cardiovascular health by decreasing their fat mass and lipid profile.

So, in cases where male patients are admitted to the hospital and tests show they have low testosterone levels, it may be smart for clinicians to discuss the feasibility of hormone therapy, highlighting the potential benefits to the patient during the recovery period.

 

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