Evidence map›Paper›PMID 30514319›Full record

Trial reportRespiratory research2018

Dihydrotestosterone is a predictor for mortality in males with community-acquired pneumonia: results of a 6-year follow-up study.

Seline Zurfluh, Manuela Nickler, Manuel Ottiger, Christian Steuer, Alexander Kutz, Mirjam Christ-Crain, Werner Zimmerli, Robert Thomann, Claus Hoess, Christoph Henzen and 5 more

Open access · goldAbstract readMulticenter StudyRandomized Controlled Trial
In one paragraph

Trial report in Respiratory research, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.8field-weighted citation impact, top 24% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 8 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors at 6 institutions in 1 country.

Seline ZurfluhMedical University Department, Division of General Internal and Emergency Medicine, Kantonsspital Aarau, Aarau, Switzerland. seline.zurfluh@ksa.ch.
Manuela NicklerMedical University Department, Division of General Internal and Emergency Medicine, Kantonsspital Aarau, Aarau, Switzerland.
Manuel OttigerMedical University Department, Division of General Internal and Emergency Medicine, Kantonsspital Aarau, Aarau, Switzerland.
Christian SteuerETH Zürich, Zürich, Switzerland.
Alexander KutzMedical University Department, Division of General Internal and Emergency Medicine, Kantonsspital Aarau, Aarau, Switzerland.
Mirjam Christ-CrainDepartment of Internal Medicine, Division of Endocrinology, Diabetes and Clinical Nutrition, University Hospital Basel, Basel, Switzerland.
Werner ZimmerliBasel University Medical Clinic Liestal, Liestal, Switzerland.
Robert ThomannDepartment of Internal Medicine, Bürgerspital Solothurn, Solothurn, Switzerland.
Claus HoessDepartment of Internal Medicine, Kantonsspital Münsterlingen, Münsterlingen, Switzerland.
Christoph HenzenDepartment of Internal Medicine, Kantonsspital Lucerne, Lucerne, Switzerland.
Luca BernasconiDepartment of Laboratory Medicine, Kantonsspital Aarau, Aarau, Switzerland.
Andreas HuberDepartment of Laboratory Medicine, Kantonsspital Aarau, Aarau, Switzerland.
Beat MuellerMedical University Department, Division of General Internal and Emergency Medicine, Kantonsspital Aarau, Aarau, Switzerland.
Philipp SchuetzMedical University Department, Division of General Internal and Emergency Medicine, Kantonsspital Aarau, Aarau, Switzerland.
proHOSP study group
Kantonsspital Aarau · CHETH Zurich · CHLuzerner Kantonsspital · CHUniversity Hospital of Basel · CHKantonsspital Münsterlingen · CHPsychiatry Baselland · CH

Funding

Research Council of the Kantonsspital Aarau 1410.000.044Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung grant SNF 3200BO-116177/1Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung SNSF Professorship, PP00P3_150531/1
6 · The paper itself

Abstract

backgroundAdrenal hormone metabolite levels are altered in acute illnesses such as community-acquired pneumonia (CAP). Our aim was to investigate associations of sex and mineralocorticoid hormone metabolites with short- and long-term mortality and severity of CAP in male and female patients.

methodsWe prospectively followed 285 patients (60.4% male, mean age 71 years) with CAP from a previous multicenter trial. At baseline, levels of different metabolites of sex hormones and mineralocorticoids were measured by liquid chromatography coupled to tandem mass spectrometry. We calculated Cox regression models adjusted for age and comorbidities.

resultsAll-cause mortality was 5.3% after 30 days and increased to 47.4% after 6 years. In males, high levels of dihydrotestosterone were associated with higher 6-year mortality (adjusted HR 2.84, 95%CI 1.15-6.99, p = 0.023), whereas high levels of 17-OH-progesterone were associated with lower 6-year mortality (adjusted HR 0.72, 95%CI 0.54-0.97, p = 0.029). Testosterone levels in males correlated inversely with inflammatory markers (CRP rho = - 0.39, p < 0.001; PCT rho = - 0.34, p < 0.001) and disease severity as assessed by the Pneumonia severity index (PSI) (rho = - 0.23, p = 0.003). No similar association was found for female patients.

conclusionWhereas in males with CAP, sex and mineralocorticoid hormone metabolite levels correlated with inflammation, disease severity and long-term survival, no similar association was found for females. Further study of sex and mineralocorticoid hormones in acute illness could generate predictive signatures with implementation in clinical practice.

Indexed as

Sex CharacteristicsAdultAgedAged, 80 and overBiomarkersCommunity-Acquired InfectionsDihydrotestosteroneFemaleFollow-Up StudiesHumansMaleMiddle AgedMortalityPneumoniaPredictive Value of TestsProspective StudiesBiomarkersDihydrotestosteroneAdrenal hormonesCommunity-acquired pneumoniaDihydrotestosteroneMortality prediction

Identifiers

PMID30514319
PMCPMC6280517
OpenAlexW2902183376

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.