Evidence map›Paper›PMID 35036888›Full record

ArticleSurgery open science2022

Low free testosterone is associated with increased mortality in frail surgical patients.

Fangyi Lin, Gordon Hong, Frances Kwon, Farha Pirani, Salima Makhani, Mark Henry, Ian Cooke, Reza Nabavizadeh, Eric Midenberg, Akanksha Mehta and 3 more

Open access · goldAbstract read
In one paragraph

Article in Surgery open science, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.2field-weighted citation impact, top 45% 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

2 citing papers in PubMed, 5 citations in OpenAlex.

  1. Article
  2. Hypogonadism and urologic surgeries: a narrative review.Translational andrology and urology · 2022
    Review
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

13 authors at 4 institutions in 1 country.

Fangyi LinDepartment of Urology, Emory University School of Medicine, Atlanta, GA, USA.
Gordon HongNortheast Ohio Medical University, Rootstown, OH, USA.
Frances KwonDepartment of Urology, Emory University School of Medicine, Atlanta, GA, USA.
Farha PiraniMedical College of Georgia, Augusta, GA, USA.
Salima MakhaniMercer University School of Medicine, Macon, GA, USA.
Mark HenryDepartment of Urology, Emory University School of Medicine, Atlanta, GA, USA.
Ian CookeDepartment of Urology, Emory University School of Medicine, Atlanta, GA, USA.
Reza NabavizadehDepartment of Urology, Emory University School of Medicine, Atlanta, GA, USA.
Eric MidenbergDepartment of Urology, Emory University School of Medicine, Atlanta, GA, USA.
Akanksha MehtaDepartment of Urology, Emory University School of Medicine, Atlanta, GA, USA.
Chad RitenourDepartment of Urology, Emory University School of Medicine, Atlanta, GA, USA.
Viraj A MasterDepartment of Urology, Emory University School of Medicine, Atlanta, GA, USA.
Kenneth OganDepartment of Urology, Emory University School of Medicine, Atlanta, GA, USA.
Emory University · USAugusta University · USMercer University · USNortheast Ohio Medical University · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPreoperative frailty has been associated with adverse postoperative outcomes. Additionally, low testosterone has been associated with physical frailty and cognitive decline. However, the impact of simultaneous frailty and low testosterone on surgical outcomes is understudied.

methodsPreoperative frailty status and testosterone levels were obtained in patients undergoing a diverse range of surgical procedures. Preoperative frailty was evaluated independently and in combination with testosterone through the creation of composite risk groups. Relationships between preoperative frailty and composite risk groups with overall survival were determined using Kaplan-Meier and logistic regression analyses. Bivariate analysis was used to determine the associations between frailty and testosterone status on postoperative complications, length of hospital stay, and readmission rates.

resultsMedian age of the cohort was 63 years, and the median follow-up time was 105 weeks. Thirty-one patients (23%) were frail, and 36 (27%) had low free testosterone. Bivariate analysis demonstrated a statistically significant relationship between preoperative frailty and overall survival (P = .044). In multivariate analysis, coexisting frailty and low free testosterone were significantly associated with decreased overall survival (hazard ratio 4.93, 95% confidence interval, 1.68-14.46, P = .004).

conclusionWe observed preoperative frailty, both independently and in combination with low free testosterone levels, to be significantly associated with decreased overall survival across various surgical procedures. Personalizing the surgical risk assessment through the incorporation of preoperative frailty and testosterone status may serve to improve the prognostication of patients undergoing major surgery.

Indexed as

ASA, American Society of AnesthesiologistsBMI, body mass indexCCI, Charlson Comorbidity IndexCI, confidence intervalECOG, Eastern COoperative Oncology GroupeGFR, estimated Glomerular Filtration RateHR, hazard ratioIQR, interquartile rangeOS, overall survivalT, testosterone

Identifiers

PMID35036888
PMCPMC8743202
OpenAlexW3211758794

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

None linked

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.