@Article{,
AUTHOR = {Alon Lazarovich, Daniel R. Greenberg, Stephen P. Rhodes, Hriday P. Bhambhvani, Luis C. Gago, Hiten D. Patel, Robert E. Brannigan, Jonathan E. Shoag, Joshua A. Halpern},
TITLE = {Hypogonadism, frailty, and postoperative outcomes among men undergoing partial nephrectomy},
JOURNAL = {Canadian Journal of Urology},
VOLUME = {31},
YEAR = {2024},
NUMBER = {6},
PAGES = {12045--12052},
URL = {http://www.techscience.com/CJU/v31n6/59553},
ISSN = {1488-5581},
ABSTRACT = {<b>Introduction:</b> To determine the prevalence of hypogonadism
in men undergoing partial nephrectomy (PN) and whether
hypogonadism and frailty are associated with adverse
postoperative outcomes.<br/>
<b>Materials and methods:</b> We identified men undergoing
PN between 2012-2021 using the Merative Marketscan
database. Patients were considered to have hypogonadism
if diagnosed within 5 years prior to PN. Frailty was
determined using the Hospital Frailty Risk Score (HFRS).
Length of stay (LOS), complications, ED visits, and
inpatient readmissions were compared. Sub-group analysis
of men with hypogonadism was performed to determine if
testosterone replacement therapy (TRT) improved clinical
outcomes.<br/>
<b>Results:</b> Among 9,105 men who underwent PN, 809
(8.9%) were hypogonadal prior to PN. Hypogonadal men
were significantly more frail compared to eugonadal men
(HFRS score: median 6.7, IQR 4.1-10.1 vs. median 5.6,
IQR 3.3-8.8, p < 0.001). However, there was no significant
difference in LOS following PN nor in 90-day postoperative
complications, ED visits, or inpatient readmission
between men with and without hypogonadism. However,
intermediate- and high-risk frailty were associated with
increased risk of 90-day ED visits and 90-day inpatient
readmission compared to low-risk patients. Among high
risk men with hypogonadism, TRT was associated with
decreased risk of 90-day ED visits (p = 0.04).<br/>
<b>Conclusions:</b> Frailty was associated with postoperative
outcomes following PN. Hypogonadism was associated
with frailty, and treatment of hypogonadal men with
TRT was associated with reduction in post-operative risk.
These findings suggest a role for frailty assessment, and
possibly testosterone screening, in men undergoing PN.},
DOI = {}
}