MP22-01 THE ASSOCIATION BETWEEN FRAILTY, LOW TESTOSTERONE, AND POSTOPERATIVE OUTCOMES AMONG MEN UNDERGOING TRANSURETHRAL RESECTION OF BLADDER TUMOR

Abstract

You have accessJournal of UrologyCME1 Apr 2023MP22-01 THE ASSOCIATION BETWEEN FRAILTY, LOW TESTOSTERONE, AND POSTOPERATIVE OUTCOMES AMONG MEN UNDERGOING TRANSURETHRAL RESECTION OF BLADDER TUMOR Daniel R. Greenberg*, Jasmin S. Lin, Sai Kaushik S. R. Kumar, Xinlei Mi, Edward M. Schaeffer, Joshua M. Meeks, Robert E. Brannigan, and Joshua A. Halpern Daniel R. Greenberg*Daniel R. Greenberg* More articles by this author , Jasmin S. LinJasmin S. Lin More articles by this author , Sai Kaushik S. R. KumarSai Kaushik S. R. Kumar More articles by this author , Xinlei MiXinlei Mi More articles by this author , Edward M. SchaefferEdward M. Schaeffer More articles by this author , Joshua M. MeeksJoshua M. Meeks More articles by this author , Robert E. BranniganRobert E. Brannigan More articles by this author , and Joshua A. HalpernJoshua A. Halpern More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003247.01AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Low testosterone (T) is highly prevalent in the male population and is associated with frailty, decreased muscle mass, lower health-related quality of life, and premature mortality, which may predispose patients to poor perioperative outcomes. However, the prevalence and importance of low T and frailty among men undergoing transurethral resection of bladder tumor (TURBT) remains unknown. We aimed to determine if low T and frailty are associated with adverse postoperative outcomes in this population. METHODS: We reviewed men who underwent TURBT who had a preoperative T value <1 year prior to surgery. Low T was defined as total T <300 ng/dL and frailty was categorized as low-, intermediate-, or high-risk using published Hospital Frailty Risk Score (HFRS) ranges. Demographics and surgical outcomes including length of stay, postoperative laboratory values and complications, and ED visits, readmissions, and mortality rates were collected. Student’s t test and Fisher’s exact test were used to determine differences between low T and normal T cohorts, and univariate and multivariate logistic regression was used to determine the association of low T and frailty on postoperative outcomes. RESULTS: Among 308 men, 64.6% had low T. Mean preoperative T in the low T cohort was 164.2 ± 98.3 ng/dL vs 414.9 ± 165.3 in the normal T cohort (p<0.001). Overall, 156 (50.6%) men were categorized as low-risk frailty, 108 (35.1%) were intermediate-risk frailty, and 44 (14.3%) were high-risk frailty, with no difference between cohorts (p=0.45). There was no difference in age, race, ED visits, readmissions, or mortality rates between groups. Men with low T had lower postoperative hemoglobin (12.9 ± 2.0 vs 13.6 ± 1.7, p=0.048) and hematocrit (38.7 ± 5.8 vs 40.0 ± 4.8, p=0.046) compared to men with normal T. T was not associated with frailty (p=0.40), however, high-risk frailty was associated with higher postoperative complications on both univariate (OR 3.2, 95% CI [1.3-8.0], p=0.01) and multivariate logistic regression (OR 3.1, 95% CI [1.2-7.8], p=0.02). CONCLUSIONS: The prevalence of low T in men undergoing TURBT was high and was associated with lower postoperative hemoglobin and hematocrit. Although T was not independently associated with frailty, high-risk frailty was associated with increased odds of postoperative complications. While prospective data is required to validate our results, these findings suggest that both T and preoperative frailty should be evaluated prior to undergoing TURBT. Source of Funding: Urology Care Foundation Research Scholar Award SP0071384 © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e295 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Daniel R. Greenberg* More articles by this author Jasmin S. Lin More articles by this author Sai Kaushik S. R. Kumar More articles by this author Xinlei Mi More articles by this author Edward M. Schaeffer More articles by this author Joshua M. Meeks More articles by this author Robert E. Brannigan More articles by this author Joshua A. Halpern More articles by this author Expand All Advertisement PDF downloadLoading ...