Testosterone Level Does Not Affect the Risk of Admission or Length of Hospital Stay in Patients with Heart Failure — A National Health and Nutrition Examination Survey-Based Study

Abstract

Introduction There is some evidence concerning the role of testosterone in cardiovascular diseases including heart failure. Some evidence favors reduced risk of cardiovascular events with higher levels while others have found no association. Hypothesis We hypothesized that lower testosterone level is associated with a lower hospital stay and admission rates in those with heart failure. Methods We used the NHANES database to identify males with a reported diagnosis of heart failure. The outcomes were inpatient admission in the past year and the number of days spent in the hospital in the past year. Results We identified 284 males with a reported a diagnosis of heart failure in 2011-2016 NHANES, mean age was 66.5 years, and there was no statistically significant difference in age between the group with serum testosterone less than 250 ng/ml and the group with serum testosterone more than 250 ng/ml(p=0.21). In the monovariate analysis, the group with lower testosterone levels are less likely to be admitted when compared to the group with higher testosterone, but this association was not statistically significant (25.6% vs. 40.0%,P=0.05). After multivariate analysis using logistic regression adjusting for comorbid conditions, the odds of being admitted is less in those with normal testosterone, but this was not statistically significant (OR 0.54, 95CI 0.25-1.57,p=0.11). In the linear regression model, we didn't find any significant effect of serum testosterone in the overall number of days spent in the hospital. Conclusions There was no evidence of an association between testosterone and increased admission and also no evidence of an association between serum testosterone and the overall length of stay. Some studies have shown possible benefits of testosterone supplementation in heart failure, but our study revealed that there is likely no effect on the risk of admission or length of stay.