Predictor Of Mortality In Men Research Articles

Long-term gender disparities in new-onset heart failure after acute coronary syndrome.

A paucity of studies addressed sex-related differences in clinical outcomes in the long term following acute coronary syndrome (ACS) treated with percutaneous coronary intervention (PCI). In these patients, it remains uncertain whether heart failure (HF) might exert a differential impact on the prognosis in the long term. We queried a large-scale database of ACS patients undergoing PCI. The primary endpoint was new-onset HF. Secondary endpoints included mortality, myocardial infarction, re-PCI and ischaemic stroke. Propensity score matching was generated to balance group characteristics. A total of 3334 patients after propensity score matching were analysed. Follow-up was assessed at the 5year term. At 5year follow-up, HF risk increased significantly in males versus females {17.9% vs. 14.8%, hazard ratio [HR] [95% confidence interval (CI)]=1.22 [1.03-1.44], P=0.02}. At 5year follow-up, mortality was significantly higher in the male cohort as compared with the female cohort [HR (95% CI)=1.23 (1.02-1.47), P=0.02]. On landmark analysis, differences in mortality emerged after the first year and were maintained thereafter. Ischaemic outcomes were comparable between cohorts. Following ACS, males experienced a greater long-term risk of developing new-onset HF as compared with females. This difference remained consistent across all prespecified subgroups. Mortality was significantly higher in males. No differences were observed in ischaemic outcomes. New-onset HF emerges as a primary contributor to long-term gender disparities after ACS and a strong predictor of mortality in men with HF.

Predictors of 1-Year Mortality in Men Versus Women Undergoing Transfemoral Transcatheter Aortic Valve Implantation

Although gender-related disparities in intermediate-term outcomes have been reported after transcatheter aortic valve implantation (TAVI), disparate predictors of mortality in men and women who underwent TAVI have not been well studied. This prospective institutional registry study included 297 consecutive patients (153 men, 144 women) who underwent transfemoral TAVI from December 2015 to June 2018 at an academic tertiary medical center. Baseline and clinical characteristics, procedural data, and clinical outcomes at 1year were recorded. Mortality rates at 1year were 11.1% and 20.3% in women and men, respectively (p=0.033). Risk-adjusted mortality was significantly higher in men who underwent TAVI than in women (odds ratio [OR] 2.45, 95% confidence interval [CI] 1.24 to 4.87, p=0.010). Gender-specific risk-adjusted predictors of 1-year mortality post-TAVI included the presence of atrial fibrillation (OR 4.20, 95% CI 1.31 to 13.46, p=0.016) and peripheral artery disease (OR 4.64, 95% CI 1.04 to 20.71, p=0.044) in women and presence of chronic obstructive pulmonary disease (OR 3.14, 95% CI 1.13 to 8.72, p=0.029), higher serum creatinine (OR 1.57, 95% CI 1.15 to 2.15, p=0.004), and lower body mass index (OR 0.88, 95% CI 0.80 to 0.97, p=0.008) in men. In this prospective institutional registry of adults who underwent TAVI, risk-adjusted 1-year mortality is significantly lower in women, and disparate predictors of risk-adjusted 1-year mortality exist in men and women.

Sex differences in the impact of frailty in elderly outpatients with heart failure.

IntroductionFrailty is common among patients with heart failure (HF). Our aim was to address the role of frailty in the management and prognosis of elderly men and women with HF.Methods and resultsProspective multicenter registry that included 499 HF outpatients ≥75 years old. Mean age was 81.4 ± 4.3 years, and 193 (38%) were women. Compared with men, women were older (81.9 ± 4.3 vs. 81.0 ± 4.2 years, p = 0.03) and had higher left ventricular ejection fraction (46 vs. 40%, p < 0.001) and less ischemic heart disease (30 vs. 57%, p < 0.001). Women had a higher prevalence of frailty (22 vs. 10% with Clinical Frailty Scale, 34 vs. 15% with FRAIL, and 67% vs. 46% with the mobility visual scale, all p-values < 0.001) and other geriatric conditions (Barthel index ≤90: 14.9 vs. 6.2%, p = 0.003; malnutrition according to Mini Nutritional Assessment Short Formulary ≤11: 55% vs. 42%, p = 0.007; Pfeiffer cognitive test's errors: 1.6 ± 1.7 vs. 1.0 ± 1.6, p < 0.001; depression according to Yesavage test; p < 0.001) and lower comorbidity (Charlson index ≥4: 14.1% vs. 22.1%, p = 0.038). Women also showed worse self-reported quality of life (6.5 ± 2.1 vs. 6.9 ± 1.9, on a scale from 0 to 10, p = 0.012). In the univariate analysis, frailty was an independent predictor of mortality in men [Hazard ratio (HR) 3.18, 95% confidence interval (CI) 1.29–7.83, p = 0.012; HR 4.53, 95% CI 2.08–9.89, p < 0.001; and HR 2.61, 95% CI 1.23–5.43, p = 0.010, according to FRAIL, Clinical Frailty Scale, and visual mobility scale, respectively], but not in women. In the multivariable analysis, frailty identified by the visual mobility scale was an independent predictor of mortality (HR 1.95, 95% CI 1.04–3.67, p = 0.03) and mortality/readmission (HR 2.06, 95% CI 1.05–4.04, p = 0.03) in men.ConclusionsIn elderly outpatients with HF frailty is more common in women than in men. However, frailty is only associated with mortality in men.

Spousal body weight concordance and the impact of spouse overweight on death risk: data form a 27-year cohort prospective study

Aim. To study the interdependence of spousal body mass and influence of spouse overweight on the death risk according to the 27-year cohort prospective study.Material and methods. We examined a random household sample (n=1546; married couples, 427). Overweight frequency among spouses was studied on the first stage of the study (1988-1991). In 2002-2005 (stage II), the examination was repeated and overweight dynamics were studied. In 2015 (stage III), we analyze mortality rates and significance of overweight and spousal overweight for the mortality risk formation. Overweight was detected in people with body mass index ≥25 kg/m2. Two hundred deaths were recorded during 27-year follow-up. Vital status was established for 97% of observed persons.Results. Overweight was detected in 61,1% of men who lived with overweight wife and in 45% of men whose wife had normal body mass (p&lt;0,01). Overweight was diagnosed more often in women whose husband also had overweight comparing with women who lived with normal weight husband (76,2% vs 61,7%; p&lt;0,001). The risk of overweight formation among individuals whose spouse’s body mass increased from norm to overweight was in 3,04 times higher than in persons whose spouse had a stable normal body mass and in 2,2 times higher than in participants whose spouse had overweight on study stages I and II. Relative risk of mortality in men who lived with overweight wife was 2,07.Conclusion. 1) We found the body mass concordance in spouses. 2) The average body mass index in men and women who lived with overweight spouse is higher than in men and women whose spouse had a normal body mass. 3) Interdependence of spousal body mass was revealed in dynamics. 4) Spousal overweight is an independent predictor of premature mortality in men.

A drug comorbidity index to predict mortality in men with castration resistant prostate cancer.

BackgroundThe Charlson Comorbidity Index is a poor predictor of mortality in men with castration resistant prostate cancer (CRPC). To improve this prediction, we created a comorbidity index based on filled prescriptions intended to be used in registry-based studies.Materials and methodsIn a population-based cohort of men with CPRC a drug comorbidity index (DCI-CRPC) was calculated based on prescriptions filled during a 365-day period before the date of CRPC diagnosis to predict mortality. Five risk categories for men with CRPC were defined based on PSA kinetics. Mortality rates were described by Kaplan-Meier curves. The predictive ability of the DCI-CRPC was compared in univariable models to that of the original DCI, derived from men in the general population, and to that of the Charlson Comorbidity Index.ResultsIn 1,885 men with CRPC the median overall survival ranged from 3.0 years (95% confidence interval [CI] 2.8 to 3.4) in the first tertile of the DCI-CRPC, to 1.0 year (95% CI 0.9 to 1.1) in the third tertile of the DCI-CRPC. The index had higher discriminative ability (C-index 0.667) than the Charlson Comorbidity Index (C-index 0.508). The discriminative ability of the DCI-CRPC was highest in the subgroup with least aggressive cancer (C-index 0.651) and lowest in men with most aggressive cancer (C-index 0.618). The performance of the DCI-CRPC was comparable to that of the original DCI.ConclusionOur newly created comorbidity index using filled prescriptions predicted death in men with CRPC better than the Charlson Comorbidity Index.

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Predictors of mortality in men and women aged 90 and older: a nine-year follow-up study in the Vitality 90+ study

information about the predictors of mortality among the oldest-old is limited. Also possible gender differences are poorly known. to examine the predictors of mortality among individuals aged 90 and older, focusing on differences between men and women. We also analysed gender differences in survival at different levels of mobility and activities in daily living (ADL). this 9-year follow-up study is part of the Vitality 90+ study, a population-based study of people aged 90 and older. all inhabitants aged 90 and older in the area of Tampere, Finland were contacted, irrespective of health or dwelling place. The study population consisted of 171 men and 717 women. data were collected with a mailed questionnaire asking questions concerning ADL and mobility, self-rated health, chronic conditions and socio-economic factors. The participation rate was 79%. Cox regression enter models were used for the analysis. older age, male gender, disability in ADL and mobility, poor self-rated health and institutionalisation increased the risk of mortality in the total study group. In age-adjusted Cox regression models, ADL and mobility were stronger predictors in men than in women (gender interactions, P < 0.001). Among those who were partly but not totally dependent in ADL or mobility women survived longer than men. the same health indicators that are important at younger old age also predict mortality in the oldest-old. Disability increases the likelihood of death more in men than women. At a very old age, women survive longer with moderate disability than do men.

Low testosterone levels as an independent predictor of mortality in men with chronic liver disease

To examine the prevalence and prognostic implications of low serum testosterone levels in men with chronic liver disease. We conducted an observational study at a tertiary referral centre. Baseline serum testosterone was measured in 171 men presenting to the Victorian Liver Transplant Unit for liver transplant evaluation. Patients were followed up to liver transplant or death. Sixty-one per cent of men had a low total testosterone level (TT, <10 nm), and 90% of men had a low calculated free testosterone level (cFT, <230 pm). During the available observation time (median 8 months, interquartile range 4-14 months), 56 men (33%) died and 63 (37%) received a liver transplant. Fifty-two (30%) survived without a transplant. Median time to death was 8 months (range 2-13) and to liver transplant was 8 months (4-14). Baseline low TT and cFT levels both (P < 0·0001) predicted mortality. Moreover, in a Cox proportional hazard model, both low total (P = 0·02) and free testosterone (P = 0·007) levels remained predictive of death independently of established prognostic factors, such as the model for end-stage liver disease (MELD) score and serum sodium levels. A decrease in TT by 1 nm and in cFT by 10 pm was associated with an 8% increase in mortality. Low testosterone levels are common in men with severe liver disease and predict mortality independent of MELD, the standard score used to prioritize the allocation of liver transplants.

Association Between Functional Measures and Mortality in Older Persons

Functional limitations may be a mortality risk among older people. The aim of this work is to determine if body composition and strength are risk factors related to mortality in older Chilean people. In a retrospective study, 306 independent elderly Chileans (age: 61–91 years) were followed for a median of 7.2 years. Baseline information was obtained, including gender, living conditions, smoking and drinking habits, educational status, history of chronic diseases, cognitive function, and depression. Body composition was assessed using dual-energy X-ray absorptiometry (DXA). Functionality was assessed by determining isometric handgrip strength and 12-minute walking capacity. The associations between all of these parameters and mortality were assessed using univariate and multivariate models. During follow-up, 23 (30.7%) male and 34 (14.7%) female participants died ( p < 0.01). Univariate analysis showed that left handgrip strength, total lean mass, and solitary living have significant associations with mortality in men, whereas 12-minute walking capacity is associated with mortality in women. According to the Weibull multivariate analysis, walking capacity was significantly associated with mortality in women, while only age and total lean mass were predictors of mortality in men. The mortality hazard ratio for women allocated to the first quartile of walking capacity was 2.72 (95% CI: 1.33–5.54), and the mortality hazard ratio for men allocated to the first quartile of total lean mass was 3.28 (95% CI: 1.43–7.54). Low muscle mass and reduced walking capacity are associated with a higher risk of mortality in older men and women, respectively.

Sex/Gender and Socioeconomic Differences in the Predictive Ability of Self-Rated Health for Mortality

BackgroundStudies have reported that the predictive ability of self-rated health (SRH) for mortality varies by sex/gender and socioeconomic group. The purpose of this study is to evaluate this relationship in Japan and explore the potential reasons for differences between the groups.Methodology/Principal FindingsThe analyses in the study were based on the Aichi Gerontological Evaluation Study's (AGES) 2003 Cohort Study in Chita Peninsula, Japan, which followed the four-year survival status of 14,668 community-dwelling people who were at least 65 years old at the start of the study. We first examined sex/gender and education-level differences in association with fair/poor SRH. We then estimated the sex/gender- and education-specific hazard ratios (HRs) of mortality associated with lower SRH using Cox models. Control variables, including health behaviors (smoking and drinking), symptoms of depression, and chronic co-morbid conditions, were added to sequential regression models. The results showed men and women reported a similar prevalence of lower SRH. However, lower SRH was a stronger predictor of mortality in men (HR = 2.44 [95% confidence interval (CI): 2.14–2.80]) than in women (HR = 1.88 [95% CI: 1.44–2.47]; p for sex/gender interaction = 0.018). The sex/gender difference in the predictive ability of SRH was progressively attenuated with the additional introduction of other co-morbid conditions. The predictive ability among individuals with high school education (HR = 2.39 [95% CI: 1.74–3.30]) was similar to that among individuals with less than a high school education (HR = 2.14 [95% CI: 1.83–2.50]; p for education interaction = 0.549).ConclusionsThe sex/gender difference in the predictive ability of SRH for mortality among this elderly Japanese population may be explained by male/female differences in what goes into an individual's assessment of their SRH, with males apparently weighting depressive symptoms more than females.

Cardiorespiratory Fitness as a Predictor of Dementia Mortality in Men and Women

Cardiorespiratory Fitness as a Predictor of Dementia Mortality in Men and Women

Comparisons of leisure-time physical activity and cardiorespiratory fitness as predictors of all-cause mortality in men and women

Comparisons of leisure-time physical activity and cardiorespiratory fitness as predictors of all-cause mortality in men and women

Usefulness of Serum Bilirubin and Cardiorespiratory Fitness as Predictors of Mortality in Men

Elevated serum bilirubin has been suggested to reduce the risk for mortality. Cardiorespiratory fitness (CRF) has also been reported to have inverse association with all-cause and cardiovascular disease (CVD) mortality. The association between serum bilirubin, all-cause and CVD mortality, and the effect of CRF on the observed association was investigated. A total of 1,279 men aged 30 to 82 years underwent baseline medical examinations from 1974 to 1997 at the Cooper Clinic in Dallas, Texas. During an average of 17 years of follow-up, 698 men died, with 253 deaths due to CVD (36%). Men in the highest bilirubin quartiles had significantly lower risk for all-cause mortality compared to men in the lowest quartiles (p for trend = 0.0043), after adjusting for age and examination year. This inverse association remained significant after further adjustment for known confounders (p for trend = 0.0018). Additional adjustment for treadmill time attenuated the association (p for trend = 0.0090). Similar patterns of association were observed between serum bilirubin quartiles and CVD mortality. CRF was inversely associated with all-cause mortality (p for trend <0.0001) after adjusting for age and examination year. This inverse association also was observed after further adjusting for known confounders (p for trend = 0.0004). After additional adjustment for serum bilirubin, the association between CRF and all-cause mortality remained significant (p for trend = 0.0012). All-cause mortality and CVD mortality were significantly lower in men in the moderate- to high-fitness quartiles in the low- and high-bilirubin groups. In conclusion, serum bilirubin level and CRF level were strongly and independently associated with all-cause and CVD mortality.

Self-rated health and mortality risk in relation to gender and education: a time-dependent covariate analysis.

This study examines the relations between self-rated health (SRH) at baseline, SRH as a time-dependent covariate (TDC), and mortality by gender and education in a community-dwelling older population in Spain. The data used are from the longitudinal study "Aging in Leganes", launched in 1993, carried out in a community-dwelling representative sample (n=1,560) of the older population of Leganes (Spain). Mortality was assessed in 2008. Proportional regression models were fitted to examine the association between mortality and baseline SRH, and SRH as a TDC among subjects aged 65-85 at baseline. The multivariate analyses were stratified by gender and education and adjusted for sociodemographic factors, smoking and physical activity, physical and mental morbidity, and ADL disability. SRH and SRH as a TDC were significant predictors of mortality in men and in people with some education, but not in women or in illiterate persons. SRH and declines in SRH were associated with increased mortality risk in older men and in those who can read and write in this Mediterranean population. Given current improvements in education and decreasing gender inequality, health professionals in Spain should pay attention to both current SRH and declines in SRH in their patients regardless of gender and literacy.

Self-rated health status and cardiorespiratory fitness as predictors of mortality in men

Self-rated health (SRH) and cardiorespiratory fitness (fitness) are independent risk factors for all-cause mortality. The purpose of this report is to examine the single and joint effects of these exposures...

Exercise: important for prevention and treatment of disease

British Journal of Hospital MedicineVol. 72, No. 4 EditorialExercise: important for prevention and treatment of diseaseMike LoosemoreMike LoosemoreSearch for more papers by this authorMike LoosemorePublished Online:16 Aug 2013https://doi.org/10.12968/hmed.2011.72.4.186AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail View article References Department of Health (2004) At least five a week: Evidence on the impact of physical activity and its relationship to health. A report from the Chief Medical Officer. Department of Health, London Google ScholarDunn A, Trivedi MH, Kampert JB, Clark CG, Chambliss HO (2005) Exercise treatment for depression: efficacy and dose response. Am J Prev Med 28(1): 1–8 Crossref, Medline, Google ScholarHu FB, Meir J, Stampfer MJ et al. (2000) Physical activity and risk of stroke in women. JAMA 283(22): 2961–7 Crossref, Medline, Google ScholarSwedish National Institute of Public Health (2010) Physical Activity in the Prevention and Treatment of Disease. Professional Associations for Physical Activity, Sweden Google ScholarWei M, Gibbons LW, Kampert JB, Nichaman MZ, Blair SN (2000) Low cardiorespiratory fitness and physical inactivity as predictors of mortality in men with type 2 diabetes. Ann Intern Med 132(8): 605–11 Crossref, Medline, Google Scholar FiguresReferencesRelatedDetailsCited byThe importance of exercise for patients with kidney diseaseAngela Lumsdon26 November 2014 | Journal of Renal Nursing, Vol. 6, No. 6EXERCISE IN KIDNEY DISEASE AND DIABETES: TIME FOR ACTION14 February 2012 | Journal of Renal Care, Vol. 38 1 April 2011Volume 72Issue 4ISSN (print): 1750-8460ISSN (online): 1759-7390 Metrics History Published online 16 August 2013 Published in print 1 April 2011 Information© MA Healthcare LimitedPDF download

Weight Loss And Fitness In Patients With Coronary Artery Disease Through Cardiac Rehabilitation – A Long Term Follow-Up.

Background and rationale: excess body weight is an established cardiovascular risk factor. Current literature on the effects of cardiac rehabilitation (CR) in weight reduction has been inconclusive and none has provided results for an ongoing long term supervised exercise program beyond 3 months. We therefore undertake to determine the relationship of CR with ongoing supervised exercise program for over two years on weight reduction and fitness. Method: This is an observational study of 47 CR patients who were followed up for ≥24 months. Patients were assessed at their entry and exit of Phase II CR and at 12 and 24 months of Phase III programs. Results: No significant weight change occurred during either phase of CR for all pre-defined weight ranges in either Phase II or Phase III while exercise capacity increased by 3.3±1.1 METs (P<0.0001) and 0.6±1.24 METs, (p=0.1) respectively. Conclusion: The study demonstrates that CR even in a long-term setting does not significantly reduce weight amongst participants. To reduce excess weight as a risk factor, further interventions such as more exercise sessions or longer, more strenuous sessions, or dietary interventions should be considered. Condensed Abstract: We conducted a retrospective observational study into the affect of long term CR on weight loss and fitness levels. No weight loss was observed after a 2 years exercise program, while fitness levels improved markedly and were maintained over the study duration. BACKGROUND AND RATIONALE Cardiac rehabilitation (CR) following a cardiac event has been shown to reduce risk of mortality by 25% over three years. While CR was originally centered around exercise and improving physical function, the current guidelines recommend that assessment and targeting of risk factors should be an integral part of CR. Obesity is an established cardiovascular risk factor (CRF), and even patients who are overweight (BMI 25-29.9) are shown to be at an increased risk of cardiovascular events. The majority of CR patients are overweight or obese, and over half of CR patients are thought to have metabolic syndrome. Therefore, weight reduction and maintenance in an ideal weight range would seem a natural and prognostically relevant objective of CR. Recent literature on the effects of CR in weight reduction has been inconclusive. While a few studies showed CR resulted in body weight reduction, others have not been able to demonstrate this. None has provided ongoing long term supervised exercise program beyond 3 months. Peak exercise capacity has been found to be the strongest predictor of mortality in men with cardiovascular disease. While CR has been shown to markedly improve exercise capacity for patients of all weight ranges, the maintenance of fitness with long term CR is yet to be established. We therefore undertake to determine the relationship of CR including an ongoing exercise program for over two years on weight reduction and fitness.

Weight loss and fitness in patients with coronary artery disease through cardiac rehabilitation—A long-term follow-up

Background and rationale: excess body weight is an established cardiovascular risk factor. Current literature on the effects of cardiac rehabilitation (CR) in weight reduction has been inconclusive and none has provided results for an ongoing long term supervised exercise program beyond 3 months. We therefore undertake to determine the relationship of CR with ongoing supervised exercise program for over two years on weight reduction and fitness. Method: This is an observational study of 47 CR patients who were followed up for ≥24 months. Patients were assessed at their entry and exit of Phase II CR and at 12 and 24 months of Phase III programs. Results: No significant weight change occurred during either phase of CR for all pre-defined weight ranges in either Phase II or Phase III while exercise capacity increased by 3.3±1.1 METs (P<0.0001) and 0.6±1.24 METs, (p=0.1) respectively. Conclusion: The study demonstrates that CR even in a long-term setting does not significantly reduce weight amongst participants. To reduce excess weight as a risk factor, further interventions such as more exercise sessions or longer, more strenuous sessions, or dietary interventions should be considered. Condensed Abstract: We conducted a retrospective observational study into the affect of long term CR on weight loss and fitness levels. No weight loss was observed after a 2 years exercise program, while fitness levels improved markedly and were maintained over the study duration. BACKGROUND AND RATIONALE Cardiac rehabilitation (CR) following a cardiac event has been shown to reduce risk of mortality by 25% over three years. While CR was originally centered around exercise and improving physical function, the current guidelines recommend that assessment and targeting of risk factors should be an integral part of CR. Obesity is an established cardiovascular risk factor (CRF), and even patients who are overweight (BMI 25-29.9) are shown to be at an increased risk of cardiovascular events. The majority of CR patients are overweight or obese, and over half of CR patients are thought to have metabolic syndrome. Therefore, weight reduction and maintenance in an ideal weight range would seem a natural and prognostically relevant objective of CR. Recent literature on the effects of CR in weight reduction has been inconclusive. While a few studies showed CR resulted in body weight reduction, others have not been able to demonstrate this. None has provided ongoing long term supervised exercise program beyond 3 months. Peak exercise capacity has been found to be the strongest predictor of mortality in men with cardiovascular disease. While CR has been shown to markedly improve exercise capacity for patients of all weight ranges, the maintenance of fitness with long term CR is yet to be established. We therefore undertake to determine the relationship of CR including an ongoing exercise program for over two years on weight reduction and fitness.

Editorial Comment on: Current Applications for Prostate-Specific Antigen Doubling Time

Prostate-specific antigen doubling time (PSADT) holds great promise for the prediction of cancer characteristics, such as stage and probability of progression before the delivery of definitive therapy [1–4]. Similarly, PSADT appears to have the ability to predict the probability of prostate cancer (PCa) diagnosis, especially after a previously negative biopsy. Moreover, PSADT was shown to predict progression towards lethal PCa phenotypes after radiation or surgery. Finally, PSADT represents one of the most powerful predictors of PCa-specific mortality in men with androgeninsensitive prostate cancer (AIPC) [5]. PSADT calculators are available at several PCa-oriented Web sites, such as the MSKCC site (www.nomograms.org) or the University of Montreal site (www.nomogram.org). The PSADT calculators allow the clinician to define the PSADT value of the individual patient at a given time. This metric showed promise as an independent predictor of cancer outcomes at different stages of the natural history of treated prostate cancer. Unfortunately, the current reports which showcase the value of PSADT might at times be difficult to interpret and even more difficult to implement. The problem relates to different PSADT cut-offs that are suggested as ‘‘ideal’’ predictors of unfavorable outcome. As a result, the clinician might not be able to derive the full benefit of the information contained within this powerful marker. Svatek et al circumvented the problem related to the interpretation of various PSADT cut-offs and integrated PSADT within a prognostic nomogram for men with AIPC [5]. Of all predictors, PSADT was the most informative, and accomplished its prognostic role for prediction of PCa-specific mortality in noncategorized format. Svatek et al demonstrated that this powerful predictor can result in most accurate predictions and can yield the best calibration, when it was combined with three other informative and significant variables [5]. Most importantly, these researchers proved that PSADT can be used to provide individualized predictions, which can be easily interpreted (prognosis expressed as a probability from 0–100% of dying from PCa at different time points) and can be equally easily accessed by patients and/or physicians (www.nomogram.org). Hopefully, more researchers will reexamine their valuable findings and will attempt to integrate PSADT within prognostic models capable of providing evidence-based, individualized prognostic information. Such measures would certainly result in much wider use of PSADT and would possibly improve patient care.