Cargando…

Factors Influencing Rate of Testicular Salvage in Acute Testicular Torsion at a Tertiary Pediatric Center

INTRODUCTION: Studies have demonstrated that variables other than duration of symptoms can affect outcomes in children with acute testicular torsion. We examined demographic and logistical factors, including inter-hospital transfer, which may affect outcomes at a tertiary pediatric referral center....

Descripción completa

Detalles Bibliográficos
Autores principales: Ramachandra, Puneeta, Palazzi, Kerrin L., Holmes, Nicholas M., Marietti, Sarah
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Department of Emergency Medicine, University of California, Irvine School of Medicine 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4307716/
https://www.ncbi.nlm.nih.gov/pubmed/25671040
http://dx.doi.org/10.5811/westjem.2014.11.22495
_version_ 1782354484879425536
author Ramachandra, Puneeta
Palazzi, Kerrin L.
Holmes, Nicholas M.
Marietti, Sarah
author_facet Ramachandra, Puneeta
Palazzi, Kerrin L.
Holmes, Nicholas M.
Marietti, Sarah
author_sort Ramachandra, Puneeta
collection PubMed
description INTRODUCTION: Studies have demonstrated that variables other than duration of symptoms can affect outcomes in children with acute testicular torsion. We examined demographic and logistical factors, including inter-hospital transfer, which may affect outcomes at a tertiary pediatric referral center. METHODS: We reviewed charts of all pediatric patients with acute testicular torsion during a five-year period. Data were collected regarding age, insurance type, socioeconomic status, duration of symptoms prior to presentation, transfer status, time of day, time to surgical exploration, and testicular salvage. RESULTS: Our study included 114 patients. Testicular salvage was possible in 55.3% of patients. Thirty-one percent of patients included in the study were transferred from another facility. Inter-hospital transfer did not affect testicular salvage rate. Time to surgery and duration of pain were higher among patients who underwent orchiectomy versus orchidopexy. Patients older than eight years of age were more likely to undergo orchidopexy than those younger than eight (61.5% vs. 30.4%, p=0.01). Ethnicity, insurance type, or time of day did not affect the testicular salvage rates. On multivariate analysis, only duration of symptoms less than six hours predicted testicular salvage (OR 22.5, p<0.001). CONCLUSION: Even though inter-hospital transfer delays definitive surgical management, it may not affect testicular salvage rates. Time to presentation is the most important factor in predicting outcomes in children with acute testicular torsion.
format Online
Article
Text
id pubmed-4307716
institution National Center for Biotechnology Information
language English
publishDate 2015
publisher Department of Emergency Medicine, University of California, Irvine School of Medicine
record_format MEDLINE/PubMed
spelling pubmed-43077162015-02-10 Factors Influencing Rate of Testicular Salvage in Acute Testicular Torsion at a Tertiary Pediatric Center Ramachandra, Puneeta Palazzi, Kerrin L. Holmes, Nicholas M. Marietti, Sarah West J Emerg Med Technology in Emergency Medicine INTRODUCTION: Studies have demonstrated that variables other than duration of symptoms can affect outcomes in children with acute testicular torsion. We examined demographic and logistical factors, including inter-hospital transfer, which may affect outcomes at a tertiary pediatric referral center. METHODS: We reviewed charts of all pediatric patients with acute testicular torsion during a five-year period. Data were collected regarding age, insurance type, socioeconomic status, duration of symptoms prior to presentation, transfer status, time of day, time to surgical exploration, and testicular salvage. RESULTS: Our study included 114 patients. Testicular salvage was possible in 55.3% of patients. Thirty-one percent of patients included in the study were transferred from another facility. Inter-hospital transfer did not affect testicular salvage rate. Time to surgery and duration of pain were higher among patients who underwent orchiectomy versus orchidopexy. Patients older than eight years of age were more likely to undergo orchidopexy than those younger than eight (61.5% vs. 30.4%, p=0.01). Ethnicity, insurance type, or time of day did not affect the testicular salvage rates. On multivariate analysis, only duration of symptoms less than six hours predicted testicular salvage (OR 22.5, p<0.001). CONCLUSION: Even though inter-hospital transfer delays definitive surgical management, it may not affect testicular salvage rates. Time to presentation is the most important factor in predicting outcomes in children with acute testicular torsion. Department of Emergency Medicine, University of California, Irvine School of Medicine 2015-01 2015-01-07 /pmc/articles/PMC4307716/ /pubmed/25671040 http://dx.doi.org/10.5811/westjem.2014.11.22495 Text en Copyright © 2015 the authors. http://creativecommons.org/licenses/by/4.0 This is an open access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) License. See: http://creativecommons.org/licenses/by/4.0/.
spellingShingle Technology in Emergency Medicine
Ramachandra, Puneeta
Palazzi, Kerrin L.
Holmes, Nicholas M.
Marietti, Sarah
Factors Influencing Rate of Testicular Salvage in Acute Testicular Torsion at a Tertiary Pediatric Center
title Factors Influencing Rate of Testicular Salvage in Acute Testicular Torsion at a Tertiary Pediatric Center
title_full Factors Influencing Rate of Testicular Salvage in Acute Testicular Torsion at a Tertiary Pediatric Center
title_fullStr Factors Influencing Rate of Testicular Salvage in Acute Testicular Torsion at a Tertiary Pediatric Center
title_full_unstemmed Factors Influencing Rate of Testicular Salvage in Acute Testicular Torsion at a Tertiary Pediatric Center
title_short Factors Influencing Rate of Testicular Salvage in Acute Testicular Torsion at a Tertiary Pediatric Center
title_sort factors influencing rate of testicular salvage in acute testicular torsion at a tertiary pediatric center
topic Technology in Emergency Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4307716/
https://www.ncbi.nlm.nih.gov/pubmed/25671040
http://dx.doi.org/10.5811/westjem.2014.11.22495
work_keys_str_mv AT ramachandrapuneeta factorsinfluencingrateoftesticularsalvageinacutetesticulartorsionatatertiarypediatriccenter
AT palazzikerrinl factorsinfluencingrateoftesticularsalvageinacutetesticulartorsionatatertiarypediatriccenter
AT holmesnicholasm factorsinfluencingrateoftesticularsalvageinacutetesticulartorsionatatertiarypediatriccenter
AT mariettisarah factorsinfluencingrateoftesticularsalvageinacutetesticulartorsionatatertiarypediatriccenter