Optimal Predictor of Gonadal Viability in Testicular Torsion: Time to Treat Versus Duration of Symptoms
| Autor: | Syamal D. Bhattacharya, Olivia A. Morin, Michael G. Carr, Jenny M. Holcombe |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Male
endocrine system medicine.medical_specialty Delayed Diagnosis Adolescent Clinical Decision-Making Urology Time-to-Treatment 03 medical and health sciences 0302 clinical medicine Clinical Decision Rules Pediatric surgery medicine Suspected diagnosis Testicular torsion Humans In patient Child Retrospective Studies Spermatic Cord Torsion Tissue Survival business.industry Medical record Significant difference Infant Emergency department medicine.disease Prognosis Pediatric urology 030220 oncology & carcinogenesis Child Preschool 030211 gastroenterology & hepatology Surgery business Orchiectomy |
| Zdroj: | The Journal of surgical research. 244 |
| ISSN: | 1095-8673 |
| Popis: | We hypothesize that in testicular torsion, the duration of symptoms (DoS) better correlates with predicting testicular viability than minimizing the "time-to-treat" (TtT) after presentation to a medical facility.Medical records of male pediatric patients treated for suspected diagnosis of testicular torsion in the emergency department (ED) from January 1, 2016, to December 31, 2018, were retrospectively evaluated. Forty-one patients met inclusion criteria. Statistical analysis compared testicular viability based on TtT, DoS, and site of initial presentation.Testicular salvage rates for patients presenting directly to our ED was 56.3% with an average TtT of 2.5 h versus 77.8% and 1.96 h, respectively, for transferred patients. Overall testicular survival was not statistically impacted by the difference in TtT. Comparing DoS, an 84% testicular salvage rate (DoS24 h) versus a 15.4% salvage rate (DoS24 h) was shown in patients presenting directly to our ED (P ≤ 0.0001). Within the total population (n = 41), a significant difference was also shown (P ≤ 0.0001) when comparing overall testicular salvage rates in patients presenting with24 h versus24 h total DoS (84% versus 25%).These data reveal that an alternative predictor of testicular salvage rates is a DoS24 h. This is a meaningful metric when providing accurate preoperating counseling to parents and may be a better focus of quality improvement efforts surrounding this topic. |
| Databáze: | OpenAIRE |
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