Pediatric Testicular Torsion Epidemiology Using a National Database: Incidence, Risk of Orchiectomy and Possible Measures Toward Improving the Quality of Care

被引:221
作者
Zhao, Lee C. [1 ]
Lautz, Timothy B. [2 ]
Meeks, Joshua J. [1 ]
Maizels, Max [1 ]
机构
[1] Northwestern Univ, Dept Urol, Chicago, IL 60611 USA
[2] Northwestern Univ, Dept Gen Surg, Chicago, IL 60611 USA
关键词
spermatic cord torsion; epidemiology; socioeconomic factors; DELAY;
D O I
10.1016/j.juro.2011.07.024
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Purpose: Testicular torsion causes considerable morbidity in the pediatric population but the societal burden is poorly quantified. We determined the modern incidence of testicular torsion as well as the current rates of orchiectomy and attempted testicular salvage, and identified the risk factors for testicular loss. Materials and Methods: A cohort analysis was performed of 2,443 boys (age 1 month to less than 18 years) and 152 newborns who underwent surgery for testicular torsion in the 2000, 2003 and 2006 Healthcare Cost and Utilization Project Kids' Inpatient Database. Patient and hospital characteristics predictive of orchiectomy vs attempted testicular salvage were analyzed. Results: There was a bimodal distribution of testicular torsion with peaks in the first year of life and in early adolescence. The overall mean age +/- SD at presentation was 10.6 +/- 5.8 years. The estimated yearly incidence of testicular torsion for males younger than 18 years old was 3.8 per 100,000. Orchiectomy was performed in 41.9% of boys undergoing surgery for torsion. The adjusted odds ratio for orchiectomy was highest for children in the youngest age quartile (younger than 10 years old, OR 1.58, 95% CI 1.25-2.00). Additional independent predictors of orchiectomy included Medicaid insurance (OR 1.39, 95% CI 1.14-1.69), black race (OR 1.33, 95% CI 1.04-1.71), nonemergency room admission source (OR 1.97, 95% CI 1.60-2.42) and surgery at a children's hospital or unit (OR 1.64, 95% CI 1.36-1.98). Conclusions: Testicular torsion is uncommon but the rate of orchiectomy is high, especially in the youngest patients.
引用
收藏
页码:2009 / 2013
页数:5
相关论文
共 14 条
[1]   Late hormonal levels, semen parameters, and presence of antisperm antibodies in patients treated for testicular torsion [J].
Arap, Marco A. ;
Vicentini, Fabio C. ;
Cocuzza, Marcello ;
Hallak, Jorge ;
Athayde, Kelly ;
Lucon, Antonio M. ;
Arap, Sami ;
Srougi, Miguel .
JOURNAL OF ANDROLOGY, 2007, 28 (04) :528-532
[2]   TESTICULAR SALVAGE AND AGE-RELATED DELAY IN THE PRESENTATION OF TESTICULAR TORSION [J].
BARADA, JH ;
WEINGARTEN, JL ;
CROMIE, WJ .
JOURNAL OF UROLOGY, 1989, 142 (03) :746-748
[3]   TESTICULAR TORSION - LATE RESULTS WITH SPECIAL REGARD TO FERTILITY AND ENDOCRINE FUNCTION [J].
BARTSCH, G ;
FRANK, S ;
MARBERGER, H ;
MIKUZ, G .
JOURNAL OF UROLOGY, 1980, 124 (03) :375-378
[4]   Incidence and Trends of Pediatric Ovarian Torsion Hospitalizations in the United States, 2000-2006 [J].
Guthrie, Bridgette D. ;
Adler, Mark D. ;
Powell, Elizabeth C. .
PEDIATRICS, 2010, 125 (03) :532-538
[5]  
HCUP Kids Inpatient Database (KID), 2006, HCUP KIDS INP DAT KI
[6]  
Mäkelä E, 2007, SCAND J SURG, V96, P62
[7]   Testicular torsion and risk factors for orchiectomy [J].
Mansbach, JM ;
Forbes, P ;
Peters, C .
ARCHIVES OF PEDIATRICS & ADOLESCENT MEDICINE, 2005, 159 (12) :1167-1171
[8]   Hospital- and patient-level characteristics and the risk of appendiceal rupture and negative appendectomy in children [J].
Ponsky, TA ;
Huang, ZHJ ;
Kittle, K ;
Eichelberger, MR ;
Gilbert, JC ;
Brody, F ;
Newman, KD .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2004, 292 (16) :1977-1982
[9]  
Rampaul MS, 1998, ANN ROY COLL SURG, V80, P169
[10]   Late hormonal function after testicular torsion [J].
Romeo, Carmelo ;
Impellizzeri, Pietro ;
Arrigo, Teresa ;
Antonuccio, Pietro ;
Valenzise, Mariella ;
Mirabelli, Silvio ;
Borruto, Francesca Astra ;
Scalfari, Gianfranco ;
Arena, Francesco ;
De Luca, Filippo .
JOURNAL OF PEDIATRIC SURGERY, 2010, 45 (02) :411-413