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{
    "pk": 8235,
    "title": "Factors Influencing Rate of Testicular Salvage in Acute Testicular Torsion at a Tertiary Pediatric Center",
    "subtitle": null,
    "abstract": "Introduction: \nStudies 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.\nMethods: \nWe 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.\nResults: \nOur 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).\nConclusion: \nEven 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. [West J Emerg Med. 2015;16(1):–0.]",
    "language": "en",
    "license": {
        "name": "Creative Commons Attribution 4.0",
        "short_name": "CC BY 4.0",
        "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.",
        "url": "https://creativecommons.org/licenses/by/4.0"
    },
    "keywords": [
        {
            "word": ": testicular torsion, inter-hospital transfer, orchiectomy, acute scrotum, scrotal exploration, pediatric"
        }
    ],
    "section": "Technology in Emergency Medicine",
    "is_remote": true,
    "remote_url": "https://escholarship.org/uc/item/0sx5810x",
    "frozenauthors": [
        {
            "first_name": "Puneeta",
            "middle_name": "",
            "last_name": "Ramachandra",
            "name_suffix": "",
            "institution": "Valley Children’s Hospital, Madera, California",
            "department": "None"
        },
        {
            "first_name": "Kerrin",
            "middle_name": "L.",
            "last_name": "Palazzi",
            "name_suffix": "",
            "institution": "University of California, San Diego, Moores Cancer Center, Division of Urology, La Jolla, California",
            "department": "None"
        },
        {
            "first_name": "Nicholas",
            "middle_name": "M.",
            "last_name": "Holmes",
            "name_suffix": "",
            "institution": "Rady Children’s Hospital San Diego, Division of Pediatric Urology, San Diego, California",
            "department": "None"
        },
        {
            "first_name": "Sarah",
            "middle_name": "",
            "last_name": "Marietti",
            "name_suffix": "",
            "institution": "Rady Children’s Hospital San Diego, Division of Pediatric Urology, San Diego, California",
            "department": "None"
        }
    ],
    "date_submitted": "2014-04-30T01:02:16Z",
    "date_accepted": "2014-04-30T01:02:16Z",
    "date_published": "2015-01-07T19:59:28Z",
    "render_galley": null,
    "galleys": [
        {
            "label": "",
            "type": "pdf",
            "path": "https://journalpub.escholarship.org/westjem/article/8235/galley/4722/download/"
        }
    ]
}