title: Factors influencing rate of testicular salvage in acute testicular torsion at a tertiary pediatric center.
abstract: BACKGROUND
  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).
  
  
  CONCLUSIONS
  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.
authors: Valley Children's Hospital, Madera, California.
authors: Puneeta
authors: P
authors: Ramachandra
authors: University of California, San Diego, Moores Cancer Center, Division of Urology, La Jolla, California.
authors: Kerrin L
authors: KL
authors: Palazzi
authors: Rady Children's Hospital San Diego, Division of Pediatric Urology, San Diego, California.
authors: Nicholas M
authors: NM
authors: Holmes
authors: Rady Children's Hospital San Diego, Division of Pediatric Urology, San Diego, California.
authors: Sarah
authors: S
authors: Marietti
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D002140:California; D002648:Child; D004636:Emergency Service, Hospital; D006801:Humans; D008297:Male; D009919:Orchiectomy / Q000706:statistics & numerical data*; D056126:Orchiopexy / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012307:Risk Factors; D013086:Spermatic Cord Torsion / Q000175:diagnosis / Q000601:surgery*; D013997:Time Factors