Inequities and Progress in Testicular Torsion Care Following a US News & World Report Metric: A Retrospective Cohort Study

IF 2.4 2区医学 Q1 PEDIATRICS

Journal of pediatric surgery Pub Date : 2025-03-05 DOI:10.1016/j.jpedsurg.2025.162273

Ahmed Souid , Maithili Gopalakrishnan , Michael Basin , Glenn Cannon , Anthony Tracey , Matthew Mason , Andrew Osten , Jeffrey Villanueva

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引用次数: 0

Abstract

Background and objectives

Pediatric testicular torsion is a surgical emergency with known health disparities. The US News and World Report is an American media company that ranks colleges and hospitals based on annually published criteria. Hospitals that complied with the US News and World Report’s (USNWR) Speed in Treating Testicular Torsion (SiTTT) metric saw improved surgical testicular salvage rates, but the metric’s impact in mitigating inequities in testicular torsion is unstudied.

Methods

A retrospective cohort study of patients 1–18 years of age presenting with testicular torsion was performed using the Pediatric Health Information System database. Hospitals were classified based on their SiTTT score at the metric’s onset in 2015: they were labeled complete-scoring if they achieved the maximum score and partial-scoring otherwise. Surgical testicular salvage was defined as orchiopexy without concomitant orchiectomy. Testicular salvage rates were compared based on various socioeconomic variables including race between the pre-metric (2010–2015) and post-metric (2015–2019) periods with both univariate and adjusted, multivariate analyses.

Results

We identified 3950 cases of testicular torsion: 2335 in complete-scoring hospitals and 1615 in partial-scoring hospitals. Only partial-scoring hospitals improved significantly in salvage rate (pre-metric 61.0 % vs post-metric 67.5 %, p < 0.01). Subgroup analysis revealed the largest benefit in patients with economic or communicative barriers such as those with complex chronic conditions (pre-metric 35.3 % vs post-metric 61.1 %, p < 0.05). No minority races had statistically significant improvement after the metric, and salvage rate gap between White and all other races increased (pre-metric 4.3 % vs post-metric 10.0 %, p < 0.05).

Conclusions

Patients with communicative or economic barriers showed improved equity after efforts to comply with a third-party metric, but disparities persisted for minority races. Future studies may better classify the mediators of this association.

Type of study

Retrospective Cohort Study.

Level of Evidence

Level IV: Evidence from well-designed case–control or cohort studies.

查看原文本刊更多论文

根据美国新闻与世界报道标准，睾丸扭转治疗的不公平与进展：一项回顾性队列研究

背景与目的小儿睾丸扭转是一种已知存在健康差异的外科急症。《美国新闻与世界报道》是一家美国媒体公司，根据每年公布的标准对大学和医院进行排名。遵守《美国新闻与世界报道》（USNWR）睾丸扭转治疗速度（SiTTT）标准的医院看到了手术睾丸挽救率的提高，但该标准在缓解睾丸扭转不公平方面的影响尚未研究。方法采用儿科健康信息系统数据库对1-18岁睾丸扭转患者进行回顾性队列研究。2015年该指标开始时，医院根据其SiTTT得分进行分类：如果达到最高分，则标记为完全得分，否则标记为部分得分。手术保留睾丸被定义为不伴有睾丸切除术的睾丸切除术。基于各种社会经济变量，包括种族，对计量前（2010-2015年）和计量后（2015-2019年）期间的睾丸保留率进行单变量和调整的多变量分析。结果3950例睾丸扭转：2335例在完全评分医院，1615例在部分评分医院。只有部分评分医院的抢救率显著提高(评分前为61.0%，评分后为67.5%,p <；0.01)。亚组分析显示，有经济或沟通障碍的患者（如患有复杂慢性疾病的患者）获益最大(测量前35.3% vs测量后61.1%,p <；0.05)。没有少数种族在测量后有统计学上的显著改善，白人和所有其他种族之间的挽回率差距增加(测量前4.3% vs测量后10.0%,p <；0.05)。结论：有沟通障碍或经济障碍的患者在努力遵守第三方指标后表现出了更好的公平，但少数族裔的差异仍然存在。未来的研究可能会更好地分类这种关联的中介。研究类型：回顾性队列研究。证据水平IV级：来自设计良好的病例对照或队列研究的证据。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of pediatric surgery 医学-外科

CiteScore

1.10

自引率

12.50%

发文量

569

审稿时长

38 days

期刊介绍： The journal presents original contributions as well as a complete international abstracts section and other special departments to provide the most current source of information and references in pediatric surgery. The journal is based on the need to improve the surgical care of infants and children, not only through advances in physiology, pathology and surgical techniques, but also by attention to the unique emotional and physical needs of the young patient.