Straight to the Operating Room: An Emergent Surgery Track for Acute Testicular Torsion Transfers.
Straight to the Operating Room: An Emergent Surgery Track for Acute Testicular Torsion Transfers.
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DOI：
10.1016/j.jpeds.2017.09.009
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发表时间：
2018-01
期刊：
影响因子：
--
通讯作者：
Baker LA
中科院分区：
文献类型：
--
作者：
Arevalo MK;Sheth KR;Menon VS;Ostrov L;Hennes H;Singla N;Koral K;Schlomer BJ;Baker LA
To assess the effect of implementing an emergency surgery track for testicular torsion transfers. We hypothesized that transferring children from other facilities diagnosed with torsion straight to the operating room (STOR) would decrease ischemia time, lower costs, and reduce testicular loss. Demographics, arrival to incision time, hospital cost in dollars, and testicular outcome (determined by testicular ultrasound) at follow up were retrospectively compared in all patients transferred to our tertiary care children’s hospital with a diagnosis of testicular torsion from 2012 – 2016. Clinical data for STOR and non-STOR patients were compared by Wilcoxon rank sum, 2-tailed t-test, or Fisher exact test as appropriate. 68 patients met inclusion criteria: 35 STOR and 33 non-STOR. Children taken STOR had a shorter median arrival to incision time (STOR: 54 min vs non-STOR: 94 min, P < .0001) and lower median total hospital costs (STOR: $3,882 vs non-STOR: $4,419, p<0.0001). However, only 46.8% of STOR patients and 48.4% of non-STOR patients achieved surgery within 6 hours of symptom onset. Testicular salvage rates in STOR and non-STOR patients were not significantly different (STOR: 68.4% vs non-STOR: 36.8%, p = 0.1), but follow up was poor. STOR decreased arrival to incision time and hospital cost, but did not affect testicular loss. The bulk of ischemia time in torsion transfers occurred prior to arrival at our tertiary care center. Further interventions addressing delays in diagnosis and transfer are needed to truly improve testicular salvage rates in these patients.
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影响因子：
2
作者：
Yiee, Jenny H.;Chang, Lynne;Kaplan, Alan;Kwan, Lorna;Chung, Paul J.;Litwin, Mark S.
通讯作者：
Litwin, Mark S.
DOI：
10.5811/westjem.2014.11.22495
发表时间：
2015-01
期刊：
The western journal of emergency medicine
影响因子：
--
作者：
Ramachandra P;Palazzi KL;Holmes NM;Marietti S
通讯作者：
Marietti S
影响因子：
2.2
作者：
Lodwick, Daniel L.;Cooper, Jennifer N.;McLeod, Daryl
通讯作者：
McLeod, Daryl
影响因子：
6.6
作者：
Bayne, Aaron P.;Madden-Fuentes, Ramiro J.;Hsieh, Michael H.
通讯作者：
Hsieh, Michael H.
影响因子：
2.4
作者：
LEWIS, AG;BUKOWSKI, TP;SHELDON, CA
通讯作者：
SHELDON, CA