Testicular torsion: epidemiological risk factors for orchiectomy in pediatric and adult patients
Testicular torsion: epidemiological risk factors for orchiectomy in pediatric and adult patients
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DOI：
10.1038/s41443-020-0331-8
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发表时间：
2020-07-18
影响因子：
2.6
通讯作者：
Rague, James T.
中科院分区：
文献类型：
--
作者：
Greear, Garrick M.;Romano, Michael F.;Rague, James T.
睾丸扭转是儿科患者发病率的已知原因，但对成人人群的负担知之甚少。我们试图确定包括所有年龄段的人群中睾丸扭转的发生率和睾丸切除术的危险因素。采用2011年和2012年全国急诊科医疗成本和利用项目样本，对1625名接受扭转手术的男性进行队列分析。检查患者和医院因素与睾丸切除术和保留睾丸的关系。估计睾丸扭转的年发病率为每10万名1-17岁男性5.9例，每10万名18岁男性1.3例。在接受手术干预的患者中，行睾丸切除术的占33.6%。1-11岁和50岁以上患者的睾丸切除术风险最高（分别为46.0%和69.7%）。睾丸切除术也与公共保险（医疗补助/医疗保险）或自费作为主要付款人有关。虽然睾丸扭转在成年人中不太常见，但睾丸切除术的发生率很高。那些处于不利支付者地位的人睾丸丢失的风险也会增加。
Testicular torsion is a known cause of morbidity in pediatric patients, but the burden in the adult population is poorly understood. We sought to determine the incidence of testicular torsion and risk factors for orchiectomy in a population encompassing all ages. A cohort analysis of 1625 males undergoing surgery for torsion was performed using the 2011 and 2012 Healthcare Cost and Utilization Project Nationwide Emergency Departments Sample. Patient and hospital factors were examined for association with orchiectomy vs. testicular salvage. The estimated yearly incidence of testicular torsion was 5.9 per 100,000 males ages 1-17 years and 1.3 per 100,000 males >= 18 years. Among those undergoing surgical intervention, orchiectomy was performed in 33.6%. The risk of orchiectomy was highest in patients 1-11 years of age and patients over 50 years of age (46.0% and 69.7% of patients, respectively). Orchiectomy was also associated with public insurance (Medicaid/Medicare) or self-pay as primary payer. While testicular torsion is less common in the adult population, the rate of orchiectomy is high. Those with disadvantaged payer status are also at increased risk for testicular loss.