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New Study Shows National Outcomes Improvements in Cases of Pediatric Testicular Torsion

May 16, 2021

Researchers from the UPMC Children’s Hospital of Pittsburgh Division of Pediatric Urology will present their findings of a new study that examined trends in salvage rates for cases of pediatric testicular torsion at the upcoming 2021 American Urologic Association annual conference. 

The study, led by Division fellow Marc Colaco, MD, MBA, looked at the testicular salvage rates and time to surgery in cases of testicular torsion prior to and after a scored quality metric of time to surgery was introduced by U.S. News & World Report in their annual survey of Best Children’s Hospitals beginning in 2015. Division Chief Glenn M Cannon, MD, in his work on the urology committee with U.S. News & World Report, was an advocating voice for the inclusion of this metric to the survey because of how critical time to operation is in cases of testicular torsion.

"Testicular torsion is one of the few emergent conditions in pediatric urology. Testicular salvage rate is correlated with how quickly the condition is recognized and the patient has surgery. Time is of the essence in these cases, but you need to have protocols in place to recognize them and react accordingly," says Dr. Colaco. "We were very interested in understanding how the outside influence of the U.S. News & World Report metric influenced hospital policy and management of these cases, and ultimately patient outcomes."

The research team analyzed national data from the Pediatric Health Information System database for cases of testicular torsion before July 2015, and after that point when the new quality metric was put into use by U.S. News & World Report.

Rates of testicular salvage showed an increase from 58.4% prior to the introduction of the metric to 70.9% in the years after its implementation.

“We saw a significant increase in salvage rates after studying the data. We examined other patient, demographic, and hospital factors, but they were consistent in cases before and after the introduction of the quality metric. This bodes well for patients in terms of outcomes, but we feel it also shows the ability of these types of outside influences to drive changes in care management, which is a significant finding," says Dr. Colaco. 

Other contributors to the study from the Division of Pediatric Urology included Division Chief Glenn M. Cannon, MD; Janelle Fox, MD, FACS; Francis X. Schneck, MD; and former Division fellow Jeffrey Villanueva, MD. Department of Urology resident Brian Chun, MD, also contributed to the study.