UPMC Children’s Pediatric Urology Team Publishes Study on How National Quality Metrics Influenced Surgical Rates for Testicular Torsion

A new study from the Division of Pediatric Urology at UPMC Children’s Hospital of Pittsburgh examined the rates of surgical salvage and adherence to quality metrics in cases of pediatric testicular torsion (TT) prior to and after the implementation of a scored quality metric of time to operation was introduced by U.S News & World Report as part of their annual survey of Best Children’s Hospitals.

The study was published in The Journal of Urology in March 2022, while preliminary results were shared in an abstract at the 2021 American Urological Association annual conference. Pediatric resident Brian Chun, MD, was the study’s lead author, former fellow Jeffrey Villanueva, MD, was the senior author, and the rest of the Division’s faculty members contributed to the study.

“The time to operation from presentation is the most crucial factor in outcomes in cases of pediatric testicular torsion,” says Glenn M. Cannon, MD, division chief of Pediatric Urology at UPMC Children’s. “Our study examined outcomes data from a multicenter national database between 2010 and 2019 and compared surgical metrics before and after the new quality measures were made a standard part of the U.S. News survey process for pediatric urology.”

Data was examined from 52 reporting hospitals comprising a total of 890 cases of TT salvage surgery in patients between the ages of 1 and 18.

The pre-quality metric cohort consisted of 551 cases and the post-metric cohort totaled 339.

The team found a 12.5% increase in the rate of salvage surgery after the new quality metric was implemented, while compliance among hospitals with TT quality parameters increased from 62% to 98%.

“There are two important takeaways from our analysis. The first, of course is that improvements in time to surgery for TT can benefit a significant proportion of patients who otherwise may face an orchiectomy, and that holds up across patient demographics and characteristics,” says Dr. Cannon. “Secondarily, quality improvement and changes in care for patients can be spurred by third-party influence with positive results. Each of these points, and the outcomes from this study, will require further validation, though, through additional prospective research.”

Learn more about the Division of Pediatric Urology at UPMC Children’s Hospital of Pittsburgh. 

Reference

Chun B, Colaco M, Fox JA, Cannon GM, Schneck FX, Chaudhry R, Villanueva J. Salvage Surgery Rates for Pediatric Testicular Torsion: Comparison of the Pre- and Post-Quality Metric Eras. J Urol. 2022 Mar 28. Online ahead of print.