AI Article Synopsis
- - In 2015, the U.S. News and World Report introduced a quality metric aimed at reducing surgery wait times for children with testicular torsion (TT), but not for those with ovarian torsion (OT), leading to a study comparing surgery timings for both conditions.
- - The study analyzed data from a cohort of children aged 1-18 who underwent surgery for suspected gonadal torsion, revealing a significant decrease in median time to operating room (TTOR) for TT after the quality metric implementation, while OT did not see a notable change.
- - The results suggest that the quality metric effectively expedited surgical care for TT, indicating a need for similar metrics for OT to ensure equitable treatment for all children presenting with
Article Abstract
Introduction: In 2015, the U.S. News and World Report (USNWR) implemented a quality metric to expedite surgery for testicular torsion (TT), but not ovarian torsion (OT). This study examined OR timing among children with suspected TT and OT before and after this metric.
Methods: A single-center retrospective cohort study of children (1-18yr) who underwent surgery for suspected gonadal torsion was performed. Time to OR (TTOR) from hospital presentation to surgery start was calculated. An interrupted time series analysis identified changes in TTOR for suspected TT versus OT after the 2015 USNWR quality metric.
Results: Overall, 216 patients presented with TT and 120 with OT. Median TTOR for TT was 147 min (IQR:99-198) versus 462 min (IQR:308-606) for OT. Post-quality metric, children with TT experienced a 27.8 min decrease (95% CI:-51.7,-3.9, p = 0.05) in annual median TTOR. No significant decrease was observed for children with OT (p = 0.22). Children with history of a known ovarian mass (N = 62) experienced a shorter TTOR compared to those without (422 vs 499min; p = 0.04).
Conclusion: Implementation of a national quality metric for TT expedited surgical care for children with TT, but not children with OT. These findings highlight the need for equitable quality metrics for children presenting with suspected gonadal torsion.
Level Of Evidence: III.
Type Of Study: Retrospective Comparative Study, Observational Cohort Study.
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Source |
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| http://dx.doi.org/10.1016/j.jpedsurg.2024.03.016 | DOI Listing |
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