Mp02-15 Is the Us News and World Report's Speed in Treating Testicular Torsion Metric Relevant to the Care of Early Neonates?

You have accessJournal of UrologyHealth Services Research: Quality Improvement & Patient Safety I (MP02)1 May 2024MP02-15 IS THE US NEWS AND WORLD REPORT'S SPEED IN TREATING TESTICULAR TORSION METRIC RELEVANT TO THE CARE OF EARLY NEONATES? Ahmed Souid, Michael Basin, Brian Chun, Glenn Cannon, Matthew Mason, Anthony Tracey, and Jeffrey Villanueva Ahmed SouidAhmed Souid , Michael BasinMichael Basin , Brian ChunBrian Chun , Glenn CannonGlenn Cannon , Matthew MasonMatthew Mason , Anthony TraceyAnthony Tracey , and Jeffrey VillanuevaJeffrey Villanueva View All Author Informationhttps://doi.org/10.1097/01.JU.0001008600.97797.3b.15AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: In 2015, the US News and World Report (USNWR) instituted a time-to-OR metric for testicular torsion in an effort to rank children's hospitals in pediatric urology. Previous work has suggested that as hospitals became compliant with this metric, rates of testicular salvage surgeries increased for males one to eighteen years of age. We hypothesized that this trend would not be observed in infants since neonatal testicular torsion is unique both in its presentation and management. METHODS: The Pediatric Health Information System was queried to identify surgical cases of neonatal testicular torsion based on CPT, ICD-9, and ICD-10 codes across 52 hospitals between January 2010 and December 2019. Data from hospitals with non-continuous reporting were excluded. To avoid contamination with semi-urgent explorations, cases were included if the patient had surgery on the first day of life with either orchiectomy or orchiopexy. Any case with orchiectomy was considered a failed testicular salvage surgery. Salvage surgery rates before and after the publication of the USNWR metric on June 15, 2015 were compared for statistical significance with Chi-squared analysis. Subgroup analysis of hospitals receiving a partial or complete score for the torsion metric was also analyzed. RESULTS: A total of 96 cases of early neonatal torsion were identified. The overall salvage rate was 12.5% (12 cases). Forty-nine cases and four salvages were from the pre-metric era (8.2%). Forty-seven cases and eight salvages were post-metric (17.0%). The difference was not statistically significant (p=0.32). Limiting the analysis to the 33 cases from partial scoring hospitals also failed to reach statistical significance (6.3% vs 5.9%, p=0.96), as did the analysis on complete scoring hospitals (4.5% vs 26.1%, p=0.11). Race, distance from hospital, household income, and payor type were not different between pre- and post- metric cohorts. CONCLUSIONS: While the USNWR's torsion metric may have improved rates of testicular salvage surgery for older males, there is less clear evidence for early neonates. Neonatal torsion is a rare entity with unique perioperative, surgical, and anesthetic risks. This population should be handled separately by metrics designed to measure the quality of testicular torsion care. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e18 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Ahmed Souid More articles by this author Michael Basin More articles by this author Brian Chun More articles by this author Glenn Cannon More articles by this author Matthew Mason More articles by this author Anthony Tracey More articles by this author Jeffrey Villanueva More articles by this author Expand All Advertisement PDF downloadLoading ...