Pd62-02 Code Torsion: A Multidisciplinary Approach for Streamlining Testicular Torsion Patient Care

You have accessJournal of UrologyHealth Services Research: Quality Improvement & Patient Safety III (PD62)1 May 2024PD62-02 CODE TORSION: A MULTIDISCIPLINARY APPROACH FOR STREAMLINING TESTICULAR TORSION PATIENT CARE Omar Almidani, Ammar Al Homsi, Rashed Rowaiee, Ayman Moussa, Alaeddin Barham, and Waleed Hassen Omar AlmidaniOmar Almidani , Ammar Al HomsiAmmar Al Homsi , Rashed RowaieeRashed Rowaiee , Ayman MoussaAyman Moussa , Alaeddin BarhamAlaeddin Barham , and Waleed HassenWaleed Hassen View All Author Informationhttps://doi.org/10.1097/01.JU.0001008656.89655.67.02AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Testicular torsion (TT) is a surgical emergency that necessitates prompt detection and management to prevent testicular loss. As with any ischemic organ, prompt detection and intervention are vital for testicular salvage. The standard accepted practice is to attempt to address TT within 4-6 hours. This study aimed to assess if a formal "code torsion" pathway modeled after other ischemic events (CVA and STEMI) would improve testicular salvage rates. METHODS: A clinical pathway was developed in January 2022 to assess all males with acute scrotal pain presenting to the emergency department at a tertiary care institution. Risk stratification was based on the TWIST score as well as the availability of Doppler ultrasonography depending on the time of presentation. A "code torsion" then triggered a chain of events culminating in the expedited transfer of high-risk patients to the OR with a goal of a door-to-OR time of 60 minutes or less. A retrospective analysis was then performed to compare testicular salvage rates pre and post-implementation. RESULTS: The study included 57 patients with 28 in the pre-implementation group and 29 in the post-implementation group with a mean age of 21.6 years. After implementing Code Torsion, the post-implementation group demonstrated significantly reduced time-to-event metrics compared to the pre-implementation group, including time to examination (13.2 versus 19.1 minutes), imaging (28.8 versus 64.1 minutes), and surgery (69.0 versus 206.4 minutes). Testicular salvage rates significantly improved in the post-implementation group with an orchiectomy rate of 14.3% compared to 51.9% in the pre-implementation group. CONCLUSIONS: The implementation of a standardized clinical pathway for acute scrotal pain along with the creation of a hospital-wide "code torsion" led to significantly improved "door to imaging" and "door to OR" times as well as improved rates of testicular salvage improved patient outcomes. Download PPT Source of Funding: Not applicable © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e1285 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Omar Almidani More articles by this author Ammar Al Homsi More articles by this author Rashed Rowaiee More articles by this author Ayman Moussa More articles by this author Alaeddin Barham More articles by this author Waleed Hassen More articles by this author Expand All Advertisement PDF downloadLoading ...