TY - JOUR
T1 - Leveraging NSQIPP testicular torsion process measures
T2 - Initial survey of the NSQIPP testicular torsion collaborative
AU - Finkelstein, Julia B
AU - Weber, Bryce
AU - Quigley, Susan
AU - De, Shuvro
AU - Zann, Anja
AU - Rove, Kyle
AU - Liebrecht, Debra
AU - Zee, Rebecca
AU - Chan, Yvonne
AU - Battie, Shane
AU - Pohl, Hans
AU - Carmen Tong, Ching Man
AU - Dudley, Anne
AU - McQuiston, Leslie
AU - Durkin, Emily T
AU - Davis, Tanya D
AU - Whitehouse, Jill
AU - Polsky, Ethan
AU - Killian, Mary
AU - Wu, His-Yang
AU - Gong, Ed
AU - Chalmers, David
AU - Figueroa, T Ernesto
AU - Grimsby, Gwen
AU - Fernandez, Nicolas
AU - Ballesteros, Natalia
AU - Saito, Jacqueline M
AU - Metcalfe, Peter
AU - Schober, Megan
AU - Lambert, Sarah
AU - Grant, Catherine
AU - Ellison, Jonathan S
N1 - Copyright © 2025 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.
PY - 2025/12
Y1 - 2025/12
N2 - BACKGROUND: Testicular torsion is a pediatric emergency that poses a time-sensitive risk to the testicle. Best practices for testicular torsion protocols remain unclear. We convened the Testicular Torsion Collaborative, leveraging National Surgical Quality Improvement Program Pediatric (NSQIPP) Testicular Torsion Process Measure collection to assess factors associated with favorable metrics.METHODS: Data were accrued across 29 participating NSQIPP sites, excluding neonatal and non-urgent cases. Post-processed data available through NSQIPP included site of initial presentation and time stamps for presentation, ultrasound, and operating room entry; number of cases greater than the NSQIPP median for each time stamp; and orchiectomy rate. Hospital level data and torsion-related care processes were collected from each participating site via an electronic survey.RESULTS: From 10/1/2021 to 9/30/22, 1007 testicular torsion patients were included, with 494 (49.1 %) transferred from another institutions. A standardized evaluation protocol was associated with fewer patients exceeding the NSQIPP median from presentation to ultrasound (38.8 % vs 60 %, p = 0.03). Testicular Workup for Ischemia and Suspected Torsion (TWIST) score use was associated with a shorter time frame from presentation to ultrasound (0.7 vs 1.1 h, p = 0.03). Free-standing children's hospitals (p > 0.01) and institutions with an American College of Surgeons Children's Surgery Verification (p = 0.03) also demonstrated improved time to ultrasound. Overall orchiectomy rate was 15.8 % and there were no statistical differences noted across the study variables.CONCLUSIONS: Across a wide spectrum of hospitals within NSQIPP, we demonstrate that certain torsion-related processes and hospital-level factors are associated with faster times to ultrasound. The NSQIPP Testicular Torsion Collaborative will continue to explore interventions to improve testicular torsion care and outcomes.
AB - BACKGROUND: Testicular torsion is a pediatric emergency that poses a time-sensitive risk to the testicle. Best practices for testicular torsion protocols remain unclear. We convened the Testicular Torsion Collaborative, leveraging National Surgical Quality Improvement Program Pediatric (NSQIPP) Testicular Torsion Process Measure collection to assess factors associated with favorable metrics.METHODS: Data were accrued across 29 participating NSQIPP sites, excluding neonatal and non-urgent cases. Post-processed data available through NSQIPP included site of initial presentation and time stamps for presentation, ultrasound, and operating room entry; number of cases greater than the NSQIPP median for each time stamp; and orchiectomy rate. Hospital level data and torsion-related care processes were collected from each participating site via an electronic survey.RESULTS: From 10/1/2021 to 9/30/22, 1007 testicular torsion patients were included, with 494 (49.1 %) transferred from another institutions. A standardized evaluation protocol was associated with fewer patients exceeding the NSQIPP median from presentation to ultrasound (38.8 % vs 60 %, p = 0.03). Testicular Workup for Ischemia and Suspected Torsion (TWIST) score use was associated with a shorter time frame from presentation to ultrasound (0.7 vs 1.1 h, p = 0.03). Free-standing children's hospitals (p > 0.01) and institutions with an American College of Surgeons Children's Surgery Verification (p = 0.03) also demonstrated improved time to ultrasound. Overall orchiectomy rate was 15.8 % and there were no statistical differences noted across the study variables.CONCLUSIONS: Across a wide spectrum of hospitals within NSQIPP, we demonstrate that certain torsion-related processes and hospital-level factors are associated with faster times to ultrasound. The NSQIPP Testicular Torsion Collaborative will continue to explore interventions to improve testicular torsion care and outcomes.
KW - Adolescent
KW - Child
KW - Child, Preschool
KW - Humans
KW - Male
KW - Orchiectomy/statistics & numerical data
KW - Quality Improvement
KW - Spermatic Cord Torsion/surgery
KW - Surveys and Questionnaires
KW - United States
UR - https://www.scopus.com/pages/publications/105010067282
U2 - 10.1016/j.jpurol.2025.06.030
DO - 10.1016/j.jpurol.2025.06.030
M3 - Article
C2 - 40640002
SN - 1477-5131
VL - 21
SP - 1844
EP - 1850
JO - Journal of Pediatric Urology
JF - Journal of Pediatric Urology
IS - 6
ER -