MP66-07 TESTICULAR TORSION IN MINORS: DOES POINT-OF-CARE INFLUENCE TESTICULAR SALVAGE RATES? A POPULATION-BASED STUDY
Notice bibliographique
Résumé
You have accessJournal of UrologyPediatrics: Testis, Varicocele & Stones1 Apr 2017MP66-07 TESTICULAR TORSION IN MINORS: DOES POINT-OF-CARE INFLUENCE TESTICULAR SALVAGE RATES? A POPULATION-BASED STUDY Katherine H Anderson, Bryan Maguire, Dawn L MacLellan, Peter AM Anderson, and Rodrigo LP Romao Katherine H AndersonKatherine H Anderson More articles by this author , Bryan MaguireBryan Maguire More articles by this author , Dawn L MacLellanDawn L MacLellan More articles by this author , Peter AM AndersonPeter AM Anderson More articles by this author , and Rodrigo LP RomaoRodrigo LP Romao More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.2022AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Testicular torsion (TT) in minors is afflicted by delays in treatment due to inappropriate referrals to tertiary pediatric centers. We sought to determine whether point-of-care (community hospitals vs. tertiary centers) or other treatment delaying variables such as transfer, emergency room (ER) wait times and distance travelled affect testicular salvage rates in minors with TT using a National database. METHODS Data prospectively collected by the Canadian Institute of Health Information (CIHI) between January 2010-December 2014 were obtained; all Canadian males <18 years of age with TT based on ICD codes were included, except for the province of Quebec. Variables collected were: age, complexity level of surgical center based on case mix (community small/medium, community large, or tertiary/academic), if patient was transferred for definitive treatment, road distance travelled to the point-of-care based on postal codes, ER wait time in hours. Outcome was testicular salvage based on intervention codes used by CIHI for orchiectomy/orchidopexy. Uni and multivariate analyses were performed using logistic regression. RESULTS Complete data were available for 1736 out of 1935 TT patients <18 years of age. Overall testicular salvage rate was 70%. Most patients (52%) were treated at tertiary hospitals. On univariate analysis, there was no difference in testicular salvage rates between tertiary and large community hospitals (70% vs 66%); treatment at small/medium community hospitals was associated with higher salvage rates (77%) compared to large community ones (OR=0.59, CI 0.39-0.85, p<0.05). ER wait time longer than 1 hour was associated with a significant increase in testicular loss (OR=1.89, CI 1.41-2.52, p<0.0001). Transfer and distance travelled were not associated with higher orchiectomy rates, even on stratified analysis by type of hospital. On multivariate analysis, age 12-17 years, treatment at community small/medium or tertiary/academic hospitals and shorter ER wait times were significantly associated with higher salvage rates. CONCLUSIONS Point-of-care affects testicular salvage rates in minors with TT. Small/medium community hospitals depict the lowest orchiectomy rates; while academic centers had better outcomes than large community hospitals on multivariate analysis, it is unclear if this of clinical significance. Transfer to another facility for definitive care and distance travelled did not affect orchiectomy rates. Longer ER wait time and younger age were the most consistent risk factors associated with orchiectomy. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e864 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Katherine H Anderson More articles by this author Bryan Maguire More articles by this author Dawn L MacLellan More articles by this author Peter AM Anderson More articles by this author Rodrigo LP Romao More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,012 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,001 | 0,003 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,005 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».