Journal of pediatric and adolescent gynecology | 2021
Adnexal Torsion Predictive Tool Maintains Applicability in a Heterogeneous Pediatric Population.
Abstract
STUDY OBJECTIVE\nA previously published scoring system showed promise in identifying adnexal torsion in adolescents. However, published patients were homogeneously Caucasian. We sought to assess if this scoring system was generalizable to a more diverse population that is predominantly African American and overweight.\n\n\nDESIGN\nRetrospective chart review.\n\n\nSETTING\nTertiary Academic Hospital.\n\n\nPARTICIPANTS\nFemale patients aged 0-21 years-old undergoing surgery for suspected ovarian torsion from 2010-2019.\n\n\nINTERVENTIONS\nRecords reviewed for patients, including laboratory studies, imaging, surgery, and pathology. Significance was determined for clinical and imaging findings, and retrospective composite scores were calculated for each participant as suggested by the scoring system.\n\n\nMAIN OUTCOME MEASURES\nDetermining if the previously published composite score was predictive of pediatric adnexal torsion in our population.\n\n\nRESULTS\nA total of 57 cases of suspected torsion were included. Approximately 60% of patients were African American, 10% Hispanic, and 30% Caucasian. Average BMI across ethnicities was 29. Our findings significantly correlated with previously published predictors for all components. The presence of nausea/vomiting, leukocytosis, ovarian volume and ratio were found to be significant. The post hoc calculated composite score was applied to our cohort, and over 90% of confirmed torsion would have been identified.\n\n\nCONCLUSION\nOur study suggests that a previously published composite score assessing torsion can successfully be used to predict torsion in a more diverse setting than the original study population, potentially accelerate surgical management of patients with the condition.