Oophorectomy Rates in Pediatric & Adolescent Patients with Adnexal Torsion in U.S. Emergency Departments

Authors

Kirsten Jay Hartwick Das, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), Bethesda, MD, NIH Z1A HD008985. Electronic address: Kirsten.das@nih.gov.
Victoria Huynh, Department of Obstetrics & Gynecology, Baylor College of Medicine, Houston, TX.
Stephanie Wang, The George Washington University, School of Medicine and Department of Obstetrics and Gynecology, Washington, DC.
Eduardo A. Trujillo Rivera, Children's National Division of Critical Care Medicine, Children's National Medical Center, Washington, DC; Children's National Research Institute, Children's National Medical Center, Washington, DC; George Washington University School of Medicine and Health Sciences, Washington, DC.
Veronica Gomez-Lobo, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), Bethesda, MD, NIH Z1A HD008985.

Document Type

Journal Article

Publication Date

10-18-2024

Journal

Journal of pediatric and adolescent gynecology

DOI

10.1016/j.jpag.2024.10.002

Keywords

adnexal torsion; adolescent health; emergency department; ovarian cystectomy; ovarian sparing surgery; ovarian torsion; pediatric gynecology; surgical outcomes

Abstract

OBJECTIVE: To evaluate oophorectomy rates in pediatric and adolescent patients who presented to a United States (U.S.) emergency department (ED) with adnexal torsion. METHODS: This study is a retrospective, cross sectional analysis utilizing the National Emergency Department Sample (NEDS) data from 2016 to 2018. It includes patients who are younger than 20 years old and female sex. International Classification of Diseases Version 10 (ICD-10) and ICD 10 Procedure Coding System (ICD-10 PCS) codes were utilized to define patients with adnexal torsion who underwent adnexal surgery. Descriptive statistics and multivariate logistic regression were utilized to compare oophorectomy rates by patient demographics. RESULTS: There were 263 sampled patients less than 20 years old who presented to a U.S. Emergency Department with a diagnosis of adnexal torsion and underwent adnexal surgery. Of those, 177 had an oophorectomy (67.3%). 85 had a minimally invasive surgery (48%). 15- to 19-year-olds were 2.54 times more likely to have an oophorectomy compared to 10- to 14-year-olds (95% CI: 1.42 to 4.71, Table 2). CONCLUSIONS: Despite standards for ovarian sparing surgery since 2016 and data suggestive of safety since the 1990s, oophorectomy rates remain high in pediatric and adolescent patients with torsion who present to U.S. emergency departments for care. Continued efforts should identify barriers to ovarian sparing surgeries and better quantify specific clinical nuances when oophorectomies are performed.

APA Citation

Hartwick Das, Kirsten Jay; Huynh, Victoria; Wang, Stephanie; Trujillo Rivera, Eduardo A.; and Gomez-Lobo, Veronica, "Oophorectomy Rates in Pediatric & Adolescent Patients with Adnexal Torsion in U.S. Emergency Departments" (2024). GW Authored Works. Paper 5807.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/5807

Department

Pediatrics