A Clinical Prediction Model for Adnexal Torsion in Pediatric and Adolescent Population
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In brief
In brief
Retrospective study of 120 pediatric patients develops a clinical prediction model for preoperative detection of adnexal torsion using three independent risk factors: absence of right lower quadrant tenderness, elevated platelets (>240K), and elevated neutrophils (>5.4). The model stratifies AT risk from 12.5% with no factors to 94.1% with all three present, offering a practical tool for surgical decision-making in young women with suspected torsion.
Written by the GCMD Library team from the article.
Abstract
Purpose
To describe the clinical characteristics of children and adolescents that underwent diagnostic laparoscopy for suspected adnexal torsion (AT), and to develop a prediction model for preoperative detection of AT among young women.
Methods
A retrospective cohort study. We included all girls ≤18 years old with clinically suspected AT who underwent a diagnostic laparoscopy between 3/2011 and 6/2020. We compared patients with AT to those without AT and constructed a prediction model.
Results
Overall, 120 children and adolescents with suspected AT were included in the study. Of those, AT was identified in 83 (69.2%).
In a multivariate analysis, the following risk factors were independently associated with AT and included in the prediction model: absence of right lower quadrant tenderness upon examination [adjusted odds ratio (aOR) (95% Confidence interval (CI)) 3.23 (1.23-8.47), p=0.017], platelets level >240K [aOR (95% CI) 3.15 (1.19-8.36), p=0.021], and neutrophils level >5.4 [aOR (95% CI) 2.71 (1.02-7.52), p=0.046].
The rate of AT was 12.5% in cases without risk factors for AT, 56.7% with one, 68.8% with two, and 94.1% with three risk factors present, respectively.
Conclusions
We have identified preoperative indicators independently associated with surgically confirmed AT in a large cohort of young women.
Level of evidence- III