Factors Associated With Delay to Care in Pediatric and Adolescent Adnexal Torsion
Topic overview
Multi-institutional study of 862 pediatric adnexal torsion cases found 30% experienced diagnostic delays, with higher rates among patients from disadvantaged areas and those living farther from hospitals. Delayed diagnosis doubled oophorectomy risk (14% vs 7%), highlighting the need for improved diagnostics and awareness of social disparities to preserve ovarian tissue.
Key takeaways
- 30% of pediatric adnexal torsion cases had delayed diagnosis, with patients living >30 miles from hospital having 81% higher odds of delay.
- Delayed diagnosis doubled oophorectomy risk (14% vs 7%), emphasizing need for prompt surgical intervention to preserve ovarian tissue.
- Atypical presentations (no emesis/fever) and inconclusive ultrasound findings were associated with diagnostic delays in adnexal torsion.
- Higher area deprivation index correlated with diagnostic delay, revealing socioeconomic disparities in access to timely care.
- Early pediatric surgery consultation reduced delays; consider low threshold for specialist involvement in suspected torsion cases.
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