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

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.