TY - JOUR
T1 - A clinical prediction model for adnexal torsion in pediatric and adolescent population
AU - Meyer, Raanan
AU - Meller, Nir
AU - Mohr-Sasson, Aya
AU - Toussia-Cohen, Shlomo
AU - Komem, Daphna Amitai
AU - Mashiach, Roy
AU - Levin, Gabriel
N1 - Publisher Copyright:
© 2021 Elsevier Inc.
PY - 2022/3
Y1 - 2022/3
N2 - 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 >240 K [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.
AB - 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 >240 K [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.
KW - Abdominal pain
KW - Adolescents
KW - Children
KW - Diagnostic laparoscopy
KW - Prediction
KW - Ultrasound
UR - http://www.scopus.com/inward/record.url?scp=85106302313&partnerID=8YFLogxK
U2 - 10.1016/j.jpedsurg.2021.03.052
DO - 10.1016/j.jpedsurg.2021.03.052
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C2 - 33902897
AN - SCOPUS:85106302313
SN - 0022-3468
VL - 57
SP - 497
EP - 501
JO - Journal of Pediatric Surgery
JF - Journal of Pediatric Surgery
IS - 3
ER -