Oophorectomy Rates in Pediatric and Adolescent Patients with Adnexal Torsion in US Emergency Departments

Objective: To evaluate oophorectomy rates in pediatric and adolescent patients who presented to a US emergency department with adnexal torsion METHODS: This study was a retrospective, cross-sectional analysis utilizing the National Emergency Department Sample data from 2016 to 2018. It included patients younger than 20 years old and of the female sex. International Classification of Diseases Version 10 and ICD 10 Procedure Coding System 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 according to patient demographic characteristics.

Results: There were 263 sampled patients younger than 20 years old who presented to a US emergency department with a diagnosis of adnexal torsion and underwent adnexal surgery. Of them, 177 had an oophorectomy (67.3%); 85 had a minimally invasive surgery (48%). Compared with 10- to 14-year-olds, 15- to 19-year-olds were 2.54 times more likely to have an oophorectomy (95% CI, 1.42-4.71; Table 2).

Conclusion: 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 US emergency departments for care. Continued efforts should identify barriers to ovarian-sparing surgeries and better quantify specific clinical nuances when oophorectomies are performed.