Adnexal Torsion Predictive Tool Maintains Applicability in a Heterogeneous Pediatric Population.

Abstract

A previously published scoring system showed promise in identifying adnexal torsion in adolescents. However, published patients were homogeneously Caucasian/White. We sought to assess whether this scoring system was generalizable to a more diverse population that is predominantly African American and overweight. Retrospective chart review. Tertiary academic hospital. Female patients 0-21 years of age undergoing surgery for suspected ovarian torsion from 2010 to 2019. Records were reviewed for patients, including laboratory studies, imaging, surgery, and pathology. Significance was determined for clinical and imaging findings, and retrospective composite scores were calculated for each participant as suggested by the scoring system. Determination of whether the previously published composite score was predictive of pediatric adnexal torsion in our population. A total of 57 cases of suspected torsion were included. Approximately 60% of patients were African American, 10% Hispanic, and 30% Caucasian/White. The average body mass index (BMI) across ethnicities was 29. Our findings significantly correlated with previously published predictors for all components. The presence of nausea/vomiting, leukocytosis, ovarian volume and ratio were found to be significant. The post hoc calculated composite score was applied to our cohort, and more than 90% of confirmed torsion would have been identified. Our study suggests that a previously published composite score assessing torsion can successfully be used to predict torsion in a more diverse setting than the original study population, potentially accelerating surgical management of patients with the condition.