In 2015, the U.S. News and World Report (USNWR) implemented a quality metric to expedite surgery for testicular torsion (TT), but not ovarian torsion (OT). This study examined OR timing among children with suspected TT and OT before and after this metric. A single-center retrospective cohort study of children (1–18yr) who underwent surgery for suspected gonadal torsion was performed. Time to OR (TTOR) from hospital presentation to surgery start was calculated. An interrupted time series analysis identified changes in TTOR for suspected TT versus OT after the 2015 USNWR quality metric. Overall, 216 patients presented with TT and 120 with OT. Median TTOR for TT was 147 min (IQR:99–198) versus 462 min (IQR:308–606) for OT. Post-quality metric, children with TT experienced a 27.8 min decrease (95% CI:-51.7,-3.9, p = 0.05) in annual median TTOR. No significant decrease was observed for children with OT (p = 0.22). Children with history of a known ovarian mass (N = 62) experienced a shorter TTOR compared to those without (422 vs 499min; p = 0.04). Implementation of a national quality metric for TT expedited surgical care for children with TT, but not children with OT. These findings highlight the need for equitable quality metrics for children presenting with suspected gonadal torsion. III. Retrospective Comparative Study, Observational Cohort Study.

中文翻译：

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儿童性腺扭转治疗中的性别差异

2015 年，美国新闻与世界报道 (USNWR) 实施了一项质量指标来加快睾丸扭转 (TT) 手术的速度，但不包括卵巢扭转 (OT) 的手术速度。本研究检查了疑似 TT 和 OT 儿童在此指标前后的 OR 时间。对因疑似性腺扭转而接受手术的儿童（1-18 岁）进行了一项单中心回顾性队列研究。计算从入院到手术开始的手术时间 (TTOR)。中断时间序列分析确定了 2015 年 USNWR 质量指标后疑似 TT 与 OT 的 TTOR 变化。总体而言，216 名患者出现 TT，120 名患者出现 OT。 TT 的中位 TTOR 为 147 分钟（IQR：99-198），而 OT 的中位 TTOR 为 462 分钟（IQR：308-606）。质量后指标显示，TT 儿童的年中位 TTOR 下降了 27.8 分钟（95% CI：-51.7，-3.9，p = 0.05）。对于 OT 儿童，没有观察到显着下降 (p = 0.22)。与没有已知卵巢肿块病史的儿童 (N = 62) 相比，有已知卵巢肿块病史的儿童 (N = 62) 经历的 TTOR 较短 (422 分钟 vs 499 分钟；p = 0.04)。实施国家 TT 质量指标可以加快 TT 儿童的手术治疗，但不能加快 OT 儿童的手术治疗速度。这些发现强调需要对疑似性腺扭转的儿童制定公平的质量指标。三．回顾性比较研究、观察队列研究。