The BAL-Score Almost Perfectly Predicts Testicular Torsion in Children: A Two-Center Cohort Study

Frontiers in Pediatrics

article

Michaela Klinke¹  Julia Elrod¹  Carolin Stiel¹  Tarik Ghadban²  Julia Wenskus¹  Jochen Herrmann³  Carl-Martin Junge⁴  Konrad Reinshagen¹  Michael Boettcher¹ 

[1] Department of Pediatric Surgery, University Medical Center Hamburg-Eppendorf;Department of General, University Medical Center Hamburg-Eppendorf;Department of Diagnostic and Interventional Radiology and Nuclear Medicine, Section of Pediatric Radiology, University Medical Center Hamburg-Eppendorf;Department of Pediatric Radiology

关键词: testicular torsion;    acute scrotum;    prediction score;    epidydimitis;    hydatide torsion;    scrotal edema;    clinical;   

DOI  :  10.3389/fped.2020.601892

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Introduction: Testicular torsion (TT) is a common emergency that warrants immediate exploration to prevent infertility or testicular loss. To improve diagnostic reliability, various scoring systems have been published. The aim of this study was to evaluate and validate different testicular torsion scores in a large cohort of children with acute scrotum. Methods: Retrospective analysis of all male children that were admitted for acute scrotum at the Pediatric Surgery Department of the Altonaer Kinderkrankenhaus and University medical Center Hamburg-Eppendorf from 01/2013 to 03/2019. Two testicular torsion scores (Boettcher Alert Score, Testicular Workup for Ischemia and Suspected Torsion Score) were applied to all data sets. Furthermore, an artificial intelligence (AI)-based score was developed and compared to the two current scores. Results: In total, 460 boys were included in the study. Of those, 48 (10.4%) had TT. Children with TT suffered most often from short duration of pain, nausea and vomiting, high riding testicle and absent cremasteric reflex. The BALS and the AI-based score had excellent predictive values and all patients with TT would have been detected. Conclusion: The BAL and the AI score show excellent predictive capabilities and may be used to identify all cases of TT in a pediatric population. The scores are easy to apply. As the BALS was slightly better, we advocate to use this score but to validate our findings in prospective multicenter studies.

【 授权许可】

CC BY