Evidence map›Paper›PMID 40659986›Full record

ArticlePediatric surgery international2025

Predictors of testicular salvage failure in pediatric testicular torsion: a retrospective analysis of clinical and imaging risk factors.

Yanjun Tian, Xinran Xing, Hui Cai, ShengZhang, Xiaoyan Ma, Qi Liu

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Article in Pediatric surgery international, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

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5citing papers in PubMed
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3 · Its place in the literature

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5 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

6 authors.

Yanjun Tian *Beijing University First Hospital Ningxia Women and Children's Hospital, Yinchuan, 750004, Ningxia, China.
Xinran Xing *General Hospital of Ningxia Medical University, Yinchuan, 750004, Ningxia, China.
Hui CaiSchool of Clinical Medicine, Ningxia Medical University, Yinchuan, 750004, Ningxia, China.
ShengZhangBeijing University First Hospital Ningxia Women and Children's Hospital, Yinchuan, 750004, Ningxia, China.
Xiaoyan MaBeijing University First Hospital Ningxia Women and Children's Hospital, Yinchuan, 750004, Ningxia, China.
Qi LiuBeijing University First Hospital Ningxia Women and Children's Hospital, Yinchuan, 750004, Ningxia, China. 18809583332@163.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesThis study aimed to construct preoperative nomograms for predicting testicular necrosis in pediatric patients with testicular torsion (TT).

methodsThis retrospective study analyzed clinical data from 176 patients diagnosed with TT at the Department of Pediatric Surgery, Ningxia Medical General Hospital, between January 2010 and January 2023. To identify independent risk factors for testicular necrosis, both univariate as well as multivariate logistic regression analyses were used. A predictive nomogram model was then developed based on the coefficients derived from multivariate regression analysis. A receiver operating characteristic (ROC) curve analysis and calibration plot were employed to evaluate the performance of the model.

resultsSurgical management included orchiopexy in 55 patients (31.4%) and orchiectomy in 121 patients (68.6%). Multivariate analysis identified five independent predictors of testicular necrosis: symptom duration, torsion severity (≥ 360°), absence of testicular blood flow on Doppler ultrasound, heterogeneous testicular echogenicity, and an elevated preoperative platelet-to-lymphocyte ratio (PLR). Internal validation demonstrated strong discriminative performance of the nomogram, with the area under the ROC curve values of 0.948 for the training cohort and 0.910 for the validation cohort. The calibration plots demonstrated a strong concordance between predicted probabilities and observed outcomes.

conclusionThese findings highlight duration of onset, degree of TT, ultrasound characteristics (vascularity loss and heterogeneous echotexture), and systemic inflammatory markers (PLR) as key preoperative indicators of testicular viability. The proposed nomogram serves as an evidence-based tool to guide intraoperative decisions on testicular preservation or resection.

Indexed as

OrchiectomySalvage TherapySpermatic Cord TorsionTestisAdolescentChildChild, PreschoolHumansInfantMaleNecrosisNomogramsOrchiopexyRetrospective StudiesRisk FactorsROC CurveNomogramOrchiectomyPlatelet-to-lymphocyte ratioTesticular activityTesticular torsion

Identifiers

PMID40659986
PMCPMC12259726

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.