Predictors of Oophorectomy in Girls Hospitalized in Texas With Ovarian Torsion.

OBJECTIVES: Inconsistent results have been reported by authors of studies of the management of pediatric patients with ovarian torsion (OT). Our objective was to identify predictors of oophorectomy in girls hospitalized throughout Texas with OT. METHODS: The Texas Public Use Data File (years 2013-2014) was queried for the records of girls under the age of 18 years who had a principal or secondary discharge diagnosis of OT (International Classification of Diseases, Ninth Revision, Clinical Modification code 620.5). Adjusted odds ratios were estimated from a logistic regression model by using Firth's bias-reducing penalized likelihood. Variables for inclusion in the final model were identified by using a directed acyclic graph. RESULTS: A sample of 158 girls was identified with an overall risk of oophorectomy during the hospital stay of 41.1% (65 out of 158). After adjusting for the patient's age, health insurance status, and the presence of an ovarian cyst, girls who were treated at a nonteaching hospital were more than twice as likely to undergo oophorectomy than girls who were treated at a teaching hospital (odds ratio = 2.22; 95% confidence interval: 1.05-4.69). CONCLUSIONS: Our analysis of a statewide database revealed that girls with OT who presented at nonteaching hospitals were significantly more likely to undergo oophorectomy compared with girls who presented at teaching hospitals.

Predictors of a Prolonged Length of Stay in Children with Perforated Appendicitis.

OBJECTIVES: Little is known about the factors that affect the length of stay (LOS) of children hospitalized for perforated appendicitis. The objective of this study was to identify clinical and demographic factors associated with a prolonged LOS (PLOS) in children with perforated appendicitis. METHODS: A retrospective cohort study was conducted using the records of 197 children 0 to 17 years old with perforated appendicitis. The children were hospitalized at one of two teaching hospitals located in El Paso, Texas, and were discharged between January 2008 and January 2014. PLOS was defined as an LOS greater than the 75th percentile value in our patient cohort, which was 7 days. An initial log-binomial regression model failed to converge, and hence logistic regression was used to calculate adjusted incidence odds ratios (OR) for PLOS, 95% confidence intervals, P values, and a receiver operating characteristic curve. The best subset method was used to identify predictors for inclusion in the final model. RESULTS: The overall risk of PLOS was 23.4% (46/197). Approximately 76% of the children who experienced PLOS and 94% of those who did not have PLOS were Hispanic. After adjusting for insurance status, presence of an abscess, asthma, consulting interventional radiology, and various antibiotics, Hispanics were less likely than non-Hispanics to experience PLOS (adjusted OR 0.20; P = 0.003). Children whose providers consulted the interventional radiologist had an increased odds of PLOS (adjusted OR 3.64; P = 0.01). CONCLUSIONS: Hispanic ethnicity was associated with a lower odds of PLOS, whereas children who required the services of an interventional radiologist were more likely to experience PLOS.