Introduction: The “weekend effect” refers to patients experiencing worse outcomes when presenting to the hospital on the weekend. This phenomenon has been evaluated for several surgical procedures but has yet to be studied in patients with testicular torsion, a condition requiring emergent surgical intervention to preserve testicular function. We evaluated for the presence of a weekend effect in the management of testicular torsion in both a pediatric and adult patients. Methods: The Statewide Planning and Research Cooperative System, a New York State all payer data reporting system, was queried from 2010-2017. All patients presenting with testicular torsion requiring surgical management were stratified into pediatric ( <16 years old) or adult (>17 years old) groups, and then sub-stratified by admission on weekday (WD) or weekend (WE). Patient age, rate of orchiectomy vs. orchiopexy, rate of bilateral orchiopexy, length of stay (LOS), operative time (OPT), total hospital cost (THC), and incidence of evaluation of torsion within 7 days prior to current admission were analyzed. Results: Of 1,445 cases, 807 were pediatric (WD: 600 [74.3%], WE: 207 [25.7%]) and 638 were adult (WD: 464 [72.7%], WE: 174 [27.3%]) with no difference in rate of weekend admission between populations (p=0.487). WE pediatric patients had a greater rate of orchiectomy (WE: 11.6%, WD: 6.7%, p=0.024), and bilateral orchiopexy (WE: 71.0%, WD: 62.7%, p=0.040). They were also older (WE: 11.9, WD: 10.6, p=0.002), had a greater LOS (WE: 0.45, WD: 0.27, p=0.037) and THC (WE: $18,257, WD: $12,460, p=0.016) though these are likely clinically insignificant. There was no difference in OPT or prior torsion evaluations [Table 1A]. The adult cohorts had no significant differences for any analyses [Table 1B]. Conclusions: On weekends, pediatric patients had a greater rate of orchiectomy and of bilateral orchiopexy, suggesting a possible weekend effect in the pediatric population. This may be due to delays in presenting to the hospital by either the patient or parent. No evidence of a weekend effect was found in the adult population. Patients and parents should continue to be educated on the symptoms of testicular torsion and be encouraged to always seek immediate medical attention to improve the chances for testicular salvage. SOURCE OF Funding: NA
