This study examines the relationship between testicular torsion (TT) and seasonal or environmental factors in a pediatric population in a humid continental climate. Previous research suggests that lower temperatures may be linked to higher rates of TT. To investigate, a retrospective, IRB-approved study was conducted, analyzing data from non-traumatic cases of acute TT (symptom onset within 24 hours) in pediatric patients aged 21 years or younger, collected at a children’s hospital from 2013 to 2023. Daily weather conditions, including temperature, were recorded for both the day of and the day prior to each TT case. Statistical methods, such as Fisher’s exact test and Kruskal-Wallis rank sum test, were used to examine differences in temperature across months and seasons. Additionally, Poisson log-linear models assessed the relationship between TT occurrences and average daily temperatures.
Over the 10-year period, 149 TT cases were identified, with a median patient age of 14 years. Results showed a notably higher-than-expected rate of TT cases in December (13%), where the average daily temperature was 36°F. December, the second coldest month after January, follows a significantly warmer November. Winter overall had the lowest median average temperature at 36°F, significantly colder than fall, which had a median temperature of 54°F. Although TT cases peaked in winter (31%), the association was not statistically significant (p=0.11). However, Poisson models indicated a significant correlation between lower temperatures and increased TT cases on both seasonal and monthly levels, with a 10°F decrease predicting approximately 5 additional cases in seasonal and 1-2 in monthly models.
The findings highlight an increased risk of TT during colder months, suggesting the need for further research on environmental factors in other climates. To address this seasonal trend, the institution plans to adjust on-call schedules to manage the elevated TT caseload during colder seasons.
