This study examines the relationship between pediatric testicular torsion (TT) and environmental factors in a humid continental climate, which experiences four distinct seasons. Prior research has linked TT to colder temperatures, and this study further investigates associations between seasonal and environmental variables and TT cases at a children’s hospital. Data were gathered retrospectively for non-traumatic, acute TT cases in patients up to age 21, presenting within 24 hours of symptom onset, over a 10-year period from 2013 to 2023. Weather data from the day of and the day prior to each TT incident were included, and statistical analyses were conducted using Fisher’s exact test, Kruskal-Wallis rank sum test, and Poisson loglinear models.
Of the 149 TT cases identified, the median patient age was 14 years, with cases peaking in December (13% of cases, p<0.05). December’s average daily temperature was 36°F, the second coldest month after January, and much colder than November, which had an average of 43°F. Seasonally, winter was the coldest period with a median temperature of 36°F and held a slightly elevated proportion of TT cases (31%, p=0.11). Poisson loglinear models indicated a significant association between TT frequency and lower temperatures (p<0.05). A decrease of 10°F was associated with approximately five additional TT cases in seasonal models and one to two additional cases in monthly models.
These findings suggest a notable pattern of increased TT incidence during colder months in humid continental climates. Given these results, the hospital’s call schedule for emergency surgeries is being adjusted to accommodate the seasonal increase in TT cases. Further research is encouraged to assess whether similar patterns occur in other climates, which could improve preparedness for TT cases seasonally.
