METHODS: A retrospective analysis was conducted by reviewing clinical data of 292 patients who were admitted and surgically confirmed to have testicular torsion in the Yantai Yuhuangding hospital medical complex between January 1, 2009, and August 31, 2022. Male patients who underwent circumcision (foreskin) were allocated to the control group. Temperature data were obtained from the China Meteorological Data Service Center. Chi-squared test or Fisher\'s exact test and one-way analysis of variance were employed to compare patient characteristics and climatic variables among the different groups. Pearson\'s correlation analysis was used to analyze the association between monthly average ambient temperature and monthly cumulative number of cases. Moreover, a logistic regression model was utilized to identify the independent factors of testicular torsion.
RESULTS: The mean age of patients with testicular torsion was 16.8 years. The number of cases was the highest in autumn. The temperature was the highest in summer and the lowest in winter (p < 0.01). Furthermore, the temperature difference (TD) in autumn was the highest in the four seasons groups (p < 0.01). The patients were divided into the high TD and low TD groups according to the mean TD (7.62 ◦C) on the admission day. The high TD group had a higher number of patients than the low TD group, and the temperature was lower in the former group than in the latter group (p < 0.01). A roughly negative correlation was observed between ambient temperature and the number of cases (Pearson\'s r = -0.228, 95% confidence interval (CI): -0.366 to -0.079, p = 0.003). Logistic regression analysis revealed that the independent risk factor for testicular torsion was TD on admission day (odds ratio, 1.82; 95% CI, 1.28-2.59; p < 0.001).
CONCLUSIONS: To some extent, external temperature can affect the body surface temperature of patients and then induce testicular torsion. We concluded that testicular torsion easily occurs in the season in which the temperature drops and the TD is high.
方法:回顾性分析2009年1月1日至2022年8月31日烟台玉皇顶医院综合医院收治的经手术证实为睾丸扭转的292例患者的临床资料。将接受包皮环切术(包皮)的男性患者分配到对照组。温度数据来自中国气象数据服务中心。采用卡方检验或Fisher精确检验和单向方差分析来比较不同组之间的患者特征和气候变量。采用Pearson相关分析,分析月平均环境温度与月累积病例数的相关性。此外,采用logistic回归模型确定睾丸扭转的独立因素。
结果:睾丸扭转患者的平均年龄为16.8岁。秋季病例数最高。夏季气温最高,冬季气温最低(p<0.01)。此外,秋季温差(TD)在四个季节组中最高(p<0.01)。根据入院当天的平均TD(7.62°C)将患者分为高TD和低TD组。高TD组患者数量高于低TD组,前一组温度低于后一组(p<0.01)。在环境温度和病例数之间观察到大致负相关(皮尔逊r=-0.228,95%置信区间(CI):-0.366至-0.079,p=0.003)。Logistic回归分析显示,睾丸扭转的独立危险因素为入院当天的TD(比值比,1.82;95%CI,1.28-2.59;p<0.001)。
结论:在某种程度上,外界温度会影响患者体表温度,进而诱发睾丸扭转。我们得出结论,睾丸扭转容易发生在温度下降和TD高的季节。