溫度變化的重要性：日均溫與體感溫度波動可作為亞熱帶區域睪丸扭轉的危險因子

侯心一、蘇偉俊、陳浩瑋、阮雍順、陳妤甄

高雄醫學大學附設醫院 泌尿科

Thermal Instability Matters: Daily Fluctuations in Mean and Apparent Temperature as Risk Factors of Testicular Torsion in a Subtropical Region

Hsin-I Hou, Wei-Chun Su, Hao-Wei Chen, Yung-Shun Juan, Yu-Chen Chen

Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan

Purpose: Testicular torsion is a time-sensitive urological emergency, and emerging evidence suggests it may be influenced by environmental factors such as ambient temperature. However, no consensus has been reached on which meteorological parameter best predicts torsion risk. This study aimed to comprehensively evaluate the association between major climatic variables and the occurrence of testicular torsion at a tertiary medical center and to identify the most predictive temperature-related risk indicator.

Materials and Methods: A retrospective review was conducted on patients with surgically confirmed testicular torsion at Kaohsiung Medical University Hospital between January 2009 and September 2025. Daily meteorological data were obtained from the Central Weather Administration Kaohsiung station, located approximately 12 km from the hospital, and included mean temperature, diurnal temperature range, atmospheric pressure, relative humidity, wind speed, and sunshine duration. Day-to-day temperature variation was defined as the absolute difference between the mean temperature of the current day and that of the preceding day. Apparent temperature was calculated using the formula: (1.04 × temperature) + (0.2 × vapor pressure) − (0.65 × wind speed) − 2.7. Logistic regression and chi-square analyses were conducted to assess the associations between climatic variables and torsion occurrence.

Results: A total of seventy patients met the inclusion criteria. Day-to-day mean temperature variation was positively associated with torsion risk, with each 1 °C increase conferring a 23.6% rise in odds (OR = 1.236, 95% CI: 1.018–1.501, p = 0.032). When categorized, temperature fluctuation ≥4 °C significantly elevated torsion incidence (3.8% vs. 1.1%), corresponding to an odds ratio of 3.69 (95% CI: 1.13–12.04, p = 0.030). (Table 1A.) Apparent temperature fluctuation ≥1 °C was also associated with a higher incidence of torsion (1.5% vs. 0.9%), with an odds ratio of 1.694 (95% CI: 1.057–2.717, p = 0.029). (Table 1B.)

Conclusion: In subtropical climates, testicular torsion risk is strongly associated with rapid day-to-day fluctuations in both mean temperature and apparent temperature. A fluctuation of ≥4 °C in mean temperature and ≥1 °C in apparent temperature represents a clinically meaningful threshold for increased torsion risk. These findings suggest that acute thermal instability plays a key role in the pathophysiology of testicular torsion and support the incorporation of temperature fluctuation monitoring into climate-based risk prediction and preventive strategies.

Table 1A.

Days with day-to-day mean temperature changes ≥4 °C were associated with a significantly higher risk of testicular torsion compared with days with minimal fluctuation (0–2 °C). The incidence increased from 1.1% to 3.8%, corresponding to an odds ratio of 3.69 (95% CI: 1.13–12.04, p = 0.030).

Table 1B.

Days with apparent temperature fluctuation ≥1 °C were associated with a significantly higher risk of testicular torsion compared with days with ΔAT <1 °C. The incidence of torsion increased from 0.9% to 1.5%, corresponding to an odds ratio of 1.694 (95% CI: 1.057–2.717, p = 0.029).