Evaluation of Cell Ratios in Routine Laboratory Tests As a Prognostic Factor for Surgical Intervention in Tubo-Ovarian Abscess

Abstract

Study Objective To identify novel markers in routine laboratory tests associated with surgical intervention in patients with tubo-ovarian abscess (TOA). Design Retrospective cohort study. Setting Tertiary university-affiliated hospital. Patients or Participants Two hundred and eighty-five patients were diagnosed with TOA based on sonographic and clinical criteria. We conducted two analyses, The first between patients managed conservatively and those operated at any time since admission, The second compared between patients that after 48 hours of conservative treatment required a surgical intervention and those who completed conservative treatment with no need for surgical intervention. Interventions Electronic medical records were used to identify patients who were diagnosed with TOA between 2007 and 2018. All patients received the same antibiotic regimen upon admission. The data extracted included laboratory results and vital signs. Inflammatory markers such as neutrophil to lymphocyte ratio (NLR),lymphocyte to monocyte ratio (LMR),platelet lymphocyte ratio (PLR),white blood cell count(WBC) and C-reactive protein(CRP) levels were compared. A logistic regression model was used to determine the independent predictors of conservative treatment failure. Measurements and Main Results When comparing cell ratio from complete blood count on admission, between patients who underwent surgical intervention and those successfully treated with antibiotics, we found a statistically significant difference in WBC, CRP, NLR,LMR and PLR (P-value α Conclusion NLR upon admission can serve as a novel marker for prediction of antibiotic treatment failure for TOA.