Reduction in Hospitalized Women With Pelvic Inflammatory Disease in Oslo Over the Past Decade

Abstract

The authors compared the demographic and medical variables of Oslo women hospitalized with pelvic inflammatory disease (PID) in the years 1990-1992 and 2000-2002. A retrospective review of medical records identified 523 patients suitable for study. The total number of hospital patients with PID dropped from 301 in the first period to 222 in the second (P =.001). Overall, three fourths of patients in this series were diagnosed with salpingitis and one fourth had tuboovarian abscess. Two women were diagnosed with oophoritis. The percentage of women hospitalized with PID who were diagnosed with salpingitis decreased from 79% in the early years to 70% in the later study period. Correspondingly, the diagnosis of tuboovarian abscess in these women increased from 20% to 30% (P =.009 for difference). Clinical and demographic differences in patients with PID were similar between 1990-1992 and 2000-2002, except that more women in the early period had a history of PID (26%) compared with the later period (14%) (P =.005). This difference was significant for women diagnosed with salpingitis (24% vs. 10%, respectively; P =.002) but not for those with tuboovarian abscess. The mean length of hospital stay dropped from a mean of 5.8 days in 1990-1992 to 3.8 days in 2000-2002 ((P <.001). The percentage of women with PID who had an IUD did not change from the first to second period (35% and 34%, respectively). IUD use was associated with tuboovarian abscess or salpingitis in 51% and 31%, respectively, of women with these diagnoses in 1990-1992 (P =.025), and 61% and 25%, respectively, in 2000-2002 (P <.001). Maximum C-reactive protein and leukocyte counts were consistently higher for women with tuboovarian abscess compared with those with salpingitis, but the overall measurements increased significantly in the 10 years between time periods. In 1990-1992, maximum C-reactive protein and leukocyte counts were 176 in the abscess group and 89 in the salpingitis patients compared with 237 and 142, respectively, in 2000-2002 (P <.001). Overall, 68% of the women hospitalized with PID underwent surgery. Surgery was performed in almost all patients with tuboovarian abscess (98%), but the percentage of salpingitis patients who underwent surgery decreased from 67% in 1990-1992 to 49% in 2000-2002 (P =.03).