The prediction of surgical intervention in patients with tubo-ovarian abscess

Jong Ha Hwang,Bo Wook Kim,Soo Rim Kim,Jang Heub Kim

doi:10.1080/01443615.2020.1867965

Jong Ha Hwang, Bo Wook Kim + Show 2 more

Open Access

https://doi.org/10.1080/01443615.2020.1867965

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Abstract

The aim of this study was to compare the clinical characteristics of patients with tubo-ovarian abscess (TOA) who responded to medical treatment and those who underwent surgical intervention due to medical treatment failure. Electronic medical records were evaluated retrospectively to identify patients who were diagnosed with TOA. Demographic, clinical, and laboratory data including white blood cell (WBC) count, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) were compared between the medical treatment group and the surgical intervention group. Patient age, TOA diameter, WBC count, CRP, and ESR were significantly different between the groups. On multiple regression analysis, significant correlations were identified between age (p = .001), ESR (p = .045), and failure of medical treatment. TOA diameter (p = .065) showed a borderline association with surgical intervention. The risk of needing surgical intervention in TOA patients can be predicted using ESR in addition to age and TOA size as risk factors. IMPACT STATEMENT What is already known on this subject? For patients diagnosed with a tubo-ovarian abscess (TOA), the size of TOA and the patient’s age are helpful for early identification of patients who are likely to need surgical treatment. Inflammatory markers such as C-reactive protein and white blood cell are also associated with the risk of surgical intervention. What do the results of this study add? Erythrocyte sedimentation rate (ESR) in addition to the size of TOA and the patient’s age is a useful marker in determining whether to undergo surgery in patients with TOA. What are the implications of these findings for clinical practice and/or further research? ESR combined with the patient’s age and the size of TOA is clinically useful in predicting the need for early surgical intervention in patients with TOA. Large prospective controlled studies are required to establish relationship between inflammatory markers and the risk of surgical intervention.

Highlights

Pelvic inflammatory disease (PID) causes inflammation in the uterus, ovaries, fallopian tubes, and adjacent pelvic organs including bowel [1]
Surgical intervention is needed in approximately 30% of Tubo-ovarian abscesses (TOAs) patients who do not respond to antibiotics or whose abscesses rupture
Surgical intervention can reduce morbidity and mortality in TOA patients who do not respond to antibiotics

Summary

Introduction

Pelvic inflammatory disease (PID) causes inflammation in the uterus, ovaries, fallopian tubes, and adjacent pelvic organs including bowel [1]. Surgical intervention is needed in approximately 30% of TOA patients who do not respond to antibiotics or whose abscesses rupture. In patients diagnosed with TOA, prediction of antibiotic treatment failure may help in the early identification of patients with a high likelihood of needing surgical treatment. The prediction of antibiotic treatment failure is helpful to identify patients with a high likelihood of needing surgical treatment early in patients diagnosed with tubo-ovarian abscess (TOA). The aim of this study was to compare the clinical characteristics of patients with TOA) who responded to medical treatment and those who underwent surgical intervention due to medical treatment failure. Conclusions: The risk of needing surgical intervention in TOA patients can be predicted using ESR in addition to age and TOA size as risk factors

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