The role of systemic immune inflammation index in predicting treatment success in tuboovarian abscesses.

Abstract

The aim of this study was to determine the predictability of the systemic immune inflammation index (SII) on the response to medical treatment in tubo-ovarian abscess (TOA). 296 patients with TOA in a tertiary center were enrolled in the study. Patients were divided into two groups: Group1 (n = 165) included patients in whom medical treatment was successful, and Group2 (n = 131) included patients in whom surgery was required. Demographic, sonographic and laboratory findings were compared between groups. SII was calculated using peripheral blood parameters [SII = (platelets ∗ neutrophils)/lymphocytes]. Age, BMI, gravida, parity, smoking and menopausal status, CRP levels of patients were similar in both groups (p > 0.05). Mass size (4.398 ± 0.306 vs 7.683 ± 0.689, p < 0.001), white blood cell (WBC) (8685.08 ± 3981.98 vs 9994.35 ± 4468.024, p = 0.008), Hb (12.18 ± 1.65 vs 11.68 ± 1.65, p = 0.010), platelet to lymphocyte ratio (PLR) (151.26 ± 74.83 vs 230.77 ± 140.25, p < 0.001), neutrophil to lymphocyte ratio (NLR) (4.21 ± 3.27 vs 6.07 ± 6.6, p = 0.003), monocyte to lymphocyte ratio (MLR) (0.300 ± 0.177 vs 0.346 ± 0.203, p = 0.041) and SII (1014.18 ± 781.71 vs 2094.088 ± 2117.58, p < 0.001) were statistically higher in group 2. ROC Analysis was used to determine the predictability of the variables and PLR (AUC = 0.718, p < 0.001), NLR (AUC = 0.593, p = 0.593), MLR (AUC = 0.576, p = 0.024), SII (AUC = 0.723, p < 0.001) and size of mass (AUC = 0.670, p < 0.001) were found to be significant. The SII, size of mass and bilateral involvement of adnexa were found to be the strongest prognostic factors for surgical intervention (OR:1.004 (1.002-1.005), OR:1.018 (1.010-1.027), OR:3.397 (1.338-8.627); p < 0.001, p < 0.001, p = 0.010 resspectively). SII, size of mass and bilaterality can be used to predict medical treatment success in patients with TOA.