Can the Risk Factors Predicting Surgical Treatment be Determined in Patients with Tubo-Ovarian Abscess?

OBJECTIVES: In this study, we aimed to determine the risk factors in predicting the need for surgical treatment due to medical treatment failure in patients with tubo-ovarian abscess. STUDY DESIGN: This is a retrospective cohort study performed in a university hospital between 2015 and 2020. Sixt...

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Main Authors: Tayfun Vural, Burak Bayraktar, Suna Yildirim Karaca, Emir Gurbuz, Mehmet Ozeren, Cuneyt Eftal Taner
Format: Article
Language:English
Published: Medical Network 2023-03-01
Series:Gynecology Obstetrics & Reproductive Medicine
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Online Access:https://gorm.com.tr/index.php/GORM/article/view/1325
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author Tayfun Vural
Burak Bayraktar
Suna Yildirim Karaca
Emir Gurbuz
Mehmet Ozeren
Cuneyt Eftal Taner
author_facet Tayfun Vural
Burak Bayraktar
Suna Yildirim Karaca
Emir Gurbuz
Mehmet Ozeren
Cuneyt Eftal Taner
author_sort Tayfun Vural
collection DOAJ
description OBJECTIVES: In this study, we aimed to determine the risk factors in predicting the need for surgical treatment due to medical treatment failure in patients with tubo-ovarian abscess. STUDY DESIGN: This is a retrospective cohort study performed in a university hospital between 2015 and 2020. Sixty-nine patients with tubo-ovarian abscess were treated with parenteral antibiotics. Some of them required surgery because antibiotic treatment was not successful. We compared the group in which parenteral antibiotic treatment was successful with the group that required surgical treatment. The conservative treatment group consisted of 43 (62.3%) patients who responded to antibiotic therapy alone (gentamicin-clindamycin), and the operation group consisted of 26 women (37.7%) who did not reply to antibiotic therapy and required operation. Demographic, clinical, sonographic, and laboratory results were compared between the two groups using univariate and logistic regression analyses. RESULTS: Overall, up to 37.7% (26/69) of the patients underwent surgery after failure of antibiotic therapy. Patients who failed antibiotic therapy had higher infection parameters such as C-reactive protein (205±109 mg/dL vs. 115 ± 90 mg/dL, p=0.002), platelet count (349 ± 108 x 103/mm3 vs. 298 ± 95 x 103/mm3, p=0.042), and neutrophil-to-lymphocyte ratio (18.8 ± 35.7 vs. 8.2 ± 6.9, p=0.022). Also in the same group, larger tubo-ovarian abscess size (61.6±16.6 mm vs 45.8 ± 10.3 mm, p<0.001) and more frequent intrauterine device use (46.2% vs 16.3%, p=0.007) were observed. But none of them (C-reactive protein, neutrophil-to-lymphocyte ratio, tubo-ovarian abscess size, presence of an intrauterine device) was found to be a significant independent factor in anticipating conservative treatment failure of tubo-ovarian abscess in logistic regression analysis. CONCLUSION: Although helpful in diagnosis, none of the demographic, sonographic, or laboratory parameters can predict surgical treatment in women with tubo-ovarian abscess.
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publishDate 2023-03-01
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series Gynecology Obstetrics & Reproductive Medicine
spelling doaj-art-f8d72cb0b14d4b35a35412b6dcfa253e2025-02-11T21:16:46ZengMedical NetworkGynecology Obstetrics & Reproductive Medicine1300-47512602-49182023-03-0129110.21613/GORM.2022.1325Can the Risk Factors Predicting Surgical Treatment be Determined in Patients with Tubo-Ovarian Abscess?Tayfun Vural0Burak Bayraktar1Suna Yildirim Karaca2Emir Gurbuz3Mehmet Ozeren4Cuneyt Eftal Taner5Department of Obstetrics and Gynecology, University of Health Sciences Tepecik Training and Research Hospital, TurkeyDepartment of Obstetrics and Gynecology, University of Health Sciences Tepecik Training and Research HospitalDepartment of Obstetrics and Gynecology, University of Health Sciences Tepecik Training and Research Hospital, TurkeyDepartment of Obstetrics and Gynecology, University of Health Sciences Tepecik Training and Research Hospital, TurkeyDepartment of Obstetrics and Gynecology, University of Health Sciences Tepecik Training and Research Hospital, TurkeyDepartment of Obstetrics and Gynecology, University of Health Sciences Tepecik Training and Research Hospital, Turkey OBJECTIVES: In this study, we aimed to determine the risk factors in predicting the need for surgical treatment due to medical treatment failure in patients with tubo-ovarian abscess. STUDY DESIGN: This is a retrospective cohort study performed in a university hospital between 2015 and 2020. Sixty-nine patients with tubo-ovarian abscess were treated with parenteral antibiotics. Some of them required surgery because antibiotic treatment was not successful. We compared the group in which parenteral antibiotic treatment was successful with the group that required surgical treatment. The conservative treatment group consisted of 43 (62.3%) patients who responded to antibiotic therapy alone (gentamicin-clindamycin), and the operation group consisted of 26 women (37.7%) who did not reply to antibiotic therapy and required operation. Demographic, clinical, sonographic, and laboratory results were compared between the two groups using univariate and logistic regression analyses. RESULTS: Overall, up to 37.7% (26/69) of the patients underwent surgery after failure of antibiotic therapy. Patients who failed antibiotic therapy had higher infection parameters such as C-reactive protein (205±109 mg/dL vs. 115 ± 90 mg/dL, p=0.002), platelet count (349 ± 108 x 103/mm3 vs. 298 ± 95 x 103/mm3, p=0.042), and neutrophil-to-lymphocyte ratio (18.8 ± 35.7 vs. 8.2 ± 6.9, p=0.022). Also in the same group, larger tubo-ovarian abscess size (61.6±16.6 mm vs 45.8 ± 10.3 mm, p<0.001) and more frequent intrauterine device use (46.2% vs 16.3%, p=0.007) were observed. But none of them (C-reactive protein, neutrophil-to-lymphocyte ratio, tubo-ovarian abscess size, presence of an intrauterine device) was found to be a significant independent factor in anticipating conservative treatment failure of tubo-ovarian abscess in logistic regression analysis. CONCLUSION: Although helpful in diagnosis, none of the demographic, sonographic, or laboratory parameters can predict surgical treatment in women with tubo-ovarian abscess. https://gorm.com.tr/index.php/GORM/article/view/1325Conservative treatmentC-reactive protein Neutrophil to lymphocyte ratio Pelvic inflammatory disease Surgery Tubo-ovarian abscess
spellingShingle Tayfun Vural
Burak Bayraktar
Suna Yildirim Karaca
Emir Gurbuz
Mehmet Ozeren
Cuneyt Eftal Taner
Can the Risk Factors Predicting Surgical Treatment be Determined in Patients with Tubo-Ovarian Abscess?
Gynecology Obstetrics & Reproductive Medicine
Conservative treatment
C-reactive protein
Neutrophil to lymphocyte ratio
Pelvic inflammatory disease
Surgery
Tubo-ovarian abscess
title Can the Risk Factors Predicting Surgical Treatment be Determined in Patients with Tubo-Ovarian Abscess?
title_full Can the Risk Factors Predicting Surgical Treatment be Determined in Patients with Tubo-Ovarian Abscess?
title_fullStr Can the Risk Factors Predicting Surgical Treatment be Determined in Patients with Tubo-Ovarian Abscess?
title_full_unstemmed Can the Risk Factors Predicting Surgical Treatment be Determined in Patients with Tubo-Ovarian Abscess?
title_short Can the Risk Factors Predicting Surgical Treatment be Determined in Patients with Tubo-Ovarian Abscess?
title_sort can the risk factors predicting surgical treatment be determined in patients with tubo ovarian abscess
topic Conservative treatment
C-reactive protein
Neutrophil to lymphocyte ratio
Pelvic inflammatory disease
Surgery
Tubo-ovarian abscess
url https://gorm.com.tr/index.php/GORM/article/view/1325
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