Risk factors for adverse clinical outcomes in patients with tubo-ovarian abscess

Abstract

This study assessed the risk factors for poor clinical outcomes in patients with tubo-ovarian abscess (TOA). Patients managed with medical therapy and discharged within 7 days without complications constituted the favourable prognosis group (n = 22), whereas those who were managed surgically or discharged after 7 days of antibiotic therapy constituted the poor prognosis group (n = 87). Variables including age, gravidity, number of dilation and curettage procedures, caesarean delivery, smoking status, serum C-reactive protein levels, serum white blood count, body temperature, abscess diameter, presence of an intrauterine device (IUD), duration of IUD placement and length of hospitalisation were evaluated to assess their relationship with the clinical prognosis of TOA. Abscess diameter of ≥ 6 cm was a significant parameter that increased the risk eightfold for poor prognosis. No significant differences were observed regarding the other variables.

The evaluation of risk factors for failed response to conservative treatment in tubo-ovarian abscesses

“…In this study, they found the cut-off value for CRP and ESR levels as 6.7 mg/L and 50 mm/h, respectively (13). Unlike these studies, a significant difference was not observed in CRP levels and WBC count between the favorable or poor prognosis group in the study by Topçu et al (19). In our study, we found that there was no significant difference in CRP and ESR counts between the groups.…”

Comparison of Ultrasound-Guided Drainage with Other Available Treatment Modalities for, Treatment of Tubo-Ovarian Abscess

“…The highest reported body temperature in patients with TOA was 37.6 °C ±0.6 °C in a study by Karakulak et al, and 37.24 °C ±0.788 °C in a study by Topçu et al 6,14 In the present study, the average body temperature in patients with TOA was 37.4°C ±0.77 °C, which was similar to that reported in the previous studies.…”

“…Previous studies reported leukocyte counts and CRP levels of 11.500-16.000/mm 3 and 7.6-14 mg/dL, respectively, in patients undergoing medical treatment, and 14000-16700/mm 3 and 16.1-53.8 mg/dL, respectively, in patients undergoing surgical treatment, indicating that leukocyte counts and CRP levels of patients undergoing surgical treatment were higher than those of patients undergoing medical treatment. 7,12,[14][15][16] In the present study, the mean leukocyte count and CRP level of patients undergoing medical treatment were 11.850/mm 3 and 11.1 mg/dL, respectively, while those of patients undergoing surgical treatment were 13.780/mm 3 and 14.1 mg/dL, respectively, and those of patients undergoing USG-guided drainage were 14.870/mm 3 and 16.2 mg/dL, respectively. These findings indicated that leucocyte counts and CRP levels of patients undergoing surgical treatment were higher than those of patients undergoing medical treatment, which was consistent with that reported in previ- ous studies.…”

“…Mizushima et al reported that mean body temperatures of patients undergoing medical and surgical treatments were 37.6 °C ±0.85 °C and 37.5 °C ±0.9 °C, respectively. 14,15 In the present study, the mean body temperature of patients undergoing the medical treatment was 37.3 °C ±0.7 °C, that of patients undergoing the surgical treatment was 37.4 °C ±0.8°C…”

“…Topçu et al reported the mean abscess sizes of patients undergoing surgical and medical treatments to be 4.50 ±1.71 and 6.38 ±2.18 cm, respectively, while Mizushima et al reported sizes of 3.9 ±1.3 and 6.6 ±1.5 cm, respectively, Kuru et al reported sizes of 5.3 ±0.1 and 6.1 ±0.1 cm, respectively, and Soydinç et al reported sizes of 4.75 ±0.98 and 6.18 ±2.12 cm, respectively. [14][15][16][17] The mean abscess sizes of patients undergoing the surgical and medical treatments in our study were 6.6 ±2.6 and 8 ±3.3 cm, respectively. Previous studies demonstrated that surgical cure rate was higher than medical cure rate in patients, when the abscess sizes was based on 6, 7, and 8 cm.…”