Clinical Predictors of Failed Medical Treatment in Patients with Tubo-Ovarian Abscess

Abstract Background: 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.Material and Methods: Electronic medical records were evaluated retrospectively to identify patients who were diagnosed with TOA and hospitalized in our obstetrics and gynecology department between March 2014 and June 2019. 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. Logistic regression was used to determine the independent predictors of treatment failure.Results: 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 = 0.001), ESR (p = 0.045), and failure of medical treatment. TOA diameter (p = 0.065) showed a borderline association with surgical intervention. The risk group was defined as the combination of factors producing a risk score > 2. The area under the curve (AUC) for the risk group (age >34.3 years, ESR > 45 mm/h, and TOA size > 5.9 cm) was 0.844. The sensitivity, specificity, accuracy, PPV, and NPV were 93.8%, 75%, 83.3%, 75%, and 93.8%, respectively.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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The prediction of surgical intervention in patients with tubo-ovarian abscess

10.21203/rs.2.23551/v1 ◽

2020 ◽

Author(s):

Jong Ha Hwang ◽

Bo Wook Kim

Keyword(s):

Treatment Failure ◽

Medical Treatment ◽

Surgical Intervention ◽

Risk Group ◽

Laboratory Data ◽

Intervention Group ◽

Area Under The Curve ◽

Wbc Count ◽

Sensitivity Specificity ◽

Ovarian Abscess

Abstract Background: 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. Material and Methods: Electronic medical records were evaluated retrospectively to identify patients who were diagnosed with TOA and hospitalized in our obstetrics and gynecology department between March 2014 and June 2019. 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. Logistic regression was used to determine the independent predictors of treatment failure. Results: 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 = 0.001), ESR ( p = 0.045), and failure of medical treatment. TOA diameter ( p = 0.065) showed a borderline association with surgical intervention. The risk group was defined as the combination of factors producing a risk score > 2. The area under the curve (AUC) for the risk group (age >34.3 years, ESR > 45 mm/h, and TOA size > 5.9 cm) was 0.844. The sensitivity, specificity, accuracy, PPV, and NPV were 93.8%, 75%, 83.3%, 75%, and 93.8%, respectively. 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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Do Pre-treatment Neutrophil/Lymphocyte and Platelet/Lymphocyte Ratios Predict Success of Medical Treatment in Patients with Tubo-ovarian Abscess?

Kocaeli Medical Journal ◽

10.5505/ktd.2018.65902 ◽

2018 ◽

Vol 7 (3) ◽

pp. 165-171

Author(s):

Fatma Aydın ◽

Alper Biler ◽

Cüneyt Eftal Taner ◽

İbrahim Egemen Ertaş

Keyword(s):

Medical Treatment ◽

Pre Treatment ◽

Ovarian Abscess

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Parents' Perception of Diagnostic Reports and Conferences

Language Speech and Hearing Services in Schools ◽

10.1044/0161-1461.1402.114 ◽

1983 ◽

Vol 14 (2) ◽

pp. 114-120 ◽

Cited By ~ 2

Author(s):

Betty U. Watson ◽

Ronald W. Thompson

Keyword(s):

Medical Treatment ◽

Diagnostic Information ◽

Learning Language ◽

Speech Learning ◽

Hearing Problems

The purpose of this study was to evaluate parents' reactions and understanding of diagnostic information from written reports and conferences in a clinic which provides multidisciplinary evaluations for children with speech, learning, language, and hearing problems. Previous studies and anecdotal reports suggested that many parents do not receive appropriate diagnostic information about their children. In the present study questionnaires were mailed to parents who had received reports of evaluations and most of whom had attended hour-long conferences covering the findings. Questionnaires were also sent to professionals who had received reports. Fifty-seven percent of the parents, and 63% of the professionals returned the questionnaires. Ninety percent of the parents indicated that they had understood the results as they were presented in the conference. Ninety-three percent of the professionals and 89% of the parents stated they understood the conclusions of the written reports .Further, 83% of the parents and 80% of the professionals reported that the findings had made a change in the child's educational or medical treatment. The percentage of parents who reported understanding the findings was greater than expected. The specific informing techniques used in this study are discussed.

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