Predictive factors for emergent surgical intervention in patients with ovarian endometrioma hospitalized for pelvic inflammatory disease: A retrospective observational study

Reiko Matsuyama, Akira Tsuchiya, Nishii O, Osamu Nishii
Journal of Obstetrics and Gynaecology Research · 2017 · vol. 44(2) , pp. 286–291 · doi:10.1111/jog.13513 · PMID:29171117 · W2768991957
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In patients with ovarian endometrioma hospitalized for pelvic inflammatory disease, a history of prior intrauterine or intrapelvic procedures and delayed antibiotic initiation predict the need for emergent surgical intervention.

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Abstract

AIM: The aim of this study was to identify predictive factors for emergent surgical interventions in patients with ovarian endometriomas hospitalized for pelvic inflammatory disease (PID). METHODS: We retrospectively identified 22 patients with ovarian endometriomas who were hospitalized to manage PID. Patients were divided into two groups: those who required emergent surgery after failed antibiotic therapy (emergent surgery group, n = 6) and those who were discharged with successful antibiotic therapy (conservative group, n = 16). Logistic regression analysis was performed to analyze the factors associated with emergent surgery. RESULTS: Patients in the emergent surgery group were significantly more likely to have intrauterine or intrapelvic procedures before the onset of PID compared to those in the conservative group (83% vs 38%, odds ratio 8.33, 95% confidence interval 1.02-181.3; P = 0.048). The mean interval between the onset of PID symptoms and the commencement of parenteral antibiotic therapy was significantly longer in the emergent surgery compared to the conservative group (6.5 vs 1 day, odds ratio 1.28, 95% confidence interval 1.01-1.75; P = 0.041). CONCLUSION: A history of an intrauterine or intrapelvic procedure before the onset of PID was more likely to result in emergent surgery. A longer interval between the onset of PID symptoms and the commencement of parenteral antibiotics was also associated with emergent surgery. These findings could help to identify patients with ovarian endometriomas hospitalized with PID at higher risk of emergent surgical intervention.

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Condition tags

endometriosisendometrioma

MeSH descriptors

Endometriosis Ovarian Diseases Pelvic Inflammatory Disease Adult Adult Endometriosis Endometriosis Female Female Humans Humans Middle Aged Middle Aged Ovarian Diseases Ovarian Diseases Pelvic Inflammatory Disease Pelvic Inflammatory Disease Prognosis Prognosis Retrospective Studies

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Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. Outer rings show 2-hop neighbours — papers reached through the immediate citers/citees. [ collapse to 1-hop ]

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