Prognosis Predictors of Pelvic Inflammatory Disease among the Hospitalized Patients

Introduction: Serious reproductive health consequences linked to pelvic inflammatory disease (PID) include infertility and ectopic pregnancy. Thus, it is important to identify patients likely to have a poor prognosis in choosing the best initial treatment. The aim of our study was to identify the valuable prognosis predictors of PID among the hospitalized patients and determined cut off values of quantitative independent prognosis predictors. Material and methods: Hospital records for women hospitalized with PID were retrospectively examined. The PID patients were divided into two sub-groups according to their clinical outcome. Prognostic factors were evaluated by T-test, χ2-test, and logistic regression analysis. The cut-off values of age, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and ESR combined with CRP were calculated by receiver-operator curve analysis. Results: Independent prognosis predictors of PID were advanced age (OR=1.031, 95% CI=1.002-1.062; P=0.036), elevated ESR (OR=1.029, 95% CI=1.013-1.046; P<0.001), increased CRP (OR=1.096, 95% CI=1.027- 1.169; P=0.006), and presence of endometriosis (OR=5.700, 95% CI=1.123-28.943; P=0.025). The cut-off values of age, ESR, CRP, and ESR combined with CRP were 35 years, 30.5 mm/hr, 7.0 mg/dL, and 25 mm/hr and 6.5 mg/ dL respectively. Conclusions: The initial treatment of patients who are elderly, and/or who have endometriosis, elevated ESR, or increased CRP should be carefully decided. Evaluation of ESR together with CRP is recommended to gain a more accurate prediction of disease outcome.