The effect of serum biomarkers on the requirement for surgical intervention in tuboovarian abscess

INTRODUCTION: Tubo-ovarian abscess (TOA) is a complex infectious mass of the adnexa, which is treated by antibiotherapy or surgery. Antibiotherapy failure may occur during TOA treatment. The aim of this study is to assess the effect of TOA size and serum biomarkers on the requirement for surgical intervention.
METHODS: Eighty-four patients over five years in our clinic were evaluated. TOA size and laboratory values such as hemoglobin, white blood cell count, lymphocyte, monocyte, platelet, albumin, neutrophil, C-reactive protein (CRP) levels, and if antibiotics were switched to another treatment protocol or changed to a surgical approach, were also reported. Prognostic Nutritional Index (PNI), the platelet-lymphocyte ratio (PLR), neutrophil-lymphocyte ratio (NLR), and monocyte-lymphocyte ratio (MLR) were also used to evaluate medical therapy failure and the requirement for surgery.
RESULTS: Eighty-four patients hospitalized with the diagnosis of TOA, 13 of them required surgery due to antibiotherapy failure and the surgical intervention rate was calculated as 15.47%. Platelet count and TOA size were found to be statistically significantly higher and hospital stay was found to be statistically significantly longer in the surgery group. CRP and other laboratory values did not have a statistically significant difference between groups. Among the indexes, only PLR had a statistically significant prediction value (p=0.020).
DISCUSSION AND CONCLUSION: TOA volume and PLR were found to be effective predictors in antibiotherapy failure and surgical intervention.