The usefulness of serum procalcitonin levels in predicting surgical intervention in patients with tubo-ovarian abscess

Abstract

Objective: Pelvic inflammatory disease is one of the most common gynecological diseases, and 15% of cases are accompanied by tubal-ovarian abscesses. The aim of this study was to evaluate the usefulness of abscess mass size, serum procalcitonin, and other biochemical markers in patients with tubo-ovarian abscesses in predicting surgical intervention.

Methods: This case-control study included 113 women who were diagnosed with tubo-ovarian abscess, hospitalized, and started on antibiotic treatment. Demographic characteristics, biochemical markers, ultrasound findings, and length of hospital stay were recorded during medical treatment.

Result: In terms of demographic characteristics, there was no significant difference between cases requiring complete recovery with medical treatment and cases requiring surgery for complete recovery. While serum cancer antigen 125 level was not statistically significant, there was a significant difference among biochemical markers: serum white blood cell level (18,007.0±6,406.3; p=0.001), C-reactive protein level (261.2±122.2; p<0.001), procalcitonin level (0.88±0.46; p<0.001), and abscess mass size (6.1±1.2; p<0.001) in cases that required surgery for full recovery. The highest sensitivity variable predicting surgical intervention in tubo-ovarian abscess patients was abscess mass size (cut-off value>5.25 cm and area under the curve 0.768) with a sensitivity of 72.2%. The second highest sensitivity variant, procalcitonin (cut-off value>0.635 ng/mL and area under the curve 0.756), showed a sensitivity of 70.4%.

Conclusion: Although procalcitonin provides information about the severity of the disease in patients with tubo-ovarian abscesses, evaluation of the abscess mass size along with its size was useful in deciding surgical intervention.