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The effectiveness of neutrophil to lymphocyte ratio in prediction of medical treatment failure for tubo‐ovarian abscess
Author(s) -
Alay Ismail,
Kaya Cihan,
Karaca Ibrahim,
Eren Ecem,
Hosgoren Murat,
Aslanova Fidan,
Cengiz Huseyin,
Ekin Murat,
YaSar Levent
Publication year - 2019
Publication title -
journal of obstetrics and gynaecology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 50
eISSN - 1447-0756
pISSN - 1341-8076
DOI - 10.1111/jog.13946
Subject(s) - medicine , neutrophil to lymphocyte ratio , white blood cell , confidence interval , abscess , surgery , regimen , obstetrics and gynaecology , lymphocyte , gastroenterology , pregnancy , biology , genetics
Aim We aimed to compare the neutrophil‐to‐lymphocyte ratio (NLR) in tubo‐ovarian abscess (TOA) patients who responded to medical treatment or who underwent surgical intervention due to medical treatment failure. Methods The files of the patients, hospitalized in our Obstetrics and Gynecology Department with TOA diagnosis between August 2015 and December 2017, were evaluated retrospectively. The conservative management group was comprised of 38 of the 81 patients (46.9%) who responded to sole medical treatment with the triple antibiotic regimen (gentamicin‐clindamycin‐ampicillin) and the surgical intervention group was comprised of 43 patients (53.1%) who did not respond to medical treatment and needed further surgery and/or interventional radiologic abscess drainage. Demographic and clinical data, imaging findings, and laboratory results including NLR were compared between two groups. Results There were statistically significant differences between the groups in terms of age, TOA diameter, white blood cell and neutrophil counts, and NLR levels ( P < 0.05). The mean NLR was 7.4 ± 5.8 for the conservative management group and 10.3 ± 5.8 for the surgical intervention group ( P = 0.004). The area under the curve (AUC) for NLR was 0.69 (threshold value was ≥6.97, 95% confidence interval, sensitivity 79.1%, specificity 57.9%). On multiple regression analysis, a significant correlation was identified between age, NLR and resistance to the medical treatment. Conclusion Neutrophil‐to‐lymphocyte ratio and age are significantly higher in patients with medical treatment failure and NLR could be used as a novel marker in addition to white blood cell in the prediction of medical treatment failure in TOA patients.