title: Factors that predict poor clinical course among patients hospitalized with pelvic inflammatory disease.
abstract: OBJECTIVE
  The aim of this study was to identify factors that can predict clinical course among patients hospitalized with pelvic inflammatory disease (PID).
  
  
  METHODS
  Ninety-three patients who needed hospitalization with a diagnosis of PID were retrospectively studied. Patients who were discharged within 7 days by conservative treatment were defined as favorable course cases (n = 44). Patients who needed more than 7 days of hospitalization and/or surgery were defined as poor course cases (n = 49). Twenty variables were evaluated by univariate and logistic regression analysis: age, history of pregnancy/delivery, gynecological open/laparoscopic surgery, PID, oral contraceptives/intrauterine device use and intrauterine operation before onset, body temperature, signs of peritoneal irritation, vomiting/diarrhea, abnormal vaginal discharge, endometriosis/fibroid/adenomyosis/any cystic lesion detected by ultrasonography, white blood cell counts/C-reactive protein (CRP) levels . The cut-off value was calculated by receiver-operator curve (ROC) analysis.
  
  
  RESULTS
  Factors associated with poor clinical course were advanced age (P < 0.01), history of gynecological open surgery (P < 0.05), any cystic lesion detected by ultrasonography (P < 0.05) and high CRP levels (P < 0.05). High CRP levels and intrauterine operation before onset were independently associated with poor clinical course. The cut-off value for CRP was 4.4 mg/dL.
  
  
  CONCLUSIONS
  This study identified variables that can predict poor clinical course of PID. These results can assist gynecologists with identifying patients at risk and optimizing the choice of management.
authors.affiliation: Department of Obstetrics and Gynecology, The University of Tokyo, Tokyo, Japan.
authors.forename: Miyoko
authors.initials: M
authors.lastname: Terao
authors.forename: Kaori
authors.initials: K
authors.lastname: Koga
authors.forename: Akihisa
authors.initials: A
authors.lastname: Fujimoto
authors.forename: Osamu
authors.initials: O
authors.lastname: Wada-Hiraike
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Osuga
authors.forename: Tetsu
authors.initials: T
authors.lastname: Yano
authors.forename: Shiro
authors.initials: S
authors.lastname: Kozuma
mesh_terms: D000328:Adult; D000367:Age Factors; D002097:C-Reactive Protein / Q000378:metabolism; D003560:Cysts / Q000150:complications / Q000000981:diagnostic imaging; D005260:Female; D013509:Gynecologic Surgical Procedures; D006801:Humans; D007902:Length of Stay; D008875:Middle Aged; D000292:Pelvic Inflammatory Disease / Q000097:blood / Q000150:complications / Q000628:therapy*; D011379:Prognosis; D012189:Retrospective Studies; D014463:Ultrasonography
chemical_list: D002097:C-Reactive Protein
keywords: C-reactive protein; pelvic inflammatory disease; risk factors; tubo-ovarian abscess; ultrasonography