title: Hospitalisations for pelvic inflammatory disease temporally related to a diagnosis of Chlamydia or gonorrhoea: a retrospective cohort study.
abstract: OBJECTIVE
  The presence and severity of pelvic inflammatory disease (PID) symptoms are thought to vary by microbiological etiology but there is limited empirical evidence. We sought to estimate and compare the rates of hospitalisation for PID temporally related to diagnoses of gonorrhoea and chlamydia.
  
  
  METHODS
  All women, aged 15-45 years in the Australian state of New South Wales (NSW), with a diagnosis of chlamydia or gonorrhoea between 01/07/2000 and 31/12/2008 were followed by record linkage for up to one year after their chlamydia or gonorrhoea diagnosis for hospitalisations for PID. Standardised incidence ratios compared the incidence of PID hospitalisations to the age-equivalent NSW population.
  
  
  RESULTS
  A total of 38,193 women had a chlamydia diagnosis, of which 483 were hospitalised for PID; incidence rate (IR) 13.9 per 1000 person-years of follow-up (PYFU) (95%CI 12.6-15.1). In contrast, 1015 had a gonorrhoea diagnosis, of which 45 were hospitalised for PID (IR 50.8 per 1000 PYFU, 95%CI 36.0-65.6). The annual incidence of PID hospitalisation temporally related to a chlamydia or gonorrhoea diagnosis was 27.0 (95%CI 24.4-29.8) and 96.6 (95%CI 64.7-138.8) times greater, respectively, than the age-equivalent NSW female population. Younger age, socio-economic disadvantage, having a diagnosis prior to 2005 and having a prior birth were also associated with being hospitalised for PID.
  
  
  CONCLUSIONS
  Chlamydia and gonorrhoea are both associated with large increases in the risk of PID hospitalisation. Our data suggest the risk of PID hospitalisation is much higher for gonorrhoea than chlamydia; however, further research is needed to confirm this finding.
authors.affiliation: The Kirby Institute, UNSW Australia, Sydney, Australia.
authors.forename: Joanne
authors.initials: J
authors.lastname: Reekie
authors.affiliation: The Kirby Institute, UNSW Australia, Sydney, Australia; Sydney Sexual Health Centre, Sydney Hospital, Sydney, Australia.
authors.forename: Basil
authors.initials: B
authors.lastname: Donovan
authors.affiliation: The Kirby Institute, UNSW Australia, Sydney, Australia.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Guy
authors.affiliation: Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia.
authors.forename: Jane S
authors.initials: JS
authors.lastname: Hocking
authors.affiliation: Centre for Health Research, University of Western Sydney, Sydney, Australia.
authors.forename: Louisa
authors.initials: L
authors.lastname: Jorm
authors.affiliation: The Kirby Institute, UNSW Australia, Sydney, Australia.
authors.forename: John M
authors.initials: JM
authors.lastname: Kaldor
authors.affiliation: School of Medicine, University of Notre Dame, Fremantle, Australia.
authors.forename: Donna B
authors.initials: DB
authors.lastname: Mak
authors.affiliation: Centre for Health Services and Research, University of Western Australia, Crawley, Australia.
authors.forename: David
authors.initials: D
authors.lastname: Preen
authors.affiliation: Faculty of Pharmacy and School of Public Health, University of Sydney, Sydney, Australia.
authors.forename: Sallie
authors.initials: S
authors.lastname: Pearson
authors.affiliation: Kolling Institute of Medical Research, University of Sydney, Sydney, Australia.
authors.forename: Christine L
authors.initials: CL
authors.lastname: Roberts
authors.affiliation: Centre for Population Health Research, Curtin University, Perth, Australia.
authors.forename: Louise
authors.initials: L
authors.lastname: Stewart
authors.affiliation: The Kirby Institute, UNSW Australia, Sydney, Australia.
authors.forename: Handan
authors.initials: H
authors.lastname: Wand
authors.affiliation: The Kirby Institute, UNSW Australia, Sydney, Australia; Baker IDI, Alice Springs, Northern Territory, Australia.
authors.forename: James
authors.initials: J
authors.lastname: Ward
authors.affiliation: School of Public Health and Community Medicine, UNSW Australia, Sydney, Australia; The Sax Institute, Sydney, Australia.
authors.forename: Bette
authors.initials: B
authors.lastname: Liu
mesh_terms: D000328:Adult; D002690:Chlamydia Infections / Q000150:complications / Q000175:diagnosis*; D015331:Cohort Studies; D005260:Female; D006069:Gonorrhea / Q000150:complications / Q000175:diagnosis*; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008875:Middle Aged; D000292:Pelvic Inflammatory Disease / Q000150:complications / Q000628:therapy*; D012189:Retrospective Studies; D055815:Young Adult
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