Adnexal torsion: a predictive score for pre-operative diagnosis  

Oleh:

Huchon, Cyrille ; Staraci,Stephanie ; Fauconnier, Arnaud

Jenis: Article from Journal - ilmiah internasional
Dalam koleksi: Human Reproduction vol. 25 no. 09 (Sep. 2010), page 2276-2280.
Topik: * adnexal torsion * diagnostic model * jackknife procedure * ovarian cyst

Ketersediaan

Perpustakaan FK Nomor Panggil: H07.K.2010.03 Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

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BACKGROUND Adnexal torsion (AT) is difficult to diagnose and requires immediate surgery. The aim of this study was to develop a simple score for assisting in the pre-operative diagnosis of AT in women with acute pelvic pain. METHODS Using data from a retrospective cohort of 142 patients with acute pelvic pain, we developed a score based on multiple logistic regression after a jackknife procedure. We validated the score in a prospective cohort of 35 women with acute pelvic pain. RESULTS Five criteria were independently associated with AT confirmed by surgery: unilateral lumbar or abdominal pain [adjusted odds ratio (aOR), 4.1; 95% confidence interval (95% CI), 1.2–14.0]; pain duration <8 h at first presentation (aOR, 8.0; 95% CI, 1.7–37.5), vomiting (aOR, 7.9; 95% CI, 2.3–27.0), absence of leucorrhoea and metrorrhagia (aOR, 12.6; 95% CI, 2.3–67.6) and ovarian cyst larger than 5 cm by ultrasonography (aOR, 10.6; 95% CI, 2.9–38.8). The torsion score was based on these five criteria. Low-risk and high-risk groups were derived from values of the score [probability of AT, 3.7% (95% CI, 0–7.8) and 69% (95% CI, 53–84), respectively]. Application of these criteria to the prospective cohort confirmed the diagnostic accuracy of the score [probability of AT, 0% (95% CI, 0–16) and 75% (95% CI, 26–100) in the low-risk and high-risk groups, respectively]. CONCLUSIONS This easy-to-calculate score may prove useful for diagnosing AT in patients with acute pelvic pain seen at general or gynaecology emergency departments.

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