| Adnexal torsion: a predictive score for pre-operative diagnosis. | |
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MedLine Citation:
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PMID: 20605899 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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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Authors:
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Cyrille Huchon; Stéphanie Staraci; Arnaud Fauconnier |
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Publication Detail:
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Type: Journal Article; Validation Studies Date: 2010-07-06 |
Journal Detail:
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Title: Human reproduction (Oxford, England) Volume: 25 ISSN: 1460-2350 ISO Abbreviation: Hum. Reprod. Publication Date: 2010 Sep |
Date Detail:
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Created Date: 2010-08-18 Completed Date: 2010-12-22 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8701199 Medline TA: Hum Reprod Country: England |
Other Details:
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Languages: eng Pagination: 2276-80 Citation Subset: IM |
Affiliation:
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Department of Gynecology, Obstetrics, and Reproductive Medicine, Centre Hospitalier Intercommunal de Poissy Saint Germain en Laye, 10 rue du Champ Gaillard, F-78300 Poissy, France. cyrillehuchon@yahoo.fr |
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| MeSH Terms | |
Descriptor/Qualifier:
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Abdominal Pain
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etiology* Adnexal Diseases / diagnosis*, epidemiology, surgery Cohort Studies Female Humans Logistic Models Low Back Pain / etiology Ovarian Cysts / ultrasonography Predictive Value of Tests Prospective Studies ROC Curve Retrospective Studies Risk Factors Time Factors Torsion Abnormality / diagnosis*, epidemiology, surgery Triage / methods Vomiting |
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