Document Detail

Compliance after loop electrosurgical excision procedure or cold knife cone biopsy.
MedLine Citation:
PMID:  17766617     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To examine rates and predictors of compliance with follow-up recommendations in low-income women from a county hospital clinic undergoing loop electrosurgical excision procedure (LEEP) and cone knife cone biopsy. METHODS: A retrospective cohort study of 135 patients who underwent LEEP or cold knife cone biopsy was performed. Demographic data, results of cytology, colposcopy biopsy, excision specimen pathology, and indication for the LEEP or cold knife cone biopsy were collected. Compliance was determined by whether the patient adhered to the recommended follow-up within 1 year from the date of the procedure. Multivariable analysis was performed by using logistic regression. RESULTS: A total of 135 patients were included for analysis (81 LEEP and 54 cold knife cone cases). Type of procedure was significant in predicting compliance: 74.1% of cold knife cone patients were compliant compared with 43.2% of LEEP patients (adjusted relative risk 1.64, 95% confidence interval 1.30-1.87). There was a trend for older patients to be more compliant than younger patients in the univariable analyses but not in multivariable analysis. After adjusting for age, LEEP patients were still significantly less compliant than cold knife cone patients. Pathologic indication (severity of disease), race, payor source, and gravidity were not significant predictors of compliance and not included in the multivariable analysis. CONCLUSION: Compared with LEEP, cold knife cone patients were significantly more compliant with follow-up. Because LEEP is a less invasive in-office procedure, it may convey to patients the idea that their condition is less severe. LEVEL OF EVIDENCE: II.
David L Greenspan; Michelle Faubion; Dean V Coonrod; Kim Ward Hart; Kathleen Mathieson
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Obstetrics and gynecology     Volume:  110     ISSN:  0029-7844     ISO Abbreviation:  Obstet Gynecol     Publication Date:  2007 Sep 
Date Detail:
Created Date:  2007-09-03     Completed Date:  2007-10-02     Revised Date:  2009-10-26    
Medline Journal Info:
Nlm Unique ID:  0401101     Medline TA:  Obstet Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  675-80     Citation Subset:  AIM; IM    
Department of Obstetrics, Gynecology, Maricopa Integrated Health System, Phoenix, Arizona, USA.
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MeSH Terms
Age Factors
Aged, 80 and over
Ambulatory Surgical Procedures
Biopsy, Needle
Cervical Intraepithelial Neoplasia / diagnosis*,  pathology,  surgery
Cohort Studies
Conization / methods*
Cryosurgery / methods*
Electrosurgery / methods*
Follow-Up Studies
Logistic Models
Middle Aged
Multivariate Analysis
Neoplasm Staging
Patient Compliance*
Retrospective Studies
Severity of Illness Index
Uterine Cervical Neoplasms / diagnosis*,  pathology,  surgery

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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