Abstract
Tubo-ovarian abscess (TOA) is an intra-abdominal infection that can cause mortality, involves other organs in the abdomen, and can cause many surgical complications. The aim of this study was to investigate the role of delta neutrophil index (DNI) and other inflammation markers in the prognosis of patients with TOA and in predicting adverse events in TOA surgery. This study is the first study on this subject in the literature. This study included 69 patients aged 18 to 65 years who underwent TOA surgery. The laboratory parameters examined were the preoperative white blood cell, neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), C-reactive protein (CRP), and DNI levels. Adverse events were defined as intraoperative complications, postoperative complications, intensive care unit (ICU) requirement, length of ICU stay, and length of hospital stay. The relationship between the laboratory parameters and adverse events was investigated. Receiver operating characteristic curves were used to determine the cutoff value for DNI levels to predict patients at high risk for intraoperative complications, postoperative complications, and length of ICU stay. NLR, PLR, DNI, and serum CRP levels were significantly higher in the intraoperative complication-positive group than in the complication-negative group (P < .05). However, only the DNI level was significantly higher in the postoperative complication-positive and ICU requirement positive groups than in the postoperative complication-negative and ICU requirement negative groups (P < .05). In addition, DNI levels were positively correlated with the length of ICU and hospital stays (P < .05). The optimal cutoff DNI levels for predicting intraoperative complication, postoperative complication, and ICU requirement were 2.0 (sensitivity = 100%, specificity = 82.3%), 1.6 (sensitivity = 80%, specificity = 82.9), and 1.2 (sensitivity = 65%, specificity = 60%), respectively. DNI is a promising noninvasive method for the prognosis and prediction of adverse events in TOA. It was more valuable than other markers (white blood cell, CRP, NLR, and PLR) in predicting adverse events in TOA prognosis.