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Predicting acute pelvic inflammatory disease: a multivariate analysis.

A Hadgu, L Westrom, C A Brooks

    American Journal of Obstetrics and Gynecology
    |November 1, 1986
    PubMed
    Summary
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    Clinical findings can accurately predict acute pelvic inflammatory disease (PID), reducing the need for invasive laparoscopy. This study identifies key symptoms and lab results for diagnosing PID effectively.

    Area of Science:

    • Gynecology
    • Infectious Diseases
    • Epidemiology

    Background:

    • Acute pelvic inflammatory disease (PID) is a significant gynecological infection.
    • Accurate diagnosis is crucial for effective treatment and preventing long-term complications.
    • Laparoscopy is the gold standard but is invasive and costly.

    Purpose of the Study:

    • To develop a predictive model for acute pelvic inflammatory disease (PID) using clinical and laboratory findings.
    • To evaluate the effectiveness of simple clinical parameters in diagnosing PID.
    • To identify women who would most benefit from diagnostic laparoscopy.

    Main Methods:

    • Multivariate logistic regression analysis of data from 628 women with clinically diagnosed PID.
    • Development of a mathematical model incorporating symptoms, signs, and laboratory results.

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  • Creation of "mixed model I" and "mixed model II" combining clinical data with laparoscopy.

    • Main Results:

    • The developed mathematical model correctly predicted 87.0% of PID cases with an overall classification rate of 75.6%.
    • Key predictors included purulent vaginal discharge, elevated erythrocyte sedimentation rate (ESR), positive gonorrhea tests, adnexal swelling, and fever (rectal temperature ≥38°C).
    • Mixed Model II demonstrated high sensitivity (100%) and specificity (67.2%), with an overall classification of 89.2%.

    Conclusions:

    • Simple, reproducible clinical parameters can effectively predict acute pelvic inflammatory disease (PID).
    • These clinical findings can help identify patients who would benefit most from diagnostic laparoscopy.
    • The study supports a more targeted approach to PID diagnosis, potentially reducing unnecessary invasive procedures.