Tubo-ovarian abscess (TOA) is a serious complication of pelvic inflammatory disease (PID) reported in 34% of patients. Obesity is a concern among women of all ages and has been shown to adversely affect healthcare outcomes. We compared PID infections in women with BMI > 30 and < 30 admitted for the treatment of PID to determine how obesity impacts PID.METHODS:
A retrospective study was performed on patients admitted with PID (ages 18-40) between January 2010 and July 2017. Patients were stratified into BMI ≥30 vs. BMI <30. Data reviewed included diagnosis, past medical history, length of stay, readmissions and procedural interventions.RESULTS:
72 patients met inclusion criteria. Thirty-eight patients had BMI > 30 and 34 patients had a BMI < 30. Women with a BMI > 30 had a higher incidence of TOA (65.8% v. 38.2%); greater number of procedures (50% v. 14.7%) and a greater length of hospital stay (6.9 ± 5.1 v. 4.0 ± 1.9). Patients with BMI > 30 were less likely to use tobacco (28.9% v. 41.2%), less likely to be readmitted (15% vs 50%) and more likely to be diabetic (26.3% v. 2.9%).CONCLUSION:
BMI > 30 was associated with greater morbidity demonstrated by more severe PID infections with a greater incidence of TOAs, need for more invasive interventions and longer length of hospital stay. In women with BMI > 30, TOA was diagnosed twice as often than reported in the literature. Elevated BMI may be an additional risk factor to consider when treating women with PID.