The Role of Systemic Inflammatory Indices ( NLR , PLR , SII ) in Predicting the Response to Medical Treatment in Patients With Tubo‐Ovarian Abscess: A Retrospective Evaluation

ABSTRACT Objective This study aimed to evaluate the role of systemic inflammatory indices—including neutrophil‐to‐lymphocyte ratio (NLR), platelet‐to‐lymphocyte ratio (PLR), and systemic immune‐inflammation index (SII)—in predicting the response to medical treatment in patients diagnosed with tubo‐ovarian abscess (TOA). Methods This retrospective cross‐sectional study included 100 female patients aged ≥ 18 years diagnosed with TOA between January 2020 and April 2025 at İzmir Buca Seyfi Demirsoy Training and Research Hospital and Manisa City Hospital. Patients were divided into two groups: those who responded to medical treatment ( n = 50) and those who required surgical intervention after treatment failure ( n = 50). Demographic, clinical, laboratory (NLR, PLR, SII, CRP), and radiological data (abscess diameter) were analyzed. Statistical analyses were conducted using SPSS version 27.0, with p < 0.05 considered significant. Results There were no significant differences between the groups regarding NLR (4.92 ± 2.80 vs. 4.87 ± 4.53; p = 0.947), PLR (163.7 ± 93.2 vs. 160.5 ± 139.2; p = 0.893), and SII (1570 ± 1096 vs. 1657 ± 1647; p = 0.756). However, CRP levels (89.8 ± 51.1 vs. 125.9 ± 67.1; p = 0.003) and abscess diameter (41.4 ± 19.1 mm vs. 68.9 ± 18.7 mm; p < 0.001) were significantly higher in the surgical group. Conclusion NLR, PLR, and SII showed limited value in predicting treatment response in TOA patients. Elevated CRP levels and larger abscess diameter were significant predictors of surgical need. Considering these factors may guide more individualized treatment strategies.