When Should Gynecology Be Consulted to Manage a XXXX ? [301].

@entity1 @entity6068
INTRODUCTION: A variety of treatment approaches are available for @entity6068 . Many specialties are involved in their management, but criteria for early recognition of high-risk @entity1 and prompt referral guidelines do not exist. METHODS: A retrospective cohort of @entity6068 cases treated at a single, urban tertiary care center from 2011 to 2013 was identified. Analyses were completed on two groups: pediatric (younger than 18 years old) and adults (older than 18 years old). Univariate analyses examined @entity1 factors associated with length of stay. RESULTS: A total of 250 @entity1 with @entity6068 were identified. Of those, 54 (25%) were pediatric @entity1 with a mean age of 5 years (standard deviation [SD] 5.6), and 196 (75%) were adults with a mean age 43 years (SD 17.8, range 18-95 years). The prevalence of length of stay of 1 or more days was 57% (n=31) in the pediatric group, and the majority were managed with a surgical procedure (97.8% [53/54]) by nongynecologic surgeons (95.4%). In the adult population, the prevalence of length of stay of 1 or more days was 27% (n=53), and 74.4% (133/180) of adult @entity1 had operative procedures performed by a gynecologist. Characteristics that predicted length of stay of 1 or more days were two preoperative comorbidities for @entity1 (odds ratio [OR] 2.07, 95% confidence interval [CI] 1.59-3.37) and seven comorbidities for adult @entity1 (OR 4.9, 95% CI 6.64-8.00). An increasing trend between comorbidities and number of procedures performed was demonstrated (r=0.497, P=.01). CONCLUSION: This study identified a subset of high-risk @entity1 with @entity6068 who would benefit from earlier treatment and more specialized services and interventions.
