A dynamic nomogram for predicting the need for invasive interventions in patients with tubo-ovarian abscess

Timely identification of tubo-ovarian abscess (TOA) patients who will fail antibiotic therapy is crucial for guiding early intervention. This study aimed to develop and validate a dynamic nomogram to predict the need for invasive intervention in TOA patients. In this retrospective cohort study of 167 TOA patients from a single center, multivariate logistic regression identified four independent predictors of antibiotic treatment failure: fever (OR = 3.117, 95% CI: 1.408–6.901), elevated C-reactive protein (OR = 1.007, 95% CI: 1.001–1.013), larger lesion diameter (OR = 1.349, 95% CI: 1.145–1.591), and poor ultrasonic transmission within the lesion (OR = 7.254, 95% CI: 2.943–17.881). A nomogram integrating these factors demonstrated good predictive performance, with an area under the receiver operating characteristic curve of 0.844 (95% CI: 0.785–0.903). The model showed good calibration and clinical utility in decision curve analysis. An online calculator was developed to facilitate clinical use. This dynamic nomogram provides a practical tool for individualized risk assessment and may aid in optimizing management strategies for TOA patients.