Huanhao Zhou1, Xiaojiao Ruan1, Xia Shao1, Xiaming Huang1, Guan Fang1, Xiaofeng Zheng2. 1. Department of General Surgery, The First Affiliated Hospital of Wenzhou Medical University, 2 Fuxue Lane, Wenzhou, 325000, Zhejiang, China. 2. Department of General Surgery, The First Affiliated Hospital of Wenzhou Medical University, 2 Fuxue Lane, Wenzhou, 325000, Zhejiang, China. Electronic address: xfzheng0577@126.com.
Abstract
BACKGROUND: Diagnosis of incarcerated inguinal hernia (IIH) is not difficult, but currently, there are no diagnostic criteria that can be used to differentiate it from strangulated inguinal hernia (SIH). This research aimed to evaluate the clinical value of the neutrophil/lymphocyte ratio (NLR) in diagnosing SIH. METHODS: We retrospectively analyzed 263 patients with IIH who had undergone emergency operation. The patients were divided into two groups according to IIH severity: group A, patients with pure IIH validated during operation as having no bowel ischemia; group B, patients with SIH validated during operation as having obvious bowel ischemia, including bowel necrosis. We statistically evaluated the relation between several clinical features and SIH. The accuracy of different indices was then evaluated and compared using receiver operating characteristic (ROC) curve analyses, and the corresponding cutoff values were calculated. RESULT: Univariate analysis showed eight clinical features that were significantly different between the two groups. They were then subjected to multivariate analysis, which showed that the NLR, type of hernia, and incarcerated organ were significantly related to SIH. ROC curve analysis showed that the NLR had the largest area under the ROC curve. CONCLUSION: Among the different clinical features, the NLR appears to be the best index in diagnosing SIH.
BACKGROUND: Diagnosis of incarcerated inguinal hernia (IIH) is not difficult, but currently, there are no diagnostic criteria that can be used to differentiate it from strangulated inguinal hernia (SIH). This research aimed to evaluate the clinical value of the neutrophil/lymphocyte ratio (NLR) in diagnosing SIH. METHODS: We retrospectively analyzed 263 patients with IIH who had undergone emergency operation. The patients were divided into two groups according to IIH severity: group A, patients with pure IIH validated during operation as having no bowel ischemia; group B, patients with SIH validated during operation as having obvious bowel ischemia, including bowel necrosis. We statistically evaluated the relation between several clinical features and SIH. The accuracy of different indices was then evaluated and compared using receiver operating characteristic (ROC) curve analyses, and the corresponding cutoff values were calculated. RESULT: Univariate analysis showed eight clinical features that were significantly different between the two groups. They were then subjected to multivariate analysis, which showed that the NLR, type of hernia, and incarcerated organ were significantly related to SIH. ROC curve analysis showed that the NLR had the largest area under the ROC curve. CONCLUSION: Among the different clinical features, the NLR appears to be the best index in diagnosing SIH.
Authors: Caroline J Rieser; Esmaeel R Dadashzadeh; Robert M Handzel; Kadie J Clancy; Christof T Kaltenmeier; J B Moses; Raquel M Forsythe; Shandong Wu; Matthew R Rosengart Journal: J Trauma Acute Care Surg Date: 2021-03-01 Impact factor: 3.697
Authors: Lauren V Huckaby; Esmaeel Reza Dadashzadeh; Robert Handzel; Alexa Kacin; Matthew R Rosengart; Dirk J van der Windt Journal: J Am Coll Surg Date: 2020-08-19 Impact factor: 6.532