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Neutrophil-to-Lymphocyte Ratio Predicts the Severity of Incarcerated Groin Hernia

Xingming Xie, Shu Feng, Zhongling Tang, Longyu Chen, Yongsheng Huang, Xianzhi Yang

Department of Gastrointestinal Surgery, The First People’s Hospital of Zunyi and Third Affiliated Hospital of Zunyi Medical College, Zunyi, Guizhou, China (mainland)

Med Sci Monit 2017; 23:5558-5563

DOI: 10.12659/MSM.905728

Available online:

Published: 2017-11-22


BACKGROUND: The incarceration of a segment of bowel within a groin hernia can result in intestinal strangulation if hernia treatment is delayed. Once intestinal strangulation occurs, a bowel resection may be required, and there is an overall increased risk for postoperative complications. The aim of this study was to identify biomarkers to predict the severity of an incarcerated groin hernia.
MATERIAL AND METHODS: We retrospectively evaluated the records of 95 patients with incarcerated groin hernias who underwent emergency surgical correction of the hernias. The need for a bowel resection was regarded as an indicator of severity in incarcerated groin hernia patients. The patients were divided into 2 groups: patients with bowel resection surgery and patients without bowel resection surgery.
RESULTS: We discovered that leukocyte count (leukocyte count ≥10×10³/mm³), neutrophil-to-lymphocyte ratio (NLR, NLR ≥11.5), presentation of bowel obstruction, and duration of incarceration (duration of incarceration ≥26 h) were significantly associated with bowel resection in incarcerated groin hernia patients by using the chi-square test. Factors such as leukocyte count, NLR, presentation of bowel obstruction, and duration of incarceration were analyzed using multivariate logistic regression analysis. We found that NLR, presentation of bowel obstruction, and duration of incarceration were independently and significantly related to bowel resection in incarcerated groin hernia patients.
CONCLUSIONS: An elevated NLR can serve as a biomarker for the prediction of severity of incarcerated groin hernias. Additionally, incarcerated groin hernia patients who present with bowel obstruction or with duration of intestinal incarceration longer than 26 h have an increased risk for bowel resection.

Keywords: general surgery, Hernia, Lymphocytes, Neutrophils



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