title: Clinical value of the neutrophil/lymphocyte ratio in diagnosing adult strangulated inguinal hernia.
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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  Among the different clinical features, the NLR appears to be the best index in diagnosing SIH.
authors: Department of General Surgery, The First Affiliated Hospital of Wenzhou Medical University, 2 Fuxue Lane, Wenzhou, 325000, Zhejiang, China.
authors: Huanhao
authors: H
authors: Zhou
authors: Department of General Surgery, The First Affiliated Hospital of Wenzhou Medical University, 2 Fuxue Lane, Wenzhou, 325000, Zhejiang, China.
authors: Xiaojiao
authors: X
authors: Ruan
authors: Department of General Surgery, The First Affiliated Hospital of Wenzhou Medical University, 2 Fuxue Lane, Wenzhou, 325000, Zhejiang, China.
authors: Xia
authors: X
authors: Shao
authors: Department of General Surgery, The First Affiliated Hospital of Wenzhou Medical University, 2 Fuxue Lane, Wenzhou, 325000, Zhejiang, China.
authors: Xiaming
authors: X
authors: Huang
authors: Department of General Surgery, The First Affiliated Hospital of Wenzhou Medical University, 2 Fuxue Lane, Wenzhou, 325000, Zhejiang, China.
authors: Guan
authors: G
authors: Fang
authors: Department of General Surgery, The First Affiliated Hospital of Wenzhou Medical University, 2 Fuxue Lane, Wenzhou, 325000, Zhejiang, China. Electronic address: xfzheng0577@126.com.
authors: Xiaofeng
authors: X
authors: Zheng
mesh_terms: D000368:Aged; D005260:Female; D006552:Hernia, Inguinal / Q000097:blood* / Q000473:pathology* / Q000601:surgery; D006801:Humans; D007422:Intestines / Q000098:blood supply* / Q000473:pathology; D007511:Ischemia / Q000097:blood* / Q000175:diagnosis*; D007958:Leukocyte Count; D008214:Lymphocytes; D008297:Male; D008875:Middle Aged; D009504:Neutrophils; D012372:ROC Curve; D012189:Retrospective Studies
keywords: Diagnose; Inguinal hernia; Neutrophil/lymphocyte ratio; Strangulated hernia