Background: Systemic inflammatory indices such as the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and systemic immune inflammation index (SII) have been increasingly investigated as inexpensive biomarkers in various inflammatory and thrombotic conditions. However, their clinical utility in thrombosed hemorrhoids remains poorly defined. This study aimed to evaluate the diagnostic and predictive performance of NLR, PLR and SII in a real-world cohort of patients with hemorrhoidal disease. Methods: We conducted a retrospective observational study including 120 consecutive adult patients admitted with hemorrhoidal disease between January 2020 and December 2024. Systemic inflammatory indices were calculated from admission blood tests. Comparative analyses, receiver operating characteristic (ROC) curves, tertile trend assessment, and univariate and multivariable logistic regression models were used to evaluate the association between inflammatory indices and thrombosed hemorrhoids. Results: Thrombosed hemorrhoids were identified in 55.8% of patients. Median values of NLR, PLR and SII did not differ significantly between thrombosed and non-thrombosed cases (all p > 0.05). ROC analysis demonstrated poor discriminatory performance (AUC: 0.52 for NLR, 0.55 for PLR, and 0.51 for SII). In multivariable analysis adjusted for age, sex and bleeding status, none of the inflammatory indices were independently associated with thrombosed hemorrhoids (all p > 0.05). No significant trends were observed across NLR tertiles. Conclusions: In this real-world cohort, systemic inflammatory indices showed limited diagnostic and predictive value for thrombosed hemorrhoids. These findings suggest that routine inflammatory ratios provide minimal incremental benefit beyond standard clinical assessment in this predominantly localized benign anorectal condition. Further prospective multicenter studies exploring dynamic and tissue-level biomarkers are warranted.
Vasile et al. (Tue,) studied this question.