Lymphocyte/CRP Levels in Emergency Operated Incarcerated Hernias for Predicting the Level of Ischemia

Background A hernia is defined as a protrusion, bulge, or projection of an organ or a part of an organ through the body wall. Incarcerated or strangulated hernias may present with nausea, vomiting or abdominal pain and emergency surgery may be required. Method In our study, 132 patients admitted to the emergency department for incarcerated hernia between the year 2020 and 2022 were retrospectively evaluated. Patients were divided into two groups according to the need for resection; demographic data, WBC, LDH, lactate and Lymphocyte/CRP (L/C) ratios that may be predictive for ischaemia were evaluated. Results The mean age of the patients was 67.37 ± 14.52 years, 70 (53%) were male and 62 (47%) were female.47 (35.6%) were operated for incisional hernia; 19 (14.4%) for umbilical hernia, 56 (42.4%) for inguinal hernia and 10 (7.6%) for femoral hernia. Resection was performed in 37 patients (28%); 29 (22%) of them had intestinal resection and 8 (6.1%) had colon resection. Patients were divided into two groups according to resection; no difference was found in WBC, LDH and lactate levels. The mean L/C ratio was 0.30 ± 0.74 in the resection group and 1.43 ± 3.66 in the non-resection group (p <0.001). The L/C ratio was evaluated by ROC analysis. Area under the curve was 70.1% [0.595–0.797]. Cut-off value was calculated and found as 0.0409. Patients were divided into two groups according to cut-off value, it was founded that resection was performed in patients with lower L/C ratio (p <0.001). Conclusion In our study, it was statistically shown that the need for resection decreased as the L/C ratio increased. The L/C ratio can be used as a simple, effective and inexpensive method to predict ischaemia in incarcerated hernias.