Utilizing of the Lymphocyte/CRP Ratio as a Predictor of Ischemia in Acute Incarcerated Hernias

ÖzObjective: This study aimed to evaluate the lymphocyte-to-[C-reactive protein (CRP)] (LCR) ratio as a potential biomarker for predicting ischemia in patients with acute incarcerated hernias (AIH) and its role in determining the need for bowel resection.Methods: A retrospective analysis was conducted on 132 patients with AIH who presented to the Ege University Department of Emergency between January 2020 and January 2022.Clinical data, laboratory values (including leukocyte and lymphocyte counts, CRP, and LCR), and imaging results were collected.Patients were divided into two groups: those who underwent bowel resection (n=37) and those who did not (n=95).Relevant parameters were compared between the groups, and receiver operating characteristic (ROC) analysis was performed to assess the predictive value of LCR for ischemia.Results: The study found that LCR was significantly lower in patients who required bowel resection (p<0.001).The ROC curve analysis showed that LCR had an area under the curve of 70.1%, with a sensitivity of 91.6% and specificity of 78.4%.A cut-off value of 0.0409 was identified, with patients above this threshold showing a lower likelihood of requiring resection (p<0.001).Mortality was also higher in the low LCR group (p<0.001). Conclusion:The LCR was found to be a significant and reliable predictor of ischemia in AIH.LCR can be used as a simple, cost-effective biomarker to assist in clinical decision-making, particularly in predicting the need for resection and improving patient outcomes.Further studies are recommended to validate these findings.