Hematologic and Biochemical Markers in Predicting Bowel Resection for Incarcerated Hernias

This study aims to evaluate patient demographics and laboratory parameters that may aid in predicting the risk of bowel resection in incarcerated abdominal wall hernias. Additionally, it investigates independent risk factors associated with the need for bowel resection.

We retrospectively analyzed data from 709 patients, categorizing them into two groups: Group 1 (incarcerated hernia without strangulation, no bowel resection required) and Group 2 (incarcerated hernia with strangulation, requiring bowel resection). We collected data on age, gender, BMI, hernia type, comorbidities, bowel obstruction status, preoperative blood tests (including complete blood count and biochemistry), operative time, hospital stay, and mesh use. We specifically examined white blood cell (WBC) count, C-reactive protein (CRP), lactate dehydrogenase (LDH), and lactate levels. Additionally, we calculated the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammatory index (SII), and hematological immune-inflammatory index (HII).

Of the 709 patients, 624 (88%) were in Group 1, and 85 (12%) were in Group 2. Advanced age, elevated WBC, CRP, NLR, PLR, SII, and LDH values were significantly associated with bowel resection (p < 0.005). Multivariate logistic regression analysis identified lactate levels (OR = 22.252, 95% CI: 9.550-51.849, p < 0.001), presence of femoral hernia (OR = 3.515, 95% CI: 1.014-12.191, p = 0.048), and bowel obstruction (OR = 54.922, 95% CI: 24.787-121.694, p < 0.001) as independent risk factors for bowel resection.

Advanced age and elevated WBC, CRP, NLR, PLR, SII, and LDH values are effective predictors of bowel resection in incarcerated abdominal wall hernias. Furthermore, bowel obstruction, femoral hernia, and lactate levels serve as independent risk factors for bowel resection.