A New Marker Evaluating the Risk of Ischemic Bowel in Incarcerated Hernia: Immature Granulocytes

Abstract

To evaluate the predictive value of immature granulocytes in intestinal necrosis in incarcerated hernia. The study included patients who were operated on due to incarcerated hernia. The cases were separated into 2 groups as those with or without bowel resection. Age, gender, hernia type, side, white blood cell count, neutrophil count, neutrophil-lymphocyte ratio, red cell distribution width count, immature granulocyte count, platelet count, and platelet lymphocyte ratio were statistically compared between the groups. There were 27 cases (17.3%) in the group with bowel resection and 127 cases (82.7%) in the group without bowel resection. A statistically significant difference was determined between the groups in respect of the hernia type, white blood cell count, neutrophil count, neutrophil-lymphocyte ratio and immature granulocyte count (p < 0.05). The cut-off value of the immature granulocyte count was found to be 0.065, with sensitivity of 63% and specificity of 80%. In multivariate analysis, age over 65 years and immature granulocyte count > 0.065 were found to be independent predictors of necrosis development. The immature granulocyte value is a fast, easily accessible and reliable marker that can be used to predict intestinal necrosis in cases of incarcerated hernia.