To assess the predictive value of the systemic immunoinflammatory index (SII) for intestinal tissue viability in patients with incarcerated inguinal hernia.

Case data of 140 patients who underwent surgery for incarcerated inguinal hernia in the emergency department of the Affiliated Hospital of Chuanbei Medical College from January 2014 to April 2023 and whose hernia contents were only intestinal tubes were retrospectively analyzed. According to intraoperative intestinal tissue viability, they were divided into non-ischemic necrosis group (49 cases) and ischemic necrosis group (91 cases). Univariate analysis of factors influencing intestinal ischemic necrosis was performed using the independent-samples t-test, Mann-Whitney U test, χ² test, or Fisher's exact probability test. Multivariate analysis was conducted with logistic regression. Spearman correlation analysis was applied to explore the relationship between the systemic immune-inflammation index (SII) and inflammation. Receiver operating characteristic (ROC) curve analysis was used to determine the optimal cut-off value of SII and to evaluate its diagnostic value in predicting intestinal ischemic necrosis.

Of the 91 patients in the ischemia group, irreversible intestinal ischemia for colectomy occurred in 59 patients, accounting for 42.1% (59/140) of all patients. The results of multifactorial analysis showed that elevated leukocyte count, incarceration duration of more than two days, increased SII, and elevated serum phosphorus (P<0.05) were independent risk factors for the development of intestinal ischemic necrosis in patients with incarcerated hernia in the inguinal area. Leukocyte count was positively correlated with SII (P<0.001) with a correlation coefficient of r=0.636. ROC curve analysis showed that the area under the curve of the SII index predicting intestinal tissue viability was 0.820, with a 95.0% credible interval (0.744~0.895, P<0.001, and the optimal cut-off value was 1128.1127, with a specificity of 79.6% and a sensitivity of 75.8%.

An early SII index of more than 1128.1127 is highly correlated with poor intestinal tissue ischemic necrosis in patients with incarcerated inguinal hernias and can be used to predict intestinal tissue viability in patients with incarcerated inguinal hernias.