To construct a nomogram model to predict the risk of intestinal necrosis in patients with incarcerated inguinal hernia.

Clinicopathological data of patients diagnosed with incarcerated inguinal hernia in the Department of Gastrointestinal Surgery, Affiliated Huai’an Hospital of Xuzhou Medical University, were retrospectively analyzed. Univariate and multivariate logistic regression analyses were performed to identify independent risk factors for intestinal necrosis in incarcerated inguinal hernia. A corresponding nomogram prediction model was then established.

Tenderness in the groin area (OR=9.164, 95% CI=2.540-33.066), intestinal obstruction (OR=6.781, 95% CI=1.568- 29.330), C-reactive protein (CRP; OR=1.023, 95% CI=1.009-1.037), and neutrophil count (OR=1.253, 95% CI=1.073-1.463) were identified as independent risk factors for intestinal necrosis in incarcerated inguinal hernia, whereas prealbumin (OR=0.992, 95% CI=0.986-0.998) was identified as an independent protective factor. Based on the five independent risk and protective factors, a nomogram model was established to predict the risk of intestinal necrosis in incarcerated inguinal hernia. The discrimination ability of the model was evaluated using the ROC curve. The area under the ROC curve was 0.906 (95% CI=0.851-0.962; P<0.05). The calibration curve showed good agreement with the ideal curve, and the decision curve analysis demonstrated the clinical utility of the model.

Tenderness in the groin area, intestinal obstruction, CRP, and neutrophil count are independent risk factors, whereas prealbumin is an independent protective factor for intestinal necrosis in incarcerated inguinal hernia. The established nomogram model demonstrated high sensitivity, specificity, and clinical applicability.