Haematological Profile in Pre-Surgery Hernia Patients: A Case-Control Study in Ghana

Abstract

Introduction: The burden of hernia is disproportionately high in low-to-middle-income countries, due to the lack of fundamental resources needed to effectively diagnose and manage cases. The patterns of hernia, the haematological profile, and the predictive ability of blood cell indices were all investigated in this study. Methods: Fifty-four subjects: 27 hernia patients and 27 healthy controls were included in this single-centre, unmatched case-control study. Hernia was diagnosed using physical examination and ultrasound scan. Haematological indices of each subject were measured with an automated blood cell counter. Results: Herniae recorded were 92.59% inguinal, and 3.27% each epigastric and uterine prolapse. Hernia was prevalent in males (85.2%, p=0.008) and older subjects ≥53 years (48.1%, p=0.004). HgB (p=0.006), MCHC (p≤0.001), and RDW-CV (p=0.042) levels were significantly elevated in strangulated than non-strangulated hernia and controls respectively, while Abs GRAN (p=0.024) was decreased in non-strangulated than strangulated hernia and control groups respectively. MCHC (AUC=0.947 [0.895-0.999], p≤0.001) was the most sensitive predictor for herniation followed by age (AUC=0.750 [0.610-0.889], p=0.002); HgB (AUC=0.718 [0.580-0.857], p=0.006); and RDW-CV (AUC=0.700 [0.559-0.840], p=0.012). Also, MCHC (AUC=0.831 [0.723-0.938], p≤0.001); HgB (AUC=0.738 [0.590-0.887], p=0.005); and RBC (AUC=0.671 [0.502-0.840], p=0.045) respectively, were significant predictors of strangulation. Conclusion: Gender and age were significantly associated with hernias. Inguinal hernia and strangulation were common in the study setting, especially, among males. Also, there were significant variations in erythrocyte- and leucocyte indices across the groups, but not platelets. Erythrocyte indices were significant predictive biomarkers for hernia and strangulation. The CBC is a useful test for the early detection of herniation and strangulation. Doi: 10.28991/SciMedJ-2022-0401-1 Full Text: PDF