Objective: This study evaluated the association between admission inflammatory indices and surgically confirmed hollow viscus injury in patients undergoing surgery for abdominal or thoracoabdominal stab wounds.
Materials and
Methods: Patients aged 16 years or older who underwent surgery between January 2015 and December 2023 were retrospectively reviewed. Patients with diaphragmatic, concomitant intra-abdominal solid-organ or vascular or extra-abdominal injuries, those requiring another surgical specialty, and those undergoing tube thoracostomy were excluded. Fifty patients with hollow viscus injury and 50 without hollow viscus injury were included. Admission laboratory parameters and derived inflammatory indices were assessed using logistic regression and receiver operating characteristic analysis.

Results: The mean age of the 100 patients was 31.4±11.6 years, and 95% were male. Neutrophil, monocyte, platelet, C-reactive protein (CRP), and several derived inflammatory indices were higher in patients with hollow viscus injury, whereas the lymphocyte-to-monocyte ratio (LMR) and lymphocyte-to-CRP ratio were lower. Platelet count (odds ratio [OR]=1.008; 95% confidence interval [CI], 1.001–1.015; p=0.036) and LMR (OR=0.679; 95% CI, 0.559–0.825; p<0.001) were independently associated with hollow viscus injury. The area under the curve for LMR was 0.764 (95% CI, 0.671–0.857). An LMR cutoff of <5.5 yielded 64% sensitivity and 80% specificity.

Conclusion: A lower admission LMR and a higher platelet count were independently associated with surgically confirmed hollow viscus injury. LMR is insufficient as a stand-alone diagnostic test but may provide a low-cost adjunct to clinical and radiological assessment. Validation in larger independent cohorts is required.