This was a retrospective study conducted in Grande International Hospital, Kathmandu, Nepal, after obtaining approval from the institutional review committee of the same institute (approval no. 12/2021). Data of all the gynecological surgeries done over a period of five years from January 1st 2016 to January 1st 2020 were retrieved from the record section/department/database of the institute. All the patients who had undergone surgery for adnexal torsion and ovarian cyst confirmed postoperatively were selected. A total of 213 patients were found who had undergone surgery for adnexal torsion and ovarian cyst in that duration. Patients with a suspicion of malignancy [14 (link)], ruptured ovarian cyst [15 (link)], tubal ovarian abscess [10 (link)], comorbidities such as atherosclerotic heart disease, diabetes mellitus, heart disease (30), and recent surgical procedures [13 (link)] were excluded from the study because these may have an effect on blood count parameters. Excluding all these cases, a total of 125 cases were included in the study.
Two groups were formed (adnexal torsion (AT, n = 25) and untwisted unruptured ovarian cyst (UOC, n = 100)) and investigated. All the data about the demographic parameters (age, parity, and abortion), hematological parameters (WBC count and differential counts), operative approach and technique, and the histopathological reports were obtained from the electronic database and documented in a preformed proforma. SPSS was used for data entry and statistical analysis. Normality of data was assessed by Shapiro–Wilk test. In the study, descriptive and categorical data were evaluated as number (n) and percentage (%), and continuous data were studied as interquartile range and medians. Logistic regression analysis and the influence of each factor on the preoperative diagnosis of AT were evaluated. Receiver operating curve (ROC) analysis was used to evaluate the diagnostic value of neutrophil-lymphocyte ratio in predicting AT. Area under the curve (AUC) was used to determine sensitivity and specificity of each marker. P value <0.05 was considered as statistically significant. Most important factor in determining adnexal torsion was identified as odds ratio. In the present study, the cut-off value for ROC curve analysis was 3, while it was determined as 8.8 K/L for WBC [16 (link)].
Two groups were formed (adnexal torsion (AT, n = 25) and untwisted unruptured ovarian cyst (UOC, n = 100)) and investigated. All the data about the demographic parameters (age, parity, and abortion), hematological parameters (WBC count and differential counts), operative approach and technique, and the histopathological reports were obtained from the electronic database and documented in a preformed proforma. SPSS was used for data entry and statistical analysis. Normality of data was assessed by Shapiro–Wilk test. In the study, descriptive and categorical data were evaluated as number (n) and percentage (%), and continuous data were studied as interquartile range and medians. Logistic regression analysis and the influence of each factor on the preoperative diagnosis of AT were evaluated. Receiver operating curve (ROC) analysis was used to evaluate the diagnostic value of neutrophil-lymphocyte ratio in predicting AT. Area under the curve (AUC) was used to determine sensitivity and specificity of each marker. P value <0.05 was considered as statistically significant. Most important factor in determining adnexal torsion was identified as odds ratio. In the present study, the cut-off value for ROC curve analysis was 3, while it was determined as 8.8 K/L for WBC [16 (link)].
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