{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T10:52:51Z","timestamp":1791543171153,"version":"4.3.4"},"reference-count":17,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T00:00:00Z","timestamp":1791504000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T00:00:00Z","timestamp":1791504000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Paediatrics Child Health"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>Ovarian necrosis is a severe complication of incarcerated ovary hernia in female children, yet reliable preoperative predictors are lacking. We aimed to evaluate the systemic immune\u2010inflammation index (SII) as a predictor of ovarian necrosis and to compare its diagnostic performance with the neutrophil\u2010to\u2010lymphocyte ratio (NLR) and C\u2010reactive protein (CRP).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively reviewed female children who underwent emergency surgery for incarcerated ovary or fallopian\u2010tube hernia between October 2018 and April 2026. SII was calculated as platelet count \u00d7 neutrophil count\/lymphocyte count and NLR as neutrophil count\/lymphocyte count. Univariable Firth\u2010penalised logistic regression and receiver\u2010operating\u2010characteristic (ROC) analyses were performed. AUCs were estimated with DeLong 95% confidence intervals, optimal cut\u2010offs by the Youden index, and AUCs were compared using the DeLong test.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 45 patients, 10 (22.2%) had intraoperatively confirmed ovarian necrosis. SII and CRP were significantly associated with necrosis in univariable Firth analyses. SII showed an AUC of 0.894 (95% CI 0.790\u20130.999), sensitivity 90.0%, and specificity 85.7%. NLR showed an AUC of 0.917 (95% CI 0.836\u20130.998), sensitivity 100.0%, and specificity 80.0%. The AUCs of SII and NLR did not differ significantly (DeLong\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.542). CRP had an AUC of 0.867 (95% CI 0.681\u20131.000), sensitivity 80.0%, and specificity 94.3%.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>SII showed good discrimination for ovarian necrosis in paediatric incarcerated ovary hernia, but did not outperform the simpler NLR in this small cohort. Both CBC\u2010derived indices may assist preoperative risk stratification; however, the proposed thresholds are exploratory and require prospective multicentre external validation before clinical implementation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jpc.70618","type":"journal-article","created":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T10:15:09Z","timestamp":1791540909000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Systemic Immune\u2010Inflammation Index as a Predictor of Ovarian Necrosis in Children With Incarcerated Ovary Hernia: A Single\u2010Centre Retrospective Study"],"prefix":"10.1111","author":[{"given":"Gang","family":"Zhao","sequence":"first","affiliation":[{"name":"Department of Paediatric Surgery Dali Bai Autonomous Prefecture Maternal and Child Health Care Hospital  Dali Yunnan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chenghui","family":"Ke","sequence":"additional","affiliation":[{"name":"Department of Paediatric Orthopaedics Shanghai Children's Hospital  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hong","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Neonatology Dali Bai Autonomous Prefecture Maternal and Child Health Care Hospital  Dali Yunnan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Longhua","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Paediatric Surgery Dali Bai Autonomous Prefecture Maternal and Child Health Care Hospital  Dali Yunnan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ming","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Paediatric Surgery Dali Bai Autonomous Prefecture Maternal and Child Health Care Hospital  Dali Yunnan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peiji","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Paediatric Surgery Dali Bai Autonomous Prefecture Maternal and Child Health Care Hospital  Dali Yunnan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yunpeng","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Neurology Dali Bai Autonomous Prefecture People's Hospital  Dali Yunnan China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,9]]},"reference":[{"issue":"1","key":"e_1_2_13_2_1","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1016\/j.suc.2016.08.010","article-title":"Incarcerated Paediatric Hernias","volume":"97","author":"Abdulhai S. A.","year":"2017","journal-title":"Surgical Clinics of North America"},{"issue":"3","key":"e_1_2_13_3_1","doi-asserted-by":"crossref","first-page":"139","DOI":"10.4103\/jiaps.JIAPS_166_16","article-title":"Male Gender and Prematurity Are Risk Factors for Incarceration in Paediatric Inguinal Hernia: A Study of 922 Children","volume":"22","author":"Ksia A.","year":"2017","journal-title":"Journal of Indian Association of Pediatric Surgeons"},{"issue":"2","key":"e_1_2_13_4_1","doi-asserted-by":"crossref","first-page":"107","DOI":"10.13029\/jkaps.1995.1.2.107","article-title":"Incarcerated Inguinal Hernia in Children","volume":"1","author":"Jung P. M.","year":"1995","journal-title":"Journal of the Korean Association of Pediatric Surgeons"},{"issue":"1","key":"e_1_2_13_5_1","doi-asserted-by":"crossref","first-page":"708","DOI":"10.4081\/cp.2015.708","article-title":"Bilateral Inguinal Hernias Containing Ovaries","volume":"5","author":"Basrur G. B.","year":"2015","journal-title":"Clinical Practice"},{"issue":"2","key":"e_1_2_13_6_1","first-page":"120","article-title":"Risk Factors for Ovarian Necrosis due to Incarcerated Ovarian Hernia","volume":"44","author":"Yang H.","year":"2023","journal-title":"Journal of Kunming Medical University"},{"issue":"8","key":"e_1_2_13_7_1","first-page":"764","article-title":"Analysis of Risk Factors of Ovarian Strangulation and Necrosis due to Incarcerated Inguinal Hernia in Female Infants","volume":"21","author":"Wang Z.","year":"2022","journal-title":"Journal of Clinical Pediatric Surgery"},{"issue":"15","key":"e_1_2_13_8_1","doi-asserted-by":"crossref","first-page":"1942","DOI":"10.3390\/diagnostics15151942","article-title":"The Role of Systemic Immune\u2010Inflammation Index (SII) in Diagnosing Paediatric Acute Appendicitis","volume":"15","author":"Firinci B.","year":"2025","journal-title":"Diagnostics"},{"key":"e_1_2_13_9_1","doi-asserted-by":"crossref","first-page":"496","DOI":"10.1186\/s12887-024-04818-8","article-title":"Role of Systemic Immune\u2010Inflammatory Index and Systemic Inflammatory Response Index in Predicting the Diagnosis of Necrotizing Pneumonia in Children","volume":"24","author":"Hassan A. M.","year":"2024","journal-title":"BMC Pediatrics"},{"key":"e_1_2_13_10_1","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1186\/s12887-025-05544-5","article-title":"Pan\u2010Immune\u2010Inflammation Value: A New Biomarker for Diagnosing Appendicitis in Children?","volume":"25","author":"Xiang B.","year":"2025","journal-title":"BMC Pediatrics"},{"key":"e_1_2_13_11_1","doi-asserted-by":"crossref","first-page":"990481","DOI":"10.3389\/fsurg.2022.990481","article-title":"A Predictive Model of Bowel Resection for Incarcerated Inguinal Hernia Based on the Systemic Immune\u2010Inflammation Index","volume":"9","author":"Chen L.","year":"2022","journal-title":"Frontiers in Surgery"},{"issue":"6","key":"e_1_2_13_12_1","doi-asserted-by":"crossref","first-page":"1491","DOI":"10.1007\/s10029-023-02776-1","article-title":"Predictive Factors of Bowel Necrosis in Patients With Incarcerated Femoral Hernia","volume":"27","author":"Beji H.","year":"2023","journal-title":"Hernia"},{"issue":"1","key":"e_1_2_13_13_1","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1007\/s10029-021-02518-1","article-title":"Haematological Inflammatory Markers for Indicating Ischaemic Bowel in Patients With Incarcerated Abdominal Wall Hernias","volume":"26","author":"Bostanc\u0131 M. T.","year":"2022","journal-title":"Hernia"},{"issue":"7","key":"e_1_2_13_14_1","doi-asserted-by":"crossref","first-page":"889","DOI":"10.3390\/life14070889","article-title":"The Role of Neutrophil\u2010To\u2010Lymphocyte Ratio as a Predictor of Ovarian Torsion in Children: Results of a Multicentric Study","volume":"14","author":"Delgado\u2010Miguel C.","year":"2024","journal-title":"Life"},{"issue":"3","key":"e_1_2_13_15_1","doi-asserted-by":"crossref","first-page":"334","DOI":"10.1016\/j.jpag.2020.12.003","article-title":"Neutrophil to Lymphocyte Ratio and Platelet to Lymphocyte Ratio Might Predict Paediatric Ovarian Torsion: A Single\u2010Institution Experience and Review of the Literature","volume":"34","author":"Nissen M.","year":"2021","journal-title":"Journal of Pediatric and Adolescent Gynecology"},{"issue":"12","key":"e_1_2_13_16_1","doi-asserted-by":"crossref","first-page":"2599","DOI":"10.1093\/humrep\/deg498","article-title":"Minimal Surgery for the Twisted Ischaemic Adnexa Can Preserve Ovarian Function","volume":"18","author":"Oelsner G.","year":"2003","journal-title":"Human Reproduction"},{"issue":"5","key":"e_1_2_13_17_1","doi-asserted-by":"crossref","first-page":"558","DOI":"10.4103\/jiaps.jiaps_207_21","article-title":"Black Ovary: Our Experience With Oophoropexy in All Cases of Pediatric Ovarian Torsion and Review of Relevant Literature","volume":"27","author":"Sriram R.","year":"2022","journal-title":"Journal of Indian Association of Pediatric Surgeons"},{"issue":"1","key":"e_1_2_13_18_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s00404-022-06522-3","article-title":"Ovarian Torsion in the Pediatric Population: Predictive Factors for Ovarian\u2010Sparing Surgery\u2014An International Retrospective Multicenter Study and a Systematic Review","volume":"308","author":"Spinelli C.","year":"2023","journal-title":"Archives of Gynecology and Obstetrics"}],"container-title":["Journal of Paediatrics and Child Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jpc.70618","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jpc.70618","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jpc.70618","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T10:15:11Z","timestamp":1791540911000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jpc.70618"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,9]]},"references-count":17,"alternative-id":["10.1111\/jpc.70618"],"URL":"https:\/\/doi.org\/10.1111\/jpc.70618","archive":["Portico"],"relation":{},"ISSN":["1034-4810","1440-1754"],"issn-type":[{"value":"1034-4810","type":"print"},{"value":"1440-1754","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,9]]},"assertion":[{"value":"2026-06-25","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-22","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-09","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"jpc.70618"}}