The predictive value of pan immune-inflammation value, systemic immune-inflammatory index, and systemic inflammation response index in distinguishing testicular torsion and epididymo-orchitis in the emergency department

Aim: This study aimed to determine the diagnostic value of pan immune-inflammation value, systemic immune-inflammatory index, and systemic inflammation response index in differentiating testicular torsion and epididymo-orchitis in patients with acute scrotum.
Methods: This retrospective observational study was conducted among male patients aged 18 and older who presented to the emergency department with testicular pain. The patients were divided into two groups: the operated testicular torsion group (n=93); epididymo-orchitis group treated for epididymoorchitis (n=125).
Results: A total of 218 patients (testicular torsion:93, epididymo-orchitis:125) were included in the study. Neutrophil/lymphocyte ratio, systemic immune-inflammatory index and systemic inflammation response index were found to have acceptable diagnostic power in testicular torsion detection (The Area Under the Curve:0.75, 0.77, and 0.78, respectively). Pan immune-inflammation value had an excellent diagnostic power in detecting testicular torsion, with >980.93 cut-off determined (The Area Under the Curve:0.81, %95Confidence interval:0.76-0.86,<0.001).
Conclusion: In the emergency department, it can be recommended to utilize pan immune-inflammation value, systemic immune-inflammatory index, and systemic inflammation response index, which are inexpensive, easily accessible, and produce quick results in the differentiation of testicular torsion and epididymo-orchitis. Pan immune-inflammation value is a superior index in predicting testicular torsion compared to other indexes.