Supplementary Material for: Complete Blood Count Markers and C-Reactive Protein as Predictors of Testicular Viability in the Event of Testicular Torsion in Adults

<b><i>Introduction:</i></b> The association between blood markers and testicular viability after testicular torsion (TT) is not well known. We evaluated the role of complete blood count markers and C-reactive protein (CRP) in predicting testicular viability after TT. <b><i>Methods:</i></b> Fifty men, ≥18 years of age, operated for TT between the years 2015–2020 were enrolled. Blood markers including neutrophil-, lymphocyte-, and platelet count, and CRP were obtained. Neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) were calculated. The study outcome was testicular salvage. <b><i>Results:</i></b> Median age was 23 years (interquartile range [IQR]: 21, 31). Median duration of torsion was 10 h (IQR: 6, 42). Sonographic texture of the testis was homogenous in 27 (56%) patients and heterogenous in 21 (44%). During scrotal exploration, 36 patients (72%) underwent orchiopexy and 14 (28%) underwent orchiectomy. Patients who underwent orchiopexy were younger (22 years vs. 31 years, <i>p</i> = 0.009), had a shorter duration of torsion (median 8 h vs. 48 h, <i>p</i> &lt; 0.001), and a homogenous texture on scrotal ultrasound (76.5 vs. 7.1%, <i>p</i> &lt; 0.001). Median NLR, PLR, and CRP were higher among patients who underwent orchiectomy; however, these differences did not reach statistical significance. Patients with heterogenous echotexture were significantly more likely to undergo orchiectomy (odds ratio = 42, 95% confidence interval: 7, 831, adjusted <i>p</i> value = 0.009). <b><i>Conclusions:</i></b> We found no association between blood-based biomarkers and testicular viability after TT; however, testicular echotexture significantly predicted outcome.

<b><i>引言：</i></b> 睾丸扭转（testicular torsion, TT）后血液标志物与睾丸活力的关联尚不明确。本研究评估了全血细胞计数指标及C反应蛋白（C-reactive protein, CRP）在预测睾丸扭转后睾丸活力中的作用。<b><i>方法：</i></b> 纳入2015至2020年间因睾丸扭转接受手术的50名18岁及以上男性患者。采集中性粒细胞计数、淋巴细胞计数、血小板计数及C反应蛋白等血液指标，计算中性粒细胞与淋巴细胞比值（neutrophil-lymphocyte ratio, NLR）及血小板与淋巴细胞比值（platelet-lymphocyte ratio, PLR）。本研究的结局为睾丸挽救情况。<b><i>结果：</i></b> 患者中位年龄为23岁（四分位间距（interquartile range, IQR）：21, 31）。中位扭转时长为10小时（IQR：6, 42）。27例（56%）患者睾丸超声回声质地均匀，21例（44%）呈不均匀回声。阴囊探查术中，36例（72%）患者接受睾丸固定术（orchiopexy），14例（28%）接受睾丸切除术（orchiectomy）。接受睾丸固定术的患者年龄更小（22岁 vs 31岁，p=0.009），扭转时长更短（中位时长8小时 vs 48小时，p<0.001），且阴囊超声提示睾丸回声质地均匀的比例更高（76.5% vs 7.1%，p<0.001）。接受睾丸切除术的患者中位NLR、PLR及CRP水平更高，但上述差异未达到统计学显著性。回声质地不均匀的患者接受睾丸切除术的概率显著更高（优势比（odds ratio）=42，95%置信区间（confidence interval）：7, 831，校正后p值=0.009）。<b><i>结论：</i></b> 本研究未发现血液生物标志物与睾丸扭转后睾丸活力之间存在关联，但睾丸超声回声质地可显著预测手术结局。