Predictive value of hematologic parameters and HALP score for testicular viability in adults with testicular torsion: A multicentric study

To evaluate the predictivity of haematologic parameters and HALP score on testicular viability in adults with testicular torsion. We retrospectively analyzed the clinical data of 139 men ≥18 years of age who underwent testicular detorsion with fixation (n = 90) or orchiectomy (n = 49) due to testicular torsion in five different tertiary centers between May 2019 and August 2023. Demographic, pre-, peri- and postoperative data were analyzed. The hemoglobin, albumin, lymphocyte, and platelet (HALP) score in the orchiectomy group was significantly lower compared to the detorsion group (adjusted p = 0.032). Platelet to lymphocyte ratio and duration of torsion were significantly higher in the orchiectomy group (adjusted p = 0.048, adjusted p = 0.000, respectively). Neutrophil-lymphocyte ratio did not reach statistical significance between the groups (adjusted p = 0.074) Furthermore, the orchiectomy group had statistically significantly more heterogeneous echotexture on scrotal ultrasonography (adjusted p = 0.000). On binary logistic regression analysis; platelet-lymphocyte ratio and HALP score were not found as significant predictors for surgical outcome (p = 0.296, p = 0.078, respectively). Multivariate logistic regression analysis revealed that only heterogeneous echotexture on scrotal Doppler ultrasonography and duration of torsion were independent risk factors for testicular necrosis development (p = 0.004, p