The relationship between hemoglobin, albumin, lymphocyte, and platelet (HALP) score and prognosis in patients with heart failure: A retrospective analysis of the MIMIC-IV database.

Heart failure (HF) remains a leading cause of hospitalization among elderly patients worldwide and is associated with high mortality rates. The hemoglobin, albumin, lymphocyte, and platelet (HALP) score has emerged as a potential prognostic biomarker in multiple malignancies, including gastric, colorectal, lung, breast, and cervical cancers. However, its association with key clinical outcomes (such as intensive care unit [ICU] length of stay [LOS], hospital LOS, and mortality) in patients with HF remains unclear. This retrospective cohort study analyzed data from 4286 patients with HF admitted to the ICU identified from the Medical Information Mart for Intensive Care-IV database, with an average age of 73.12 years and 41.8% being female. Patients were stratified into quartiles based on their HALP scores. Associations between HALP scores and clinical outcomes (including ICU LOS, hospital LOS, 28-day mortality, and 365-day mortality) were evaluated using Kaplan-Meier survival curves, Cox proportional hazards, and linear regression models, as well as restricted cubic spline analysis to assess potential nonlinear relationships. Subgroup analyses explored potential interactions between HALP scores and various clinical factors, such as age, sex, comorbidities, and other demographic variables. Without adjusting for confounders, each 10-unit increase in HALP score was associated with a 0.19-day reduction in ICU LOS and a 0.15-day decrease in hospital LOS. This association remained consistent across HALP score quartiles, with higher scores corresponding to shorter ICU, and hospital stays. Restricted cubic spline analysis revealed a linear association between higher HALP levels and reduced ICU and hospital LOS. In unadjusted analyses, each 10-unit increase in HALP score corresponded to a 14% reduction in short-term mortality and a 13% reduction in long-term mortality. These associations were nonlinear, as demonstrated by restricted cubic spline modeling. Subgroup analyses showed that the associations between HALP score and short- and long-term mortality varied across certain clinical subgroups, including body mass index, hypertension, and sepsis. A higher HALP score was associated with shorter ICU and hospital length of stay and lower short- and long-term mortality in patients with HF admitted to the ICU. HALP may be a readily available marker associated with prognosis, but further studies are needed to determine its clinical utility.