Nigerian journal of clinical practice · 2026
Prognostic Impact of the Neutrophil-to-Lymphocyte Ratio and HALP Score on Long-Term Mortality in Patients with Peripheral Artery Disease: A Retrospective Cohort Study in a Tertiary Hospital in Turkey.
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Yalım Z, Ekşi R A, Korucu C, Siner H
Аннотация
BACKGROUND: Systemic inflammation and impaired nutritional status are important drivers of adverse outcomes in peripheral artery disease (PAD). The hemoglobin-albumin-lymphocyte-platelet index (HALP) represents a multidimensional marker reflecting the interaction between hematologic, nutritional, and inflammatory status.
AIM: This study evaluated the independent prognostic value of HALP score and neutrophil-lymphocyte ratio (NLR) in determining mortality in PAD patients.
METHODS: This retrospective cohort study consisted of 638 individuals with a first-time diagnosis of PAD. Patients were categorized as deceased (n = 241) and survivors (n = 397). Clinical characteristics, laboratory findings, inflammatory indices, NLR and HALP scores were analyzed. Survival probabilities were assessed using Kaplan-Meier curves, and independent determinants of mortality were examined through logistic regression analysis.
RESULTS: The mean follow-up period was 36.17 months for deceased patients and 71.69 months for survivors. Deceased patients exhibited significantly lower HALP scores (34.6 ± 2.1 vs. 51.9 ± 2.2, P = 0.047). While the HALP score demonstrated weak discriminative capacity in ROC analysis, Cox regression showed that lower HALP levels were independently associated with decreased survival status (Hazard ratio (HR) 0.46; 95% confidence interval (CI): 0.35-0.60; P < 0.001). The higher NLR levels had significantly elevated all-cause mortality rates (HR, 1.87; 95% CI: 1.44-2.44; P < 0.001). In multivariable analysis, HALP score, age, C-reactive protein levels, chronic renal failure, diabetes mellitus, and heart failure were independent predictors of death.
CONCLUSION: Lower HALP scores are related to increased long-term mortality in PAD. The HALP score provides complementary prognostic information and may enhance holistic risk stratification in PAD.
AIM: This study evaluated the independent prognostic value of HALP score and neutrophil-lymphocyte ratio (NLR) in determining mortality in PAD patients.
METHODS: This retrospective cohort study consisted of 638 individuals with a first-time diagnosis of PAD. Patients were categorized as deceased (n = 241) and survivors (n = 397). Clinical characteristics, laboratory findings, inflammatory indices, NLR and HALP scores were analyzed. Survival probabilities were assessed using Kaplan-Meier curves, and independent determinants of mortality were examined through logistic regression analysis.
RESULTS: The mean follow-up period was 36.17 months for deceased patients and 71.69 months for survivors. Deceased patients exhibited significantly lower HALP scores (34.6 ± 2.1 vs. 51.9 ± 2.2, P = 0.047). While the HALP score demonstrated weak discriminative capacity in ROC analysis, Cox regression showed that lower HALP levels were independently associated with decreased survival status (Hazard ratio (HR) 0.46; 95% confidence interval (CI): 0.35-0.60; P < 0.001). The higher NLR levels had significantly elevated all-cause mortality rates (HR, 1.87; 95% CI: 1.44-2.44; P < 0.001). In multivariable analysis, HALP score, age, C-reactive protein levels, chronic renal failure, diabetes mellitus, and heart failure were independent predictors of death.
CONCLUSION: Lower HALP scores are related to increased long-term mortality in PAD. The HALP score provides complementary prognostic information and may enhance holistic risk stratification in PAD.