Journal of paediatrics and child health · 2026
Can the HALP Score Be Used as a Prognostic Marker in Paediatric Patients With Cystic Fibrosis?
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Özkaya Kübra, Öztürk Gökçen Kartal, Dindar Bahar Girgin, Halis Ece, Çoksüer Fevziye, Öğütcü Atacan, Gacemer Hazal, Kara Gülcan Yılbaş, Ocak Ece, Gülen Figen
Аннотация
RATIONALE: Cystic fibrosis (CF) is characterised by chronic inflammation and malnutrition, significantly affecting disease progression and prognosis. The haemoglobin-albumin-lymphocyte-platelet (HALP) score reflects inflammatory and nutritional status, and has prognostic associations in various chronic diseases; its role in paediatric CF is unclear.
OBJECTIVE: To evaluate the association between HALP measured during clinical stability and (i) baseline disease severity at the index assessment (FEV1, MSKS, and BMI z-score), and (ii) subsequent 12-month outcomes (hospitalisation-requiring pulmonary exacerbations, PICU admission, and mortality) in children with CF.
METHODS: Retrospective single-centre cohort study of 152 children with CF aged 2-18 years. HALP was calculated at clinical stability. Associations with index severity and 12-month outcomes were analysed; logistic regression for low FEV1 was restricted to participants with acceptable spirometry.
RESULTS: Lower HALP was associated with low FEV1 (< 70% predicted) at the index assessment (p < 0.001) and with a higher 12-month burden of hospitalisation -requiring pulmonary exacerbations (p < 0.001). PICU admission and mortality were infrequent and analysed exploratorily; HALP was lower in these groups (PICU p < 0.001; mortality p = 0.004). In adjusted logistic regression among participants with spirometry (n = 101), HALP remained associated with low FEV1, although the effect size was modest and precision limited (adjusted OR 0.886, 95% CI 0.788-0.996; p = 0.043).
CONCLUSIONS: HALP, reflecting nutritional and inflammatory status, may offer prognostic information in paediatric CF. Calculation from routine blood tests could make it a practical tool for identifying higher-risk individuals and informing clinical decision-making. Further large-scale studies are needed to validate its clinical utility in CF management.
OBJECTIVE: To evaluate the association between HALP measured during clinical stability and (i) baseline disease severity at the index assessment (FEV1, MSKS, and BMI z-score), and (ii) subsequent 12-month outcomes (hospitalisation-requiring pulmonary exacerbations, PICU admission, and mortality) in children with CF.
METHODS: Retrospective single-centre cohort study of 152 children with CF aged 2-18 years. HALP was calculated at clinical stability. Associations with index severity and 12-month outcomes were analysed; logistic regression for low FEV1 was restricted to participants with acceptable spirometry.
RESULTS: Lower HALP was associated with low FEV1 (< 70% predicted) at the index assessment (p < 0.001) and with a higher 12-month burden of hospitalisation -requiring pulmonary exacerbations (p < 0.001). PICU admission and mortality were infrequent and analysed exploratorily; HALP was lower in these groups (PICU p < 0.001; mortality p = 0.004). In adjusted logistic regression among participants with spirometry (n = 101), HALP remained associated with low FEV1, although the effect size was modest and precision limited (adjusted OR 0.886, 95% CI 0.788-0.996; p = 0.043).
CONCLUSIONS: HALP, reflecting nutritional and inflammatory status, may offer prognostic information in paediatric CF. Calculation from routine blood tests could make it a practical tool for identifying higher-risk individuals and informing clinical decision-making. Further large-scale studies are needed to validate its clinical utility in CF management.