Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association · 2025
Prognostic significance of the hemoglobin, albumin, lymphocyte, and platelet score in stroke survivors: A population-based study.
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Qin Haizhen, Zhao Rongrong
Аннотация
BACKGROUND: Systemic inflammation and malnutrition have been associated with unfavorable outcomes in patients with acute stroke. The Hemoglobin, Albumin, Lymphocyte, and Platelet (HALP) score is a novel composite biomarker of inflammatory and nutritional status. The current study aimed to examine the prognostic significance of the HALP score in long-term outcomes in stroke survivors.
METHODS: We analyzed data from 1,427 US adult stroke survivors from US National Health and Nutrition Examination Survey. The primary outcomes were all-cause and cardiovascular disease (CVD) mortality. The HALP score was calculated from hemoglobin, serum albumin, and platelet and lymphocyte count. Multivariable Cox proportional hazards regression models were used to estimate hazard ratios (HRs) and 95 % confidence intervals (CIs).
RESULTS: Over a median follow-up of 81 months, 630 death (37.84 %) occurred, including 276 CVD-related deaths. Compared with the lowest HALP quartile group, the HRs (95 % CIs) in the second, third and fourth quartile were 0.83 (0.63-1.10), 0.65 (0.47-0.90), and 0.61 (0.45-0.82) for all-cause mortality, and 0.84 (0.51-1.37), 0.63 (0.39-1.00), and 0.56 (0.36-0.89) for CVD mortality, respectively. Restricted cubic spline curves revealed a non-linear L-shaped association between HALP score and all-cause and CVD mortality, with inflection points at HALP = 43 and 45, respectively. Interaction analysis indicated that the association between HALP score and mortality risk was consistent among different subgroups.
CONCLUSION: The HALP score exhibits an L-shaped association with both all-cause and CVD mortality in US stroke survivors, suggesting its utility as a prognostic biomarker in this population.
METHODS: We analyzed data from 1,427 US adult stroke survivors from US National Health and Nutrition Examination Survey. The primary outcomes were all-cause and cardiovascular disease (CVD) mortality. The HALP score was calculated from hemoglobin, serum albumin, and platelet and lymphocyte count. Multivariable Cox proportional hazards regression models were used to estimate hazard ratios (HRs) and 95 % confidence intervals (CIs).
RESULTS: Over a median follow-up of 81 months, 630 death (37.84 %) occurred, including 276 CVD-related deaths. Compared with the lowest HALP quartile group, the HRs (95 % CIs) in the second, third and fourth quartile were 0.83 (0.63-1.10), 0.65 (0.47-0.90), and 0.61 (0.45-0.82) for all-cause mortality, and 0.84 (0.51-1.37), 0.63 (0.39-1.00), and 0.56 (0.36-0.89) for CVD mortality, respectively. Restricted cubic spline curves revealed a non-linear L-shaped association between HALP score and all-cause and CVD mortality, with inflection points at HALP = 43 and 45, respectively. Interaction analysis indicated that the association between HALP score and mortality risk was consistent among different subgroups.
CONCLUSION: The HALP score exhibits an L-shaped association with both all-cause and CVD mortality in US stroke survivors, suggesting its utility as a prognostic biomarker in this population.