Department of Cardiology, Faculty of Medicine, Samsun University, Samsun 33805, Turkey.
Department of Cardiology, Faculty of Medicine, Harran University, Şanlıurfa 63050, Turkey.
Medicina (Kaunas). 2024 Aug 24;60(9):1385. doi: 10.3390/medicina60091385.
Acute decompensated heart failure (ADHF) presents a significant clinical challenge characterized by frequent hospitalizations, high mortality rates, and substantial healthcare costs. The united index of hemoglobin, albumin, lymphocytes and platelets (HALP) is a new indicator that reflects systemic inflammation and nutritional status. This study aimed to investigate the prognostic utility of the HALP score and hematological parameters in predicting short-term mortality among ADHF patients admitted to the coronary care unit (CCU). This investigation adopts a retrospective observational design, encompassing a cohort of patients with ADHF who were followed in the CCU at our medical institution between January 2019 and April 2024. The cohort of 227 individuals was dichotomized into two subsets based on the presence or absence of short-term mortality in the hospital, resulting in 163 (71.8%) and 64 (28.2%) individuals in the survivor and exitus groups, respectively. Age was significantly higher in the exitus group (-value = 0.004). Hemoglobin, lymphocyte count, platelet count, albumin, and HALP score were significantly higher in the survivor group (all -values < 0.001). No significant difference was observed between the groups in terms of gender, diabetes mellitus (DM), coronary artery disease (CAD), or ejection fraction (EF), although hypertension (HT) prevalence was significantly higher in the exitus group (-value = 0.038). ROC analysis demonstrated that hemoglobin, lymphocyte, albumin, and HALP score had significant discriminative power, with albumin showing the highest AUC (0.814). In conclusion, the HALP score and hematological parameters represent valuable prognostic feature for short-term mortality prediction in ADHF patients admitted to the CCU. These findings underscore the importance of early risk stratification and targeted interventions guided by comprehensive biomarker assessments in optimizing patient outcomes.
急性失代偿性心力衰竭 (ADHF) 是一种具有挑战性的临床病症，其特征包括频繁住院、高死亡率和大量医疗保健费用。血红蛋白、白蛋白、淋巴细胞和血小板联合指数 (HALP) 是一种新的指标，反映全身炎症和营养状况。本研究旨在探讨 HALP 评分和血液学参数在预测 CCU 收治的 ADHF 患者短期死亡率方面的预后价值。
本研究采用回顾性观察设计，纳入了 2019 年 1 月至 2024 年 4 月在我院 CCU 随访的 ADHF 患者队列。根据患者在医院内是否短期死亡，将 227 例患者分为两组，其中 163 例（71.8%）和 64 例（28.2%）为存活组和死亡组。死亡组的年龄明显较高（-值=0.004）。存活组的血红蛋白、淋巴细胞计数、血小板计数、白蛋白和 HALP 评分明显较高（所有 -值均<0.001）。两组在性别、糖尿病 (DM)、冠心病 (CAD) 或射血分数 (EF) 方面无显著差异，但死亡组的高血压 (HT) 患病率明显较高（-值=0.038）。ROC 分析显示，血红蛋白、淋巴细胞、白蛋白和 HALP 评分具有显著的区分能力，白蛋白的 AUC 值最高（0.814）。
综上所述，HALP 评分和血液学参数是 CCU 收治的 ADHF 患者短期死亡率的有价值的预后特征。这些发现强调了早期风险分层和基于全面生物标志物评估的靶向干预对优化患者结局的重要性。
