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血红蛋白、白蛋白、淋巴细胞和血小板(HALP)评分可预测成人癫痫持续状态的预后:一项回顾性研究。

The Hemoglobin, Albumin, Lymphocyte, and Platelet (HALP) Score Predicts the Prognosis of Adults with Status Epilepticus: A Retrospective Study.

作者信息

Fu Jie, Chen Xiu, Li Jinglun, Rong Benbing, Peng Lilei

机构信息

Department of Neurology, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, People's Republic of China.

Department of Neurosurgery, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, People's Republic of China.

出版信息

J Inflamm Res. 2024 Nov 25;17:9625-9635. doi: 10.2147/JIR.S491666. eCollection 2024.

Abstract

OBJECTIVE

The hemoglobin, albumin, lymphocyte, and platelet (HALP) score has been indicated to be a novel indicator that reflects systemic inflammation and is associated with the functional outcome in various neurological diseases. Since inflammation is closely involved in the pathogenesis of status epilepticus (SE), this study aimed to explore the predictive value of HALP for the prognosis of SE patients.

METHODS

In the retrospective study, we investigated and validated the predictive value of HALP for the prognosis of adult SE patients. We collected patient's clinical characteristics and laboratory test data. Information of 30-day mortality after SE onset was obtained, and modified Rankin scale (mRS) scores were used to evaluate the clinical outcomes. Multivariable logistic regression models were applied to explore the association between HALP and SE prognosis. Receiver operating characteristic (ROC) curve analysis was performed to determine the optimal cutoff of HALP to predict 30-day mortality in SE patients.

RESULTS

We first analyzed the discovery cohort of 116 patients with SE. We observed that 19.0% (22/116) of the patients died within 30 days after SE onset, and 26.3% (20/76) had poor outcomes during the 6-month follow-up. Multivariate logistic regression analysis indicated that lower HALP on admission was an independent predictor of 30-day mortality (odds ratio: 0.980; 95% confidence interval, 0.962-0.999; = 0.044). In ROC analysis, a HALP of 20.32 was identified as the optimal cutoff value to predict 30-day mortality in SE patients. Furthermore, multivariate logistic regression analysis showed that HALP < 20.32 was related to an increased risk of poor SE outcomes (odds ratio: 27.051; 95% confidence interval, 3.589-203.909; = 0.001), which was validated in the external cohort.

CONCLUSION

Lower HALP is independently associated with an increased risk of 30-day mortality and poor functional outcomes in patients with SE. Our findings suggest that HALP may be a promising biomarker for predicting SE prognosis.

摘要

目的

血红蛋白、白蛋白、淋巴细胞和血小板(HALP)评分已被证明是一种反映全身炎症的新型指标,且与多种神经系统疾病的功能预后相关。由于炎症与癫痫持续状态(SE)的发病机制密切相关,本研究旨在探讨HALP对SE患者预后的预测价值。

方法

在这项回顾性研究中,我们调查并验证了HALP对成年SE患者预后的预测价值。我们收集了患者的临床特征和实验室检查数据。获取了SE发作后30天死亡率的信息,并使用改良Rankin量表(mRS)评分来评估临床结局。应用多变量逻辑回归模型探讨HALP与SE预后之间的关联。进行受试者操作特征(ROC)曲线分析以确定HALP预测SE患者30天死亡率的最佳临界值。

结果

我们首先分析了116例SE患者的发现队列。我们观察到,19.0%(22/116)的患者在SE发作后30天内死亡,26.3%(20/76)的患者在6个月随访期间预后不良。多变量逻辑回归分析表明,入院时较低的HALP是30天死亡率的独立预测因素(比值比:0.980;95%置信区间,0.962 - 0.999;P = 0.044)。在ROC分析中,HALP为20.32被确定为预测SE患者30天死亡率的最佳临界值。此外,多变量逻辑回归分析表明,HALP < 20.32与SE不良结局风险增加相关(比值比:27.051;95%置信区间,3.589 - 203.909;P = 0.001),这在外部队列中得到了验证。

结论

较低的HALP与SE患者30天死亡率增加及功能结局不良独立相关。我们的研究结果表明,HALP可能是预测SE预后的一个有前景的生物标志物。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ce17/11606709/a87552860a37/JIR-17-9625-g0001.jpg

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