Uluç Kamuran, Akkütük Öngel Esra, Çolakoğlu Şükran Merve, Köylü İlkaya Nazan, Devran Özkan, Küçük Ahmet Oğuzhan, Kutbay Özçelik Hatice
Department of Critical Care Medicine, University of Health Sciences Turkey, Istanbul Başakşehir Çam and Sakura City Hospital, Istanbul, Turkey.
Department of Critical Care Medicine, University of Health Sciences Turkey, Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey.
Clin Interv Aging. 2025 Jun 7;20:815-823. doi: 10.2147/CIA.S482214. eCollection 2025.
This study aims to evaluate the effects of the hemoglobin, albumin, lymphocyte, and platelet (HALP) score, C-reactive protein/albumin ratio (CAR), and platelet/lymphocyte ratio (PLR) on predicting mortality in geriatric patients admitted to the respiratory intensive care unit (ICU).
In this retrospective observational cohort study, data of patients followed up in the respiratory ICU between 01.07.2021 and 31.12.2023 were evaluated. Age, gender, HALP score, hemoglobin, albumin, lymphocyte, platelet, and C-reactive protein (CRP) levels, along with PLR, CAR, and patient prognosis (exitus/discharge), were recorded from patient files and the hospital data processing system.
The study included 405 patients (140 women and 265 men) over 65 years of age. In multivariate analysis, higher PLR and CAR values were associated with a higher mortality rate, whereas patients with a higher HALP score had a lower mortality rate (p<0.001). In the ROC analysis, a statistically significant cut-off value was found for the HALP score in predicting mortality (p<0.001). HALP score ≤ 9.94 indicates mortality, with a sensitivity of 67.25%, specificity of 53%, PPV (positive predictive value) of 64.98%, and NPV (negative predictive value) of 55%. CAR value ≥ 30.13 indicates mortality, with a sensitivity of 69.87%, specificity of 61.36%, PPV of 70.18% and NPV of 61.02%. There was no statistically significant cut-off value for PLR in predicting mortality (p=0.076).
We found that the HALP score, PLR value, and CAR value are important scores that may be useful in determining mortality and treatment modality in geriatric patients treated in the ICU.
本研究旨在评估血红蛋白、白蛋白、淋巴细胞和血小板（HALP）评分、C反应蛋白/白蛋白比值（CAR）以及血小板/淋巴细胞比值（PLR）对预测入住呼吸重症监护病房（ICU）的老年患者死亡率的影响。
在这项回顾性观察性队列研究中，对2021年7月1日至2023年12月31日期间在呼吸ICU接受随访的患者数据进行了评估。从患者病历和医院数据处理系统中记录了年龄、性别、HALP评分、血红蛋白、白蛋白、淋巴细胞、血小板和C反应蛋白（CRP）水平，以及PLR、CAR和患者预后（死亡/出院）情况。
该研究纳入了405名65岁以上的患者（140名女性和265名男性）。在多变量分析中，较高的PLR和CAR值与较高的死亡率相关，而HALP评分较高的患者死亡率较低（p<0.001）。在ROC分析中，发现HALP评分在预测死亡率方面有统计学意义的临界值（p<0.001）。HALP评分≤9.94表明死亡，敏感性为67.25%，特异性为53%，阳性预测值（PPV）为64.98%，阴性预测值（NPV）为55%。CAR值≥30.13表明死亡，敏感性为69.87%，特异性为61.36%，PPV为70.18%，NPV为61.02%。PLR在预测死亡率方面没有统计学意义的临界值（p=0.076）。
我们发现HALP评分、PLR值和CAR值是重要的评分，可能有助于确定在ICU接受治疗的老年患者的死亡率和治疗方式。
