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危重症外科患者中HALP评分与一年死亡率之间的L型关系:一项回顾性队列研究。

The L-shaped relationship between HALP score and one-year mortality in critically ill surgical patients: a retrospective cohort study.

作者信息

Xia Hao, Lai Jiawei, Lin Jinzhan, Yang Zhaobin, Qiu Luzhen

机构信息

Department of Medicine Intensive Care Unit, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, 363000, Fujian, China.

出版信息

Sci Rep. 2025 Jul 4;15(1):23879. doi: 10.1038/s41598-025-93821-9.

Abstract

The hemoglobin, albumin, lymphocyte, and platelet (HALP) score serves as a composite biomarker reflecting systemic inflammatory and nutritional status, which has demonstrated prognostic significance across various clinical conditions. This investigation specifically examines the association between HALP scores and 12-month mortality in critically ill surgical patients. Analyzing retrospective data from 8,052 patients in the Taichung Veterans General Hospital Critical Care Database, we employed nonlinear regression modeling with smooth curve fitting, threshold effect analysis, and multivariable logistic regression. The cohort demonstrated a 24.2% one-year mortality rate, with adjusted analyses revealing a nonlinear L-shaped association between HALP scores and mortality risk (p < 0.001). Below the inflection point of 44.8, each unit increase in HALP score was associated with a 2.6% reduction in mortality risk. When categorized into quartiles (Q2: 22.3-35.1; Q3: 35.2-53.9; Q4: 54.0-172.5), the adjusted odds ratios for 12-month mortality demonstrated progressive attenuation: 0.74 (95% confidence interval [CI] 0.64-0.86; P < 0.001) for Q2, 0.58 (95% CI 0.50-0.69; P < 0.001) for Q3, and 0.46 (95% CI 0.39-0.55; P < 0.001) for Q4, relative to the lowest quartile. Stratified and sensitivity analyses confirmed the robustness of these findings. This study demonstrates that lower HALP scores are associated with poorer long-term prognosis in critically ill surgical patients.

摘要

血红蛋白、白蛋白、淋巴细胞和血小板(HALP)评分是一种反映全身炎症和营养状况的综合生物标志物,已在各种临床情况下显示出预后意义。本研究专门探讨HALP评分与重症外科患者12个月死亡率之间的关联。通过分析台中荣民总医院重症监护数据库中8052例患者的回顾性数据,我们采用了非线性回归建模、平滑曲线拟合、阈值效应分析和多变量逻辑回归。该队列的一年死亡率为24.2%,校正分析显示HALP评分与死亡风险之间呈非线性L形关联(p<0.001)。在44.8的拐点以下,HALP评分每增加一个单位,死亡风险降低2.6%。当分为四分位数(Q2:22.3-35.1;Q3:35.2-53.9;Q4:54.0-172.5)时,12个月死亡率的校正比值比呈逐渐下降趋势:Q2为0.74(95%置信区间[CI]0.64-0.86;P<0.001),Q3为0.58(95%CI 0.50-0.69;P<0.001),Q4为0.46(95%CI 0.39-0.55;P<0.001),相对于最低四分位数。分层分析和敏感性分析证实了这些发现的稳健性。本研究表明,较低的HALP评分与重症外科患者较差的长期预后相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2005/12227695/006df82228ae/41598_2025_93821_Fig1_HTML.jpg

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