Association between C-reactive protein-albumin-lymphocyte (CALLY) index with intravenous immunoglobulin non-response in Kawasaki disease.

BACKGROUND

The CRP-albumin-lymphocyte (CALLY) index has been demonstrated to be a predictive tool for tumors. However, studies on its role and clinical significance in predicting intravenous immunoglobulin (IVIG) non-response in patients with Kawasaki disease (KD) remains limited.

METHODS

A cohort of 975 patients with KD was recruited from four medical centers to examine their clinical and laboratory characteristics. Logistic regression analysis was employed to evaluate the association between CALLY and IVIG non-response in KD patients. Restricted cubic spline (RCS) regression models were utilized to explore potential nonlinear relationships. Subgroup analyses were also conducted. The predictive capability of CALLY was compared to that of the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and the ratio of C-reactive protein to albumin (CAR).

RESULTS

Regardless of adjustments for confounding variables, CALLY, whether considered as a continuous or categorical variable, demonstrated a negative association with IVIG non-response. The relationship between the natural logarithm-transformed CALLY and IVIG non-response exhibited a non-linear trend, with a threshold identified at -0.752. Below this threshold, a negative association was observed between ln CALLY and IVIG non-response; however, no significant association was detected above the threshold. Subgroup analyses revealed no significant interactions between CALLY and IVIG non-response (all for interaction >0.05). The predictive capability of CALLY was found to be superior to that of CAR, NLR and PLR.

CONCLUSION

The CALLY parameter demonstrated a negative and nonlinear correlation with the risk of IVIG non-response, outperforming traditional inflammatory markers in predicting IVIG non-response.