The Hemoglobin, Albumin, Lymphocyte, and Platelet (HALP) Score Is Associated With Poor Outcome of Acute Ischemic Stroke

Abstract

Background: The combined index of hemoglobin, albumin, lymphocyte, and platelet (HALP) is considered a novel score to reflect systemic inflammation and nutritional status. This study aimed to investigate the association between HALP score and poor outcome in patients with acute ischemic stroke (AIS).Methods: Consecutive AIS patients within 24 h after onset were prospectively enrolled. Poor outcome was a combination of a new stroke event (ischemic and hemorrhagic) and all-cause death within 90 days and 1 year. The association between HALP score and poor outcome was analyzed using Cox proportional hazards.Results: A total of 1,337 patients were included. Overall, 60 (4.5%) and 118 (8.8%) patients experienced poor outcome within 90 days and 1 year, respectively. Patients in the highest tertile of HALP score had a lower risk of poor outcome within 90 days and 1 year (hazard ratio: 0.25 and 0.42; 95% confidence intervals: 0.11–0.57 and 0.25–0.69, P for trend <0.01 for all) compared with those in the lowest tertile after adjusting relevant confounding factors. Adding HALP score to the conventional risk factors improved prediction of poor outcome in patients with AIS within 90 days and 1 year (net reclassification index, 48.38 and 28.95%; integrated discrimination improvement, 1.51 and 1.51%; P < 0.05 for all).Conclusions: Increased HALP score was associated with a decreased risk of recurrent stroke and death within 90 days and 1 year after stroke onset, suggesting that HALP score may serve as a powerful indicator for AIS.

The efficiency of HALP score, neutrophil-lymphocyte ratio, and platelet-lymphocyte ratio in predicting mortality in intensive care patients

“…In this index, the general well-being of the patient is assessed based on hemoglobin, albumin, lymphocyte, and platelet values. A high HALP score is associated with longer survival (8,11,13). Anemia is a common condition in intensive care patients.…”

“…Feng et al (19) stated that HALP score was an independent prognostic index in patients with esophageal cancer. Tian et al (11) showed that HALP score was associated with 90-day and 1-year mortality in patients with stroke. Xu et al (13) stated that HALP score was a good predictor of postoperative survival and recurrence in patients with pancreatic cancer.…”

“…called hemoglobin, albumin, lymphocyte, platelet (HALP) score reflects the general nutritional status and systemic inflammation of the patients. This score has been proven to be a useful prognostic factor in stomach, prostate, bladder and kidney malignancies and patients with an acute ischemic attack (7)(8)(9)(10)(11). Lymphocytes play a key regulatory role in inflammation.…”

Sterile Leukocytosis Predicts Hemorrhagic Transformation in Arterial Ischemic Stroke: A National Inpatient Sample Study

“…These immune cells exacerbate the injury by releasing additional inflammatory factors, such as ROS, MMP-9, and neutrophil elastase, which are prominent effectors of BBB disruption [17]. It also has been shown that most AIS patients course some degree of immune dysregulation; however, when these mechanisms are overstimulated worsen short and long-term clinical outcomes are expected [18][19][20].…”

Atherogenic Index of Plasma Predicts Outcomes in Acute Ischemic Stroke

“…Patients enrolled in the study were from the database of the Henan Province Stroke Registry ( 14 – 16 ) at the First Affiliated Hospital of Zhengzhou University from January 2015 to December 2018. AIS was diagnosed according to criteria defined by the World Health Organization ( 17 ) based on neuroimaging results, patient history, and clinical data.…”