THE PERFORMANCE OF HALP SCORE IN PREDICTING IN-HOSPITAL MORTALITY RISK AMONG VERY ELDERLY PATIENTS WITH RESPIRATORY-RELATED HOSPITALIZATION HALP Skorunun Solunum Problemiyle Yatışı Yapılan Çok Yaşlı Hastalarda Hastane İçi Mortalite Riskinin Tahminindeki Rolü

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Akbay M. Ö., Ernam D.

Journal of Kirikkale University Faculty of Medicine, cilt.27, sa.3, ss.378-385, 2025 (Scopus, TRDizin)

Özet

Objective: This study aimed to investigate the performance of the novel score combining hemoglobin and albumin levels and lymphocyte and platelet count (HALP) in predicting in-hospital mortality risk in very elderly patients with respiratory-related hospitalization. Material and Methods: A total of 2011 very elderly (over 80 years) patients with respiratory-related hospitalization were included in this single-center retrospective cohort study. Reason for hospitalization, comorbidities, complete blood count and biochemistry findings on the first day of hospital admission, length of hospital stay (LOS), and in-hospital mortality were recorded. Factors predicting in-hospital mortality risk were analyzed via the univariate and multivariate Cox regression analyses. The ROC curve analysis was performed to determine the performance of HALP score in predicting the in-hospital mortality risk. Results: The median age was 83 years (range, 80 to 108 years) and males comprised 51.6% of the study population. The in-hospital mortality rate was 7%. The lower HALP score (HR 0.693, 95% CI: 0.549 to 0.875, p=0.002), male gender (HR 0.654, 95% CI: 0.453 to 0.945, p=0.024), and higher C-reactive protein (CRP) values (HR 1.004, 95% CI: 1.002 to 1.006, p<0.001) were found to predict the increased risk of in-hospital mortality on multivariate analysis. The median LOS was 7 days. There was a significant negative correlation between HALP scores and LOS (r=-0.153, p<0.001). ROC analysis revealed the HALP score to be a potential marker of in-hospital mortality risk in very elderly patients with respiratory-related hospitalization, at a cut-off value of ≤13.7 (AUC: 0.706, 95% CI: 0.685 to 0.726, p<0.001) and with a sensitivity of 60.7% and specificity of 69.8%. Conclusion: As an independent prognostic factor of in-hospital mortality risk in very elderly patients with respiratory-related hospitalization, the use of the HALP score may aid clinicians in timely recognition of at-risk patients and in making strategic decisions for interventions.