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Objective: The aim of this study is to compare the relationship between molecular classification and HALP score in endometrial cancer (EC). Methods: Patients who were operated with the diagnosis of EC 2014 and 2024 were included in our study. 150 patients were included in the study. We divided the patients into three groups in terms of molecular classification; group 1 was the patients with POLE mutation, group 2 was the patients with MMRd and NSMP (intermediate prognosis), and group 3 was the patients with p53 mutation. Group 2 participants were divided into two groups, a low HALP score group and a high HALP score group, according to the HALP score cut‐off value. Results: Using the value with the highest Youden's index (0.306) as a basis, it was demonstrated that the HALP score with a cut‐off value of 33.735 has a sensitivity of 61.86% and a specificity of 68.75% in intermediate‐risk EC. The 5‐year overall survival (OS) was found to be 75.4% in intermediate‐risk EC patients with low HALP scores and 91.5% in intermediate‐risk EC patients with high HALP scores (p = 0.008). The 5‐year progression‐free survival (PFS) was found to be 86% in intermediate‐risk EC patients with low HALP scores and 94.4% in intermediate‐risk EC patients with high HALP scores (p = 0.089). MMR deficiency and NSMP have been considered intermediate‐risk groups for endometrial cancer and are a heterogeneous group. Although the use of the HALP score to reduce this heterogeneity is successful in predicting OS, it is not sufficient for PFS. [ABSTRACT FROM AUTHOR]

ABSTRACT Introduction Materials and Methods Results Conclusion Hodgkin lymphoma (HL) constitutes 10% of all lymphoma diagnoses and accounts for 5% of lymphoma‐related deaths. Accurate prognostication in HL remains crucial, particularly given that 10%–20% of patients may receive either insufficient or excessive treatment. This study investigates the effect of hemoglobin, albumin, lymphocyte, and platelet (HALP) score, which is a marker of inflammation status and nutrition, at the time of diagnosis for the patients with HL on prognosis.A total of 147 patients diagnosed with cHL were included in the study, and their data were analyzed retrospectively. The significance of the HALP score and hematological indices [neutrophil‐lymphocyte ratio (NLR), lymphocyte‐monocyte ratio (LMR), and platelet‐lymphocyte ratio (PLR)] as predictors of overall survival (OS) and disease‐free survival (DFS) was evaluated.Patients were grouped according to median values for the HALP score and hematological indices. High HALP score (p = 0.034), low NLR (p = 0.033), high LMR (p = 0.003), and low PLR (p = 0.014) were statistically significant in the early‐stage favorable group. DFS and OS were not statistically significant according to the HALP score NLR, LMR, and PLR groups.The need for readily applicable, reliable prognostic markers in cHL, where immunotherapy treatments have led to significantly improved survival outcomes, remains persistent. [ABSTRACT FROM AUTHOR]

Background: The association between the Hemoglobin, Albumin, Lymphocyte, and Platelet (HALP) score and serum prostate-specific antigen (PSA) and allcause mortality remains underexplored. We aimed to investigate the relationship between HALP score and these outcomes among middle-aged and elderly individuals without prostate cancer (PCa). Methods: This cross-sectional study included participants aged 40 years and older from National Health and Nutrition Examination Survey (NHANES) 2001-- 2010. HALP score was calculated using the formula: HALP score = (Hemoglobin x Albumin x Lymphocytes)/Platelets. High PSA level was defined as a percentage free PSA (%fPSA) less than or equal to 25% and a total PSA (tPSA) level equal to or higher than 4.0 ng/mL. Mortality data were obtained through December 30, 2019 by linking to the National Death Index. Results: Among 7,334 participants, 6,826 were classified as having low PSA level, while 508 were categorized as having high PSA level. Logistic regression revealed lower odds of high PSA level with higher HALP quartiles (Ptrend<0.001). Among 508 participants with high PSA level, over a median follow-up period of 10.13 years (IQR: 5.42-13.17 years), a total of 268 all-cause deaths were recorded. Cox regression analysis showed that participants in the highest HALP quartile had the lowest risk of all-cause mortality (HR = 0.527, 95% CI: 0.368-0.754) in participants with high PSA level. Restricted cubic spline analysis indicated a non-linear and negative correlation between HALP score and all-cause mortality, with an inflection point at 43.98 (P for non-linearity = 0.009). Random survival forest analysis ranked HALP score as the most significant predictor for all-cause mortality. Conclusion: Our study highlights that the HALP score the HALP score is associated with high PSA level and all-cause mortality among middle-aged and elderly individuals without PCa. Further research is warranted to validate these findings and elucidate underlying mechanisms. [ABSTRACT FROM AUTHOR]

Colorectal polyps, precursors to colorectal cancer (CRC), require precise identification for appropriate diagnosis and therapy. This study aims to investigate the differences in hematological and inflammatory markers, specifically the CALLY index, HALP score, and immuno-inflammatory indexes, between neoplastic and nonneoplastic polyps. A retrospective cross-sectional study was conducted on 758 patients aged 61.0 ± 11.8 who underwent polypectomy between June 2021 and May 2024. Patients with colorectal adenocarcinoma (n = 22) were excluded. The polyps were classified into neoplastic and nonneoplastic categories based on histopathological evaluation. The study compared the CALLY index, HALP score, and various inflammatory indexes between neoplastic and nonneoplastic polyps. Out of 758 polyps analyzed, 514 were neoplastic, and 244 were nonneoplastic. Neoplastic polyps exhibited significantly lower CALLY and HALP scores (p < 0.05) and higher immuno-inflammatory indexes (p < 0.05) compared to nonneoplastic polyps. Dysplasia status, polyp diameter, and sigmoid colon localization were significant factors in determining neoplastic growth potential. No significant differences were observed in polyp localization in the proximal and distal colon segments or in solitary versus multiple polyps. The CALLY and HALP scores and immuno-inflammatory indexes can serve as valuable markers for distinguishing neoplastic from nonneoplastic polyps. These indexes reflect underlying inflammatory and immune responses, highlighting their potential utility in the early detection and risk stratification of colorectal polyps. Integrating these markers into clinical practice may enhance diagnostic accuracy and improve patient management, leading to timely interventions and better outcomes for individuals at risk of CRC. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to evaluate the potential of immunonutritional markers, specifically the hemoglobin, albumin, lymphocyte, and platelet (HALP) score and the prognostic nutritional index (PNI), in predicting late-onset fetal growth restriction (LO-FGR) during the first trimester. Materials and methods: This retrospective study was conducted at a tertiary care center between October 2022 and August 2023. The study included a total of 213 singleton pregnancies, with 99 women in the LO-FGR group and 114 in the healthy control group, matched by maternal age and gestational age at delivery. All blood samples were collected between 11 and 14 weeks of gestation (during the first-trimester screening test). We analyzed first-trimester laboratory parameters, specifically focusing on hemoglobin levels, white blood cells (WBCs), lymphocytes, platelets, and albumin levels. Afterwards, we calculated the HALP score and PNI, and then compared the values of both groups. Results: Both HALP score (3.58 ± 1.31 vs. 4.19 ± 1.8, p = 0.012) and PNI (36.75 ± 2.9 vs. 39.37 ± 3.96, p < 0.001) were significantly lower in the FGR group than in the control group. The HALP score cut-off value of < 3.43 in predicting FGR had a sensitivity of 62.3% and specificity of 54.5% (AUC = 0.600, 95% CI: 0.528–0.672, p = 0.012). The PNI cut-off value of < 37.9 in predicting FGR had a sensitivity of 65.8% and specificity of 62.9% (AUC = 0.707, 95% CI: 0.632–0.778, p < 0.001). While the HALP score was not a significant predictor of composite adverse neonatal outcomes in the FGR group, PNI showed a cut-off value of < 37.7 with a sensitivity of 60.9% and specificity of 59.7% (AUC = 0.657, 95% CI: 0.581–0.733, p < 0.001). Conclusion: The HALP score and PNI are valuable prognostic tools for predicting the risk of FGR in the first trimester. Low PNI values are also associated with composite adverse neonatal outcomes in pregnancies complicated by FGR. [ABSTRACT FROM AUTHOR]

Background: The HALP score, comprising hemoglobin, albumin, lymphocyte, and platelet levels, serves as an indicator of both nutritional and inflammatory status. However, its correlation with all-cause and cause-specific mortality among cancer survivors remains unclear. Therefore, this study aims to investigate the relationship between HALP scores and mortality outcomes in this population. Method: We extracted cohort data spanning ten cycles (1999-2018) from the U.S. National Health and Nutrition Examination Survey (NHANES). Mortality rates, determined using the National Death Index (NDI) as of December 31, 2019, were assessed. Weighted multivariate logistic regression analyzed the association between HALP scores and cancer prevalence. Kaplan-Meier analyses and weighted multivariate-adjusted Cox analyses investigated the link between HALP scores and all-cause and cause-specific mortality in cancer survivors. Restricted cubic spline (RCS) analysis was employed to assess nonlinear relationships. Furthermore, multi-parametric subgroup analyses were conducted to ensure the robustness of the results. Results: Our study included 41,231 participants, of whom 3,786 were cancer survivors (prevalence: 9.5%). Over a median follow-up of 91 months (range: 51-136), we observed 1,339 deaths, including 397 from cancer, 368 from cardiocerebrovascular disease, and 105 from respiratory disease. Elevated HALP scores showed a consistent association with reduced cancer incidence (P for trend <0.001). In multivariable-adjusted Cox regression analyses, HALP scores were significantly inversely associated with all-cause mortality, cancer mortality, cardio-cerebrovascular disease mortality, and respiratory disease mortality in cancer survivors (P for trend < 0.05). Nonlinear relationships between HALP scores and all-cause and cause-specific mortality in cancer survivors were evident through RCS regression modeling (P for nonlinearity < 0.01). Kaplan-Meier analyses demonstrated that higher HALP scores were indicative of a poorer prognosis. Conclusion: Our findings indicate a notable inverse correlation between HALP scores and both all-cause and cause-specific mortality among cancer survivors. [ABSTRACT FROM AUTHOR]

Background: The recent hemoglobin, albumin, lymphocyte, and platelet (HALP) scores, combined with various clinically available indicators, can comprehensively evaluate the nutritional and immune status of patients. Some observational studies have found a positive correlation between HALP score and cancer prognosis, but the clinical application of HALP score has raised concerns due to the presence of confounding factors. The aim of this study is to explore the relationship between HALP score and long-term mortality in cancer patients. Methods: We extracted 3832 cancer patients with complete baseline information from the National Health and Nutrition Examination Survey (NHANES). The COX regressions and restricted cubic spline (RCS) curves were used to explore the nonlinear relationship between HALP score and long-term mortality risk in cancer patients. Kaplan-Meier (K-M) curve was conducted to evaluate the impact of HALP score on long-term mortality risk. Additionally, subgroup analysis was conducted to verify the stability of the above results. Results: We divided participants into 4 groups based on HALP score, and the COX regression results showed that risk of long-term mortality tended to be lower in cancer patients with high HALP scores. Meanwhile, the RCS curves showed that there was a nonlinear association. The results remained stable in subgroup analyses and in breast cancer, colorectal cancer, cervix and uterus cancer, melanoma, prostate cancer and skin cancer. Conclusions: HALP score were independently associated with the risk of longterm mortality in cancer patients, and there is also a non-linear association. This will provide new perspectives on clinical and nutritional interventions for cancer patients. [ABSTRACT FROM AUTHOR]

Introduction Hemoglobin, albumin, lymphocyte, and platelet (HALP) score has been used to predict the prognosis in several types of cancers for the last few years. We aimed to reveal whether HALP score has high sensitivity and specificity in the detection of diabetic nephropathy. Methods A cross-sectional study developed in Abant Izzet Baysal University Hospital in Bolu, Türkiye. Patients with type 2 diabetes mellitus (DM) were enrolled in the study. Study cohort included patients with diabetic nephropathy and patients without diabetic nephropathy. Pregnant women, subjects with malignancy, active infections conditions, and rheumatologic or hematologic diseases were excluded. We retrospectively analyzed and compared the HALP scores of the type 2 DM patients with and without diabetic nephropathy. Moreover, we sought correlation between HALP score and fasting glucose, glycated hemoglobin (HbA1c), and estimated glomerular filtration rate (eGFR). Results A total of 356 DM patients, 162 with nephropathy and 194 without nephropathy were included in the study. The HALP score was 44.86 (4.5–119.9) in the nephropathic group, while it was 55.14 (13.2–173.7) in the nonnephropathic group (p < 0.001). HALP score was negatively correlated with HbA1c (r = –0.66, p = 0.003) and fasting glucose (r = –0.65, p = 0.002), while positive correlation was found between HALP score and eGFR (r = 0.13, p = 0.02). HALP score lower than 45.9% have 73% sensitivity and 52% specificity in detecting diabetic nephropathy (area under the curve: 0.64, p < 0.001, 95% confidence interval: 0.59–0.70). Conclusion We suggest that HALP score can become a simple and easy to assess marker for diabetic nephropathy in addition to standard tests. [ABSTRACT FROM AUTHOR]

Background/Objectives: Acute decompensated heart failure (ADHF) presents a significant clinical challenge characterized by frequent hospitalizations, high mortality rates, and substantial healthcare costs. The united index of hemoglobin, albumin, lymphocytes and platelets (HALP) is a new indicator that reflects systemic inflammation and nutritional status. This study aimed to investigate the prognostic utility of the HALP score and hematological parameters in predicting short-term mortality among ADHF patients admitted to the coronary care unit (CCU). Methods: This investigation adopts a retrospective observational design, encompassing a cohort of patients with ADHF who were followed in the CCU at our medical institution between January 2019 and April 2024. Results: The cohort of 227 individuals was dichotomized into two subsets based on the presence or absence of short-term mortality in the hospital, resulting in 163 (71.8%) and 64 (28.2%) individuals in the survivor and exitus groups, respectively. Age was significantly higher in the exitus group (p-value = 0.004). Hemoglobin, lymphocyte count, platelet count, albumin, and HALP score were significantly higher in the survivor group (all p-values < 0.001). No significant difference was observed between the groups in terms of gender, diabetes mellitus (DM), coronary artery disease (CAD), or ejection fraction (EF), although hypertension (HT) prevalence was significantly higher in the exitus group (p-value = 0.038). ROC analysis demonstrated that hemoglobin, lymphocyte, albumin, and HALP score had significant discriminative power, with albumin showing the highest AUC (0.814). Conclusions: In conclusion, the HALP score and hematological parameters represent valuable prognostic feature for short-term mortality prediction in ADHF patients admitted to the CCU. These findings underscore the importance of early risk stratification and targeted interventions guided by comprehensive biomarker assessments in optimizing patient outcomes. [ABSTRACT FROM AUTHOR]

Abstract Objective The aim of this study was to evaluate the potential of immunonutritional markers, specifically the hemoglobin, albumin, lymphocyte, and platelet (HALP) score and the prognostic nutritional index (PNI), in predicting late-onset fetal growth restriction (LO-FGR) during the first trimester. Materials and methods This retrospective study was conducted at a tertiary care center between October 2022 and August 2023. The study included a total of 213 singleton pregnancies, with 99 women in the LO-FGR group and 114 in the healthy control group, matched by maternal age and gestational age at delivery. All blood samples were collected between 11 and 14 weeks of gestation (during the first-trimester screening test). We analyzed first-trimester laboratory parameters, specifically focusing on hemoglobin levels, white blood cells (WBCs), lymphocytes, platelets, and albumin levels. Afterwards, we calculated the HALP score and PNI, and then compared the values of both groups. Results Both HALP score (3.58 ± 1.31 vs. 4.19 ± 1.8, p = 0.012) and PNI (36.75 ± 2.9 vs. 39.37 ± 3.96, p

Introduction: Endovascular aortic repair (EVAR) is commonly used for abdominal aortic aneurysms, but its mortality rate remains high. The hemoglobin, albumin, lymphocyte, and platelet (HALP) score, which measures hemoglobin, albumin, lymphocyte, and platelet levels, provides prognostic value by reflecting the nutritional status and systemic inflammation. This study aimed to explore the relationship between the HALP score upon admission and long-term mortality in patients with EVAR. Methods: Consecutive patients with EVAR at our tertiary center from October 2010 to August 2021 were retrospectively analyzed. HALP scores were calculated using the following formula: hemoglobin (g/L) × albumin (g/L) × lymphocyte count (/L)/platelet count (/L). In-hospital and long-term mortality data were extracted. Receiver operating characteristic curve analysis identified predictors of in-hospital mortality. Multivariate Cox regression analysis was performed to examine determinants of long-term mortality. Results: Among the 162 participants (mean age: 69.4±8.2 years, 90.1% male), the HALP score was the most significant predictor of in-hospital mortality (area under the curve: 0.752, 95% confidence interval: 0.674-0.830; p

Abstract Background The Hemoglobin, Albumin, Lymphocyte, Platelet Score (HALP) is a novel predictive biomarker that has surfaced in the literature in recent years. It has been applied to the prediction of many clinical outcomes related to different neoplasms. Each of these inflammatory and nutritional markers is taken into account by the HALP score, which provides an overall prognosis for patients with cancer. Methods Retrospective data was collected on the demographics of patients hospitalized to our hospital's intensive care unit (ICU) for hematologic malignancies between January 2014 and March 2021. To measure the prognostic value of the HALP score, it was retrospectively calculated for patients with hematologic malignancies on the first day of ICU admission. This study looked into the link between the HALP score and general prognostic characteristics because it has been suggested that the HALP score is a relevant prognostic marker. Results Patients with an HALP score

Shuqi Wang,1,2 Boying Jia,1,2 Sifan Niu,2,3 Shuchun Chen1,2 1Department of Internal Medicine, Hebei Medical University, Shijiazhuang, People’s Republic of China; 2Department of Endocrinology, Hebei General Hospital, Shijiazhuang, People’s Republic of China; 3Department of Internal Medicine, North China University of Science and Technology, Tangshan, People’s Republic of ChinaCorrespondence: Shuchun Chen, Department of Endocrinology, Hebei General Hospital, Shijiazhuang, People’s Republic of China, Tel/Fax +86 31185988406, Email chenshuc2014@163.comPurpose: To explore the correlation between hemoglobin, albumin, lymphocyte count, platelet count (HALP) score and type 2 diabetic retinopathy (DR).Methods: The study was conducted on 674 patients with type 2 diabetes (T2DM). According to the results of the fundus examination, they were divided into non-diabetic retinopathy group (NDR, n=388) and diabetic retinopathy group (DR, n=286). Collected patients baseline data, calculated HALP score, analyzed the correlation between HALP score and DR.Results: In all patients, male patients and female patients, the HALP score of the DR group was lower than that of the NDR group (P< 0.001), and the HALP score was negatively correlated with the incidence of DR (P< 0.05). HALP score was independent risk factors for DR, regardless of gender. In male patients, HALP score and DR had a linear relationship, but in female patients, HALP score and DR showed a nonlinear relationship, and HALP score was more sensitive to the onset of DR in male patients. The combined diagnostic model of HALP score, course of disease, SBP and BUN was used to diagnose DR, and it was found that the diagnostic value was the highest among male patients, with AUC of 0.761, sensitivity of 58.3% and specificity of 80.3%.Conclusion: HALP score was an independent risk factor for DR, attention should be paid to monitoring HALP score, especially in male T2DM patients. The accuracy of HALP score, disease course, SBP and BUN combined model diagnosis of DR was high, which can become a biological indicator for early screening of DR.Keywords: HALP score, type 2 diabetes, diabetic retinopathy

Abstract Background The hemoglobin-albumin-lymphocyte-platelet (HALP) score functions as a comprehensive index that assesses the systemic inflammatory response, nutritional, and immune status. This study aimed to explore the relationship between preoperative HALP score and the prognosis of BC patients and to develop predictive nomograms. Methods Clinicopathological data were collected for BC patients who underwent mastectomy between December 2010 and April 2014 from Sun Yat-sen University Cancer Center. The optimal cutoff value for HALP was determined by maximally selected rank statistics for overall survival data. Propensity score matching (PSM) was applied to develop comparable cohorts of high-HALP group and low-HALP group. Kaplan–Meier curves and Cox regression analyses were performed to determine the impact of HALP on BC patients. Prognostic nomograms were developed based on the multivariate Cox regression method. Then, the concordance index (C-index), calibration plots, and decision curves analysis (DCA) were applied to evaluate the prognostic performance of the nomograms. Results A total of 1,856 patients were included as the primary cohort, and 1,470 patients were matched and considered as the PSM cohort. In the primary cohort, the 5-year overall survival (OS) and progression-free survival (PFS) rates for high-HALP group (≥ 47.89) and low-HALP group (

Xulin Liu,1,&ast; Zhancheng Qiu,2,&ast; Elijah Ndhlovu,1,&ast; Yunyan Wan,3 Huapeng Sun,4 Shuai Wang,5 Yugang Cao,6 Peng Zhu1 1Department of Hepatic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People’s Republic of China; 2Division of Liver Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan Province, People’s Republic of China; 3Department of Hepatobiliary Pancreatic Surgery, Taihe Hospital, Shiyan City, Hubei Province, People’s Republic of China; 4Department of General Surgery, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, People’s Republic of China; 5Department of Hepatobiliary Surgery, Jingzhou Central Hospital, Jingzhou, People’s Republic of China; 6Department of Hepatobiliary and Pancreatic Surgery, Huangshi Central Hospital of Edong Healthcare Group, Huangshi, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Peng Zhu, Department of Hepatic Surgery, Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei, People’s Republic of China, Tel +86 13907170712, Email zhupeng@tjh.tjmu.edu.cnPurpose: Early recurrence (ER) is associated with poor prognosis in hepatocellular carcinoma (HCC). In this study, we developed and externally validated a nomogram based on the hemoglobin, albumin, lymphocytes, and platelets (HALP) score to predict ER for patients with BCLC stage 0/A HCC who underwent radical liver resection.Patients and Methods: A total of 808 BCLC stage 0/A HCC patients from six hospitals were included in this study, and they were assigned to a training cohort (n = 500) and an external validation cohort (n = 308). We used univariate and multivariate Cox regression analysis to identify the independent risk factors for disease-free survival (DFS). We also established and externally validated a nomogram based on these risk predictors. The nomogram was evaluated using the area under the receiver operating characteristic curve (AUC), the concordance index (C-index), the calibration curve, decision curve analysis (DCA), and Kaplan‒Meier analysis.Results: Multivariate COX regression showed that HBV DNA ≥ 10,000 IU/mL (P < 0.001), HALP score ≤ 38.20 (P < 0.001), tumor size (P = 0.003), clinically significant portal hypertension (P = 0.001), Edmondson-Steiner grade (III–IV) (P = 0.007), satellite nodules (P < 0.001), and MVI (P = 0.001) were independent risk factors for post-operative tumor recurrence. The AUC of our nomogram for predicting the 2-year and 5-year DFS was 0.756 and 0.750, respectively, in the training cohort and 0.764 and 0.705, respectively, in the external validation cohort. We divided the patients into low-, intermediate- and high-risk groups according to the risk score calculated by the nomogram. There were statistically significant differences in the DFS and overall survival (OS) among the three groups of patients (P < 0.001).Conclusion: We developed and externally validated a new nomogram, which is accurate and can predict ER in BCLC stage 0/A HCC patients after curative liver resection.Keywords: early recurrence, hepatocellular carcinoma, HALP score, nomogram, Barcelona Clinic of Liver Cancer staging system, disease-free survival

Introduction: Endovascular aortic repair (EVAR) is commonly used for abdominal aortic aneurysms, but its mortality rate remains high. The hemoglobin, albumin, lymphocyte, and platelet (HALP) score, which measures hemoglobin, albumin, lymphocyte, and platelet levels, provides prognostic value by reflecting the nutritional status and systemic inflammation. This study aimed to explore the relationship between the HALP score upon admission and long-term mortality in patients with EVAR. Methods: Consecutive patients with EVAR at our tertiary center from October 2010 to August 2021 were retrospectively analyzed. HALP scores were calculated using the following formula: hemoglobin (g/L) x albumin (g/L) x lymphocyte count (/L)/platelet count (/L). In-hospital and long-term mortality data were extracted. Receiver operating characteristic curve analysis identified predictors of in-hospital mortality. Multivariate Cox regression analysis was performed to examine determinants of long-term mortality. Results: Among the 162 participants (mean age: 69.4±8.2 years, 90.1% male), the HALP score was the most significant predictor of in-hospital mortality (area under the curve: 0.752, 95% confidence interval: 0.674-0.830; p<0.001). Multivariate Cox regression analysis revealed HALP (p=0.001) and C-reactive protein (p=0.004) as independent determinants of long-term mortality. Conclusion: This study is the first to investigate the association between the HALP score and in-hospital and long-term mortality in EVAR patients. The HALP score is a robust prognostic tool compared with its components and other parameters in this patient population. [ABSTRACT FROM AUTHOR]

Background: The Hemoglobin, Albumin, Lymphocyte, Platelet Score (HALP) is a novel predictive biomarker that has surfaced in the literature in recent years. It has been applied to the prediction of many clinical outcomes related to different neoplasms. Each of these inflammatory and nutritional markers is taken into account by the HALP score, which provides an overall prognosis for patients with cancer. Methods: Retrospective data was collected on the demographics of patients hospitalized to our hospital's intensive care unit (ICU) for hematologic malignancies between January 2014 and March 2021. To measure the prognostic value of the HALP score, it was retrospectively calculated for patients with hematologic malignancies on the first day of ICU admission. This study looked into the link between the HALP score and general prognostic characteristics because it has been suggested that the HALP score is a relevant prognostic marker. Results: Patients with an HALP score <37.10 had significantly higher APACHE II scores (p < 0.001). They also had significantly higher rates of qSOFA score ≥2 (89.3%), as well as statistically significantly higher rates of intubation (96%) and death (96.1%) (p < 0.001). Our study found that a HALP score <37.1 was associated with a 47.04-fold increase in mortality risk. Conclusion: In patients with hematologic malignancies, the prognosis is strongly correlated with the HALP score. When validated in large cohorts, the HALP score, APACHE II, and q SOFA scores, either individually or collectively, can be used to guide prognostic evaluation of patients and act as a reliable predictor of unfavorable clinical outcomes in patients with hematologic malignancies. [ABSTRACT FROM AUTHOR]

Background: The hemoglobin-albumin-lymphocyte-platelet (HALP) score functions as a comprehensive index that assesses the systemic inflammatory response, nutritional, and immune status. This study aimed to explore the relationship between preoperative HALP score and the prognosis of BC patients and to develop predictive nomograms. Methods: Clinicopathological data were collected for BC patients who underwent mastectomy between December 2010 and April 2014 from Sun Yat-sen University Cancer Center. The optimal cutoff value for HALP was determined by maximally selected rank statistics for overall survival data. Propensity score matching (PSM) was applied to develop comparable cohorts of high-HALP group and low-HALP group. Kaplan–Meier curves and Cox regression analyses were performed to determine the impact of HALP on BC patients. Prognostic nomograms were developed based on the multivariate Cox regression method. Then, the concordance index (C-index), calibration plots, and decision curves analysis (DCA) were applied to evaluate the prognostic performance of the nomograms. Results: A total of 1,856 patients were included as the primary cohort, and 1,470 patients were matched and considered as the PSM cohort. In the primary cohort, the 5-year overall survival (OS) and progression-free survival (PFS) rates for high-HALP group (≥ 47.89) and low-HALP group (< 47.89) were 94.4% vs. 91.0% (P = 0.005) and 87.8% vs. 82.1% (P = 0.005), respectively. Similar results were observed in PSM cohort (5-year OS, 94.3% vs. 90.8%, P = 0.015; 5-year PFS, 87.5% vs. 83.2%, P = 0.036). Notably, multivariate Cox regression analysis in the PSM cohort showed that HALP could independently predict BC patient prognosis in both OS (HR: 0.596, 95%CI [0.405–0.875], P = 0.008) and PFS (HR: 0.707, 95%CI [0.538–0.930], P = 0.013). OS and PFS nomograms showed excellent predictive performance with the C-indexes of 0.783 and 0.720, respectively. The calibration plots and DCA also indicated the good predictability of the nomograms. Finally, subgroup analysis further demonstrated a favorable impact of HALP on both OS and PFS. Conclusion: Preoperative HALP score can be used as a reliable independent predictor of OS and PFS in BC patients, and the nomograms may provide a personalized treatment strategy. [ABSTRACT FROM AUTHOR]

Objective: In recent years, the HALP score (calculated as the product of hemoglobin, albumin, lymphocytes, and platelets) has gained wide attention as a new indicator for assessing systemic inflammation and nutritional status. This study aims to investigate the relationship between the HALP score and post-stroke cognitive impairment (PSCI) in patients with acute ischemic stroke (AIS), as well as its predictive value. Methods: A total of 220 AIS patients were enrolled, and their general clinical data were collected. Based on the Montreal Cognitive Assessment (MOCA) scores, patients were categorized into the PSCI and the post-stroke non-cognitive impairment (PSNCI) groups. The HALP score was calculated using the formula: hemoglobin (g/L) × albumin (g/L) × lymphocytes (/L) / platelets (/L), and was divided into three tertiles. Binary logistic regression analysis was employed to explore the association between HALP and cognitive outcomes. Results: The HALP scores were found to be significantly lower in the PSCI group compared to the non-PSCI group (P<0.001). The HALP scores were divided into three categories: T1≤33.90, T2 33.90~53.75, and T3>53.75. In the binary logistic regression analysis, after controlling for confounding factors, the risk of PSCI was significantly higher in the T1 tertile compared to the T3 tertile (OR=9.38, 95% CI=1.93~45.95, P=0.006). However, there was no significant increase in the risk of PSCI in the T2 tertile (OR=1.52, 95% CI=0.58~4.02, P=0.393). Conclusion: The HALP score in the acute phase of AIS is associated with PSCI, and furthermore, the HALP score has diagnostic value for PSCI. [ABSTRACT FROM AUTHOR]

The immune system's amplified response to SARS-CoV-2 may lead to the production of autoantibodies, but their specific impact on disease severity and outcome remains unclear. This study aims to assess if hospitalized COVID-19 patients face a worse prognosis based on ANA presence, even without autoimmune diseases. We performed a retrospective, single-center, observational cohort study, enrolling 638 COVID-19 patients hospitalized from April 2020 to March 2021 at Hospital "Policlinico Riuniti" of Foggia (Italy). COVID-19 patients with a positive ANA test exhibited a significantly lower 30-day survival rate (64.4% vs. 83.0%) and a higher likelihood of severe respiratory complications during hospitalization than those with negative ANA screening (35.4% vs. 17.0%) (p < 0.001). The association between poor prognosis and ANA status was identified by calculating the HALP score (Hemoglobin-Albumin-Lymphocyte-Platelet), which was lower in COVID-19 patients with a positive ANA test compared to ANA-negative patients (108.1 ± 7.4 vs. 218.6 ± 11.2 AU; p < 0.011). In detail, COVID-19 patients with a low HALP showed a lower 30-day survival rate (99.1% vs. 83.6% vs. 55.2% for high, medium, and low HALP, respectively; p < 0.001) and a higher incidence of adverse respiratory events compared to those with high and medium HALP (13.1% vs. 35.2% vs. 64.6% for high, medium, and low HALP, respectively; p < 0.001). In summary, ANA positivity in COVID-19 patients appears to be linked to a more aggressive disease phenotype with a reduced survival rate. Furthermore, we propose that the HALP score could serve as a valuable parameter to assess prognosis for COVID-19 patients. [ABSTRACT FROM AUTHOR]

Background: The primary aim of this study was to investigate the correlation between diabetic retinopathy (DR) and the HALP score (hemoglobin, albumin, lymphocyte, and platelet) in individuals with diabetes within the United States population. Methods: This cross-sectional investigation was based on the National Health and Nutrition Examination Survey (NHANES) database from 2003-2018. The following module calculated the HALP score: HALP score = [lymphocytes (/L) × hemoglobin (g/L) × albumin (g/L)]/platelets (/L). By performing the receiver operating characteristic (ROC) analysis, the optimal cutoff value of HALP was ascertained. Restricted cubic splines (RCS), multivariable logistic regression analysis, sensitivity analysis, and subgroup analysis were conducted to evaluate the effect of the HALP score on DR patients. Finally, the decision curve analysis (DCA) and clinical impact curve (CIC) were conducted to estimate the predictive power and clinical utility of the HALP score with clinical indicators. Results: According to the cutoff value (42.9) determined by the ROC curve, the participants were stratified into a lower HALP group (HALPlow) and a higher HALP group (HALPhigh). An L-shaped relationship between HALP score and DR risk was presented in the RCS model (P for nonlinearity <0.001). The DR risk sharply decreased with the increase of HALP, and the decline reached a plateau when HALP was more than 42.9. After fully adjustment, the multivariate logistic regression analysis found that HALPlow was an independent risk factor for DR (OR = 1.363, 95% CI: 1.111-1.671, P < 0.001). Besides, sensitivity analysis showed consistent results. Furthermore, the combination of HALP score and clinical indicators demonstrated predictive power and clinical utility, as shown by the ROC curve, DCA, and CIC. Conclusion: The HALP score has an L-shaped correlation with the risk of DR, and thus, the HALP score may contribute to the timely intervention of diabetes patients. [ABSTRACT FROM AUTHOR]

Predictive tests are needed to ensure the development and subsequent follow-up of pre-eclampsia, which is responsible for significant rates of morbidity and mortality during pregnancy. This study aimed to evaluate the predictive value of the Hemoglobin, Albumin, Lymphocyte, and Platelet (HALP) score for the severity of preeclampsia. We retrospectively analyzed the data of women diagnosed with pre-eclampsia at our clinic from January 2019 to January 2023. The control group consisted of normotensive, healthy pregnant women. Women diagnosed with preeclampsia were further evaluated in two groups: those with severe features and those without severe features. The clinical and demographic data of the cases were evaluated. The HALP score was calculated using the first trimester blood parameters of the cases and compared between groups. The study included 229 patients with preeclampsia and 142 normotensive healthy controls. Of the patients with preeclampsia, 104 (28.1%) had severe features of the disease. The HALP score was significantly higher in the preeclampsia group with severe features than in the control group (6.18 ± 2.66 vs. 3.75 ± 1.86; p = 0.006). In multivariate logistic regression analysis, the HALP score (odds ratio: 2.02, 95% confidence interval: 1.10–3.32, p = 0.017) was found to be an independent indicator for preeclampsia with severe features. A HALP score of > 4.61 predicted the development of preeclampsia with severe features with a sensitivity of 74.5% and a specificity of 81.3%. We found a significant correlation between the HALP score and preeclampsia with severe features. The HALP score may be useful in predicting the severity of preeclampsia. [ABSTRACT FROM AUTHOR]

Background: Hemoglobin, albumin, lymphocyte, and platelet (HALP) scores are easily calculable markers that allow the evaluation of systemic inflammation and nutritional status. This study aimed to evaluate and compare the predictive power of HALP scores for 3-month and 1-year mortality in patients admitted to the emergency department with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods: Hospital records of patients aged > 18 years who had been diagnosed with AECOPD in the emergency department (ED) and hospitalized were retrospectively reviewed. The neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and HALP scores of the patients were analyzed. Three month and 1-year mortality rates of the patients were evaluated. Results: Mean age of the 957 patients were 70.6 ± 10.2 and 66.9% (n = 660) were male. The 3-month and 1-year mortality rates were 21.2% and 30.0%, respectively. For 3-month and 1-year mortality, the NLR and PLR were significantly higher and the HALP score was significantly lower in the mortality groups, and the HALP score was found to be a good predictor of 3-month and 1-year mortality. Conclusion: HALP score is a potential prognostic index for patients with AECOPD. Increased NLR and PLR were associated with increased mortality in patients with AECOPD. The HALP score, NLR, and PLR can be used as important predictors of mortality in patients with AECOPD. [ABSTRACT FROM AUTHOR]

Objectives: We aimed to investigate the relationship of neoadjuvant therapy with HALP score, menopausal status and pathological response in patients with luminal A and luminal B breast cancer. Methods: In this retrospective study, the files of patients who applied to Ondokuz Mayıs University Medical Oncology department between January 2016 and January 2023 were scanned and a total of 150 patients, 60 premenopausal and 90 postmenopausal, who received neoadjuvant chemotherapy were included. Results: The median age of premenopausal patients was 40.67±6.35 (min 25-max 50), and postmenopausal patients was 57.67±7.48 (min 43-max 78). There was no relationship between overall survival and menopausal status (p=0.33). HALP score was significant only in postmenopausal patients (p=0.008). There was a significant association with complete pathological response (Miller&Payne 5) and PFS in the entire population (p=0.003). HALP score was lower in patients with PR level below 50% (p=0.039). There was no statistical significant between Ki67 and cerbB2, menopausal status and HALP score (p=0.106, p=0.064, respectively). Conclusion: As a result, we did not detect the relationship between HALP score and pathological response in Luminal A and B patients receiving neoadjuvant therapy. [ABSTRACT FROM AUTHOR]

ST-elevation myocardial infarction (STEMI) is a medical emergency demanding immediate intervention, and primary percutaneous coronary intervention (pPCI) is the standard of care for this condition. While PCI has proven highly effective, a subset of patients experience the devastating no-reflow phenomenon, and some face increased short-term mortality. The Hemoglobin, Albumin, Lymphocyte, and Platelet (HALP) score, a novel biomarker-based tool, has recently surfaced as an innovative predictor of these adverse outcomes. This study aims to investigate the groundbreaking findings that designate a low HALP score as a robust risk factor for no-reflow and short-term mortality in STEMI patients. 1817 consecutive STEMI patients who underwent pPCI were included in this retrospective study, and the patients were divided into two groups according to whether no-reflow developed or not, and the HALP scores of the groups were compared. In addition, short-term mortality was compared between the study groups according to their HALP score values. The predictive ability of the HALP score for no-reflow was evaluated using a receiver operating characteristic curve. No-reflow developed in 198 (10.1%) of the patients included in the study. HALP score value was found to be significantly lower in the no-reflow group (27 ± 13 vs 47 ± 24, p < 0.001). After multivariable adjustment, the HALP score was an independent predictor of no-reflow (OR, 0.923, 95% CI, 0.910–0.935, p < 0.001). Furthermore, the HALP score showed good discrimination for no-reflow (AUC, 0.771, 95% CI, 0.737–0.805, p < 0.001). In addition, HALP score was determined to be an independent predictor for short-term mortality (HR, 0.955, 95% CI, 0.945–0.966, p < 0.001). HALP score can independently predict the development of no-reflow and short-term mortality in STEMI patients undergoing pPCI. [ABSTRACT FROM AUTHOR]

Colorectal polyps, precursors to colorectal cancer (CRC), require precise identification for appropriate diagnosis and therapy. This study aims to investigate the differences in hematological and inflammatory markers, specifically the CALLY index, HALP score, and immuno-inflammatory indexes, between neoplastic and nonneoplastic polyps. A retrospective cross-sectional study was conducted on 758 patients aged 61.0 ± 11.8 who underwent polypectomy between June 2021 and May 2024. Patients with colorectal adenocarcinoma (n = 22) were excluded. The polyps were classified into neoplastic and nonneoplastic categories based on histopathological evaluation. The study compared the CALLY index, HALP score, and various inflammatory indexes between neoplastic and nonneoplastic polyps. Out of 758 polyps analyzed, 514 were neoplastic, and 244 were nonneoplastic. Neoplastic polyps exhibited significantly lower CALLY and HALP scores (p < 0.05) and higher immuno-inflammatory indexes (p < 0.05) compared to nonneoplastic polyps. Dysplasia status, polyp diameter, and sigmoid colon localization were significant factors in determining neoplastic growth potential. No significant differences were observed in polyp localization in the proximal and distal colon segments or in solitary versus multiple polyps. The CALLY and HALP scores and immuno-inflammatory indexes can serve as valuable markers for distinguishing neoplastic from nonneoplastic polyps. These indexes reflect underlying inflammatory and immune responses, highlighting their potential utility in the early detection and risk stratification of colorectal polyps. Integrating these markers into clinical practice may enhance diagnostic accuracy and improve patient management, leading to timely interventions and better outcomes for individuals at risk of CRC.

We evaluated the prognostic value of the hemoglobin albumin lymphocyte and platelet (HALP) score and inflammatory index in patients with metastatic castration-resistant prostate cancer (mCRPC) treated with abiraterone and enzalutamide. In this retrospective study, 136 patients with mCRPC were treated with enzalutamide and abiraterone between January 2018 and March 2023; all data were collected from the hospital database. The HALP score and neutrophil-to-lymphocyte ratio (NLR) were calculated from baseline blood tests, and their impacts on progression-free survival (PFS) and overall survival (OS) were analyzed. Patients with lower HALP scores (= 23.78) exhibited a significantly reduced OS of 31.2 months compared with those with higher scores (> 23.78, OS: 63.9 months). Similarly, patients with a higher NLR (> 2.15) showed a poorer OS of 38.4 months compared with those with a lower NLR (= 2.15, OS: 70.1 months). The results were significant in terms of PFS. Patients with lower HALP scores had a PFS of 22.9 months, whereas those with higher scores had a longer PFS of 43.2 months. For NLR, patients with a score = 2.15 had a PFS of 43.0 months, whereas those with scores > 2.15 had a PFS of 33.5 months. These findings, supported by ROC curve analysis, Kaplan-Meier estimates, and Cox regression analysis, underscore the significance of the HALP score and NLR as prognostic factors. This study highlights the HALP score and NLR as effective, low-cost prognostic markers for patients with mCRPC undergoing treatment with next-generation anti-androgens. These biomarkers can predict patient outcomes and guiding treatment strategies. [ABSTRACT FROM AUTHOR]

Introduction: The overexpression of proinflammatory cytokines in obesity has suggested an association between obesity and inflammation. In this study, we aimed to predict the success of weight loss at the end of the first year of patients who underwent laparoscopic sleeve gastrectomy (LSG) for morbid obesity using hemoglobin, albumin, lymphocyte, and platelet (HALP) score and modified HALP (m-HALP) score. Materials and Methods: Patients were divided into two groups according to the success of weight loss. The groups were compared in terms of HALP score, m-HALP score, demographic parameters, and preoperative laboratory tests. The diagnostic performance measurements of the m-HALP score were calculated. In addition, logistic regression analysis was performed for the factors affecting weight loss in the first year after LSG. Results: Seventy-two patients were evaluated. The median m-HALP score of the patients with an excess weight loss percentage (EWL%) <60 threshold was 562 (416.6–891.9), the median m-HALP score of the patients with an EWL% above the 60 threshold was 394.3 (347.9–543), and the difference between the outcome groups was significant (P = .002).The accuracy of m-HALP score in identifying the patients whose EWL would be <60% 1 year after the surgery was 63.9 (95% confidence interval = 51.7–74.9). Conclusion: This study showed that the m-HALP score is effective in predicting weight loss after bariatric surgery. [ABSTRACT FROM AUTHOR]

Objective: This study examined systemic inflammatory indices and "Hemoglobin, Albumin, Lymphocyte, Platelet (HALP) scores" in neonates with hypoxic–ischemic encephalopathy (HIE). Methods: A total of 43 neonates with moderate-to-severe HIE at 36 weeks' gestation were assessed. Systemic inflammatory markers were measured before HT commenced within 0–6 h after birth and between 60 and 72 h during and after therapy or before adjusting for hypothermia. Results: Platelet counts, hemoglobin levels, and platelet indices in the HIE group were significantly lower at both time points (p = 0.001). Both the neutrophil-to-lymphocyte ratio (NLR) and monocyte-to-lymphocyte ratio (MLR) decreased in the HIE group after hypothermia therapy (p = 0.001). Seizures, PVL, and kidney injuries were associated with higher HALP scores. The AUCs of NLR, PLR, MLR, SII, SIRI, and platelet, neutrophil, monocyte, and lymphocyte Index (PIV) showed significant sensitivity and specified HIE, with area under the curve (AUC) values of 0.654, 0.751, 0.766, 0.700, 0.722, and 0.749, respectively. Conclusions: A significant difference in systemic inflammatory markers was found between the HIE and control groups after hypothermia treatment, with significant reductions in the MLR and NLR. These markers, particularly MLR, were significant predictors of adverse clinical outcomes including seizures, PVL, and kidney damage. [ABSTRACT FROM AUTHOR]

Systemic inflammation and nutritional status play important roles in the development and progression of various cancers, including colorectal cancer. The prognosis for malignancies can be predicted using the inflammatory marker known as HALP (calculated by hemoglobin, albumin, lymphocytes, and platelets). Furthermore, recent studies have claimed the HALP score to help distinguish between benign and malignant lesions. We aimed to research the diagnostic importance of the HALP score in the differentiation of malignant (colorectal cancer) and benign colorectal neoplasms (colorectal adenomas and hyperplastic polyps) and its prognostic significance in colorectal cancer patients. Patients diagnosed with colorectal cancer, colorectal adenoma, and hyperplastic polyps were evaluated retrospectively between January 2017 and January 2022. The median HALP score in the colorectal cancer group was significantly lower than the other groups (colorectal adenoma and hyperplastic polyps) (p [Med-Science 2023; 12(3.000): 791-5]

Background/Objectives: Acute decompensated heart failure (ADHF) presents a significant clinical challenge characterized by frequent hospitalizations, high mortality rates, and substantial healthcare costs. The united index of hemoglobin, albumin, lymphocytes and platelets (HALP) is a new indicator that reflects systemic inflammation and nutritional status. This study aimed to investigate the prognostic utility of the HALP score and hematological parameters in predicting short-term mortality among ADHF patients admitted to the coronary care unit (CCU). Methods: This investigation adopts a retrospective observational design, encompassing a cohort of patients with ADHF who were followed in the CCU at our medical institution between January 2019 and April 2024. Results: The cohort of 227 individuals was dichotomized into two subsets based on the presence or absence of short-term mortality in the hospital, resulting in 163 (71.8%) and 64 (28.2%) individuals in the survivor and exitus groups, respectively. Age was significantly higher in the exitus group (p-value = 0.004). Hemoglobin, lymphocyte count, platelet count, albumin, and HALP score were significantly higher in the survivor group (all p-values < 0.001). No significant difference was observed between the groups in terms of gender, diabetes mellitus (DM), coronary artery disease (CAD), or ejection fraction (EF), although hypertension (HT) prevalence was significantly higher in the exitus group (p-value = 0.038). ROC analysis demonstrated that hemoglobin, lymphocyte, albumin, and HALP score had significant discriminative power, with albumin showing the highest AUC (0.814). Conclusions: In conclusion, the HALP score and hematological parameters represent valuable prognostic feature for short-term mortality prediction in ADHF patients admitted to the CCU. These findings underscore the importance of early risk stratification and targeted interventions guided by comprehensive biomarker assessments in optimizing patient outcomes.

The immune system’s amplified response to SARS-CoV-2 may lead to the production of autoantibodies, but their specific impact on disease severity and outcome remains unclear. This study aims to assess if hospitalized COVID-19 patients face a worse prognosis based on ANA presence, even without autoimmune diseases. We performed a retrospective, single-center, observational cohort study, enrolling 638 COVID-19 patients hospitalized from April 2020 to March 2021 at Hospital “Policlinico Riuniti” of Foggia (Italy). COVID-19 patients with a positive ANA test exhibited a significantly lower 30-day survival rate (64.4% vs. 83.0%) and a higher likelihood of severe respiratory complications during hospitalization than those with negative ANA screening (35.4% vs. 17.0%) (p < 0.001). The association between poor prognosis and ANA status was identified by calculating the HALP score (Hemoglobin-Albumin-Lymphocyte-Platelet), which was lower in COVID-19 patients with a positive ANA test compared to ANA-negative patients (108.1 ± 7.4 vs. 218.6 ± 11.2 AU; p < 0.011). In detail, COVID-19 patients with a low HALP showed a lower 30-day survival rate (99.1% vs. 83.6% vs. 55.2% for high, medium, and low HALP, respectively; p < 0.001) and a higher incidence of adverse respiratory events compared to those with high and medium HALP (13.1% vs. 35.2% vs. 64.6% for high, medium, and low HALP, respectively; p < 0.001). In summary, ANA positivity in COVID-19 patients appears to be linked to a more aggressive disease phenotype with a reduced survival rate. Furthermore, we propose that the HALP score could serve as a valuable parameter to assess prognosis for COVID-19 patients.

Jing Zhou, Daofeng Yang Department of Infectious Diseases, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of ChinaCorrespondence: Daofeng Yang, Department of Infectious Diseases, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, People’s Republic of China, Tel +86-13387567780, Email yangdaofeng@aliyun.comPurpose: HALP score consisting of hemoglobin content, albumin content, lymphocyte count, and platelet count can comprehensively evaluate the inflammatory response and nutritional status. Many researchers have indicated that the HALP score is an effective predictor of the overall prognosis of various tumors. However, there is no relevant research to suggest whether the HALP score can predict the prognosis of patients with hepatocellular carcinoma (HCC).Patients and Methods: We retrospectively analyzed 273 HCC patients who underwent surgical resection. Hemoglobin content, albumin content, lymphocyte count, and platelet count in peripheral blood were measured for each patient. The relationship between the HALP score and overall survival (OS) was investigated.Results: With a mean of 56.69 ± 1.25 months follow-up, the 1-, 3-, and 5-year OS was 98.9%, 76.9%, and 55.3% for all patients, respectively. HALP scores (HR=1.708, 95% CI=1.192– 2.448, P=0.004) were significant independent risk factors of OS. The 1-, 3-, and 5-year OS were 99.3%, 84.3%, and 63.4% for patients with high HALP scores; and 98.6%, 69.8%, and 47.5% for patients with low HALP scores, respectively (P=0.018). In TNM I–II stage patients, compared with high HALP scores, low HALP scores have worse OS (P=0.039). In AFP positive patients, compared with high HALP scores, low HALP scores have worse OS (P=0.042).Conclusion: Our research showed the preoperative HALP score is an independent predictive factor of overall prognosis, and a low HALP score indicates a worse prognosis in HCC patients who underwent surgical resection.Keywords: hepatocellular carcinoma, survival, HALP score, surgical resection, prognostic marker

Background and Objectives: Dyslipidemia is a major risk factor for cardiovascular disease (CVD). The identification of new biomarkers that may enhance the risk assessment of lipid abnormalities is a promising approach in improving risk prediction of CVD. There is no information on the association of the hemoglobin, albumin, lymphocyte, and platelet (HALP) score with dyslipidemia. The aim of this study was to investigate the clinical utility of the HALP score in light of dyslipidemia. Materials and Methods: A retrospective analysis of 7192 subjects was initiated to assess the association between the HALP score and disturbed lipid markers. Medians were compared by Mann–Whitney U or Kruskal–Wallis tests and the diagnostic performance and risk assessment were calculated. Results: Median HALP score among all subjects was 53.3, with varying values between males and females. Notably, median HALP was significantly elevated in all forms of dyslipidemia and among males and females irrespective of age. The odds of having elevated HALP score values were significantly higher in all lipid abnormalities. Moreover, HALP score was significantly yet weakly correlated with lipid markers, while the highest diagnostic accuracy of the HALP score was observed with an elevated ratio of total cholesterol to high-density lipoprotein (TC/HDL) (area under the curve, AUC = 0.6411, p < 0.0001). The decision curve analysis (DCA) showed that the HALP score can reliably predict the presence of dyslipidemia. Conclusions: This study demonstrates that the HALP score is a novel, cost-effective index that is associated with a disturbed lipid profile. Further investigation of the nature of this association is needed. [ABSTRACT FROM AUTHOR]

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Purpose: Fournier's Gangrene (FG) is a fatal condition, therefore prognosis prediction is a crucial step before treatment planning. We aimed to investigate the predictive value of Hemoglobin, Albumin, Lymphocyte and Platelet (HALP) score which is frequently employed in vascular disorders and malignancies, on disease severity and survival in FG patients and to compare HALP score with well-known scoring systems on this aspect. Materials and methods: Eighty-seven men who had surgical debridement for FG between December 2006 and January 2022 were included in this study. Their symptoms, physical examination findings, laboratory tests, medical histories, vital signs, extent and timing of the surgical debridement and antimicrobial therapies were noted. The HALP score, Age-adjusted Charlson Comorbidity Index (ACCI) and Fournier's Gangrene Severity Index (FGSI) were evaluated for their predictive values for survival. Results: FG patients were grouped as survivors (Group 1, n = 71) and non-survivors (Group 2, n = 16) and the results were compared. The mean ages of survivors (59 ± 12.55 years) and non-survivors (64.5 ± 14.6 years) were similar (p = 0.114). The median size of necrotized body surface area was 3% in Group 1 and 4.8% in Group 2 (p = 0.013). On admission, hemoglobin, albumin and serum urea levels and white blood cell counts were significantly different in two study groups. Two study groups were similar for HALP scores. However, ACCI and FGSI scores were greater significantly in non-survivors. Conclusions: Our results indicated that HALP score does not predict a survival successfully in FG. However, FGSI and ACCI are successful outcome predictors in FG. [ABSTRACT FROM AUTHOR]

Objective: To investigate the effect of hemoglobin, albumin, lymphocytes, platelet (HALP) score and platelet to albumin ratio (PAR) on prognosis of patients with lung adenosquamous carcinoma (ASC) after surgery. Patients and methods: A total of 52 patients diagnosed with ASC after surgical resection were collected from Nanjing Chest Hospital from 2012 to 2021, and their general clinical data, pathological data and laboratory indexes were collected. The changes of Alb and Plt levels before and after surgery, HALP scores (hemoglobin albumin lymphocytes/platelets), and postoperative PAR, PLR, NLR were retrospectively analyzed, and their influence on the prognosis of patients with ASC was investigated. The cut-off value of ΔAlb, ΔPlt, postoperative PAR, PLR and NLR were determined by the receiver operating characteristic (ROC) curve, the optimal cut-off value of HALP score before and after surgery was calculated by using X-tile software, and the clinicopathological characteristics were compared between the high PAR and low PAR groups and between high HALP score and low HALP score group to analyze the factors influencing the prognosis of patients with ASC. Univariate and multivariate Cox proportional regression analyses were used to assess independent risk factors affecting overall survival (OS) and disease-free survival (DFS) in patients with ASC. Kaplan-Meier method was used to evaluate the correlation between OS, DFS and PAR and HALP score. Results: A critical value of PAR was 7.40×10-9 and an area under the curve (AUC) of 0.737 (95%CI: 0.597-0.876, P = 0.004). The best cut-off value of the preoperative HALP score was 24.3. Univariate Cox analysis showed that the cut margin (P = 0.013), the degree of differentiation (P = 0.021), N stage (P = 0.049), ΔPlt (P = 0.010), ΔAlb (P = 0.016), PAR (P = 0.003), NLR (P = 0.025), PLR (P = 0.029), preoperative HALP score (P = 0.000) and post-operative HALP score (P = 0.010) were all associated with postoperative OS in ASC patients. Cut margin (P = 0.029), the degree of differentiation (P = 0.045), maximum tumor diameter (P = 0.018), N stage (P = 0.035), ΔPlt (P = 0.007), ΔAlb (P = 0.007), PAR (P =0.004), NLR (P = 0.041), PLR (P = 0.030), preoperative HALP score (P = 0.000), and postoperative HALP score (P = 0.011) were related to postoperative DFS in ASC patients. Multivariate analysis revealed that PAR (HR: 6.877, 95%CI: 1.817-26.038, P = 0.005), differentiation degree (HR: 0.059, 95%CI: 0.006-0.591, P = 0.016) and preoperative HALP score (HR: 0.224, 95%CI: 0.068-0.733, P = 0.013) had significant effect on OS. Tumor maximum diameter (HR: 3.442, 95%CI: 1.148-10.318, P = 0.027) and preoperative HALP score (HR: 0.268, 95%CI: 0.085-0.847, P = 0.025) had significant influence on DFS. Conclusion: PAR and preoperative HALP score were potentially useful biomarkers for evaluating the outcome of patients with postoperative ASC. PAR, the degree of differentiation and preoperative HALP score were independent prognostic factors for postoperative OS in ASC patients. Maximum tumor diameter and preoperative HALP score were independent prognostic factors for postoperative DFS in ASC patients. [ABSTRACT FROM AUTHOR]

Systemic inflammation and nutritional status play important roles in the development and progression of various cancers, including colorectal cancer. The prognosis for malignancies can be predicted using the inflammatory marker known as HALP (calculated by hemoglobin, albumin, lymphocytes, and platelets). Furthermore, recent studies have claimed the HALP score to help distinguish between benign and malignant lesions. We aimed to research the diagnostic importance of the HALP score in the differentiation of malignant (colorectal cancer) and benign colorectal neoplasms (colorectal adenomas and hyperplastic polyps) and its prognostic significance in colorectal cancer patients. Patients diagnosed with colorectal cancer, colorectal adenoma, and hyperplastic polyps were evaluated retrospectively between January 2017 and January 2022. The median HALP score in the colorectal cancer group was significantly lower than the other groups (colorectal adenoma and hyperplastic polyps) (p<0.001). There was no statistical difference between the median HALP scores of the colorectal adenoma and hyperplastic groups (p=0.525). ROC analysis found the cut-off value of the HALP score as 41.01 to differentiate colorectal cancer from benign colorectal lesions (sensitivity= 0.73, specitivity=0.62, 95% CI=0.67-0.76, p<0.001). The HALP level below 28.1 was associated with worse overall survival (p=0.046) and was shown to be an independent prognostic factor in the colorectal cancer group. The HALP score can be used to differentiate colorectal cancer from benign colorectal neoplasms and as a prognostic factor in colorectal cancer. [ABSTRACT FROM AUTHOR]

Objective To investigate the value of HALP+NIHSS score in predicting the prognosis of patients with large artery atherosclerosis (LAA) cerebral infarction. Methods A retrospective analysis was performed for the clinical data of 500 patients who were diagnosed with LAA cerebral infarction in our hospital from January 2020 to October 2021. On day 30 after di-sease onset, modified Rankin Scale (mRS) score was used to evaluate clinical outcome, and according to the mRS score, the patients were divided into good prognosis group (mRS score ≤2) and poor prognosis group (mRS score >2). Related clinical data were compared between the two groups. A logistic regression analysis was used to evaluate the influencing factors for poor prognosis in patients with LAA cerebral infarction, and the receiver operating characteristic (ROC) curve was plotted to analyze the value of NIHSS score, HALP score, and NIHSS+HALP score in predicting the prognosis of patients with LAA cerebral infarction. Results The multivariate logistic regression analysis showed that old age, hypertension, high NIHSS score, and increased low-density lipoprotein level were risk factors for poor prognosis in patients with LAA cerebral infarction (P

Significant advances in reconstructive head and neck surgery with free microvascular flaps have had a positive impact on esthetic outcomes and quality of life. However, complications still occur in some patients. This study investigated the influence of the Hemoglobin, Albumin, Lymphocyte, and Platelet Score (HALP score), an immunonutritive marker, on complications and flap success. The retrospective analysis included 194 patients who underwent reconstruction of head and neck defects with free microvascular flaps. The HALP score correlated strongly with overall complications, including flap necrosis, infection, fistula, and hematoma. Hemoglobin, albumin, lymphocytes, and platelets individually showed associations with specific complications. HALP score was an extremely strong predictor of complications (AUC = 0.85). HALP score may be valuable for assessing patient status and predicting complications in microvascular free-flap reconstruction to allow timely interventions and improve outcomes. Further research is needed to investigate additional predictors and improve postoperative care. [ABSTRACT FROM AUTHOR]

The HALP score, which is a combined index composed of hemoglobin, albumin, lymphocyte, and platelet, is a new indicator showing both inflammation and nutritional status. This study aims to evaluate the relationship of this combined index consisting of simple laboratory values with the degree of appendicitis complication and postoperative results in patients operated on for acute appendicitis. The data of 684 patients operated for acute appendicitis between January 2017 and December 2022 and inclusion criteria were analyzed with a single-center retrospective cross-sectional study design. Using routine laboratory data, patients' HALP scores were divided into two groups as low and high. The cut-off value of the HALP score according to the presence of postoperative complications was determined as < 31.2 by ROC analysis and the ROC curve. Patients were grouped as HALP score cut-off value below (group 1) and above (group 2). Complicated appendicitis and postoperative outcomes were compared to the HALP score groups. According to the cut-off value of the HALP score, 113 (16.5%) of the patients were in Group 1, and 571 (83.5%) were in Group 2. Complications developed in 15 (26%) patients (p < 0.001). Low HALP scores were a significant risk factor for peri-appendicular abscess (OR 29.12 95% CI 12.39–68.43), appendicitis perforation (OR = 20.82 95% 12.67–34.19), gangrenous appendicitis (OR = 35, 54, 95% 13.33–94.77), and postoperative complications (OR = 15.29 95% 7.95–29.41) (p < 0.001). Besides clinical and radiological findings, the HALP score shows the degree of acute appendicitis complication. It can be used as a simple, inexpensive, and easily applicable diagnostic tool. [ABSTRACT FROM AUTHOR]

Background and aims: Cardiovascular and cerebrovascular disease (CCDs) contribute to leading causes of morbidity and mortality in the United States of America (USA). Hemoglobin, albumin, lymphocyte, and platelet (HALP) score, a simple and convenient indicator, could reflect the combination of inflammation and nutritional status. This study was undertaken to evaluate the associations between HALP score and risk of cardiovascular, cerebrovascular, and all-cause mortality in the general population from the National Health and Nutrition Examination Survey (NHANES) 1999--2018. Methods: We identified 21,578 participants during the 1999-2018 cycles of the NHANES in this research. HALP score was calculated as hemoglobin (g/L) x albumin (g/L) x lymphocytes (/L)/platelets (/L). Outcomes were cerebrovascular, cardiovascular, and all-cause mortality determined by the NHANES-linked National Death Index record and followed until 31 December 2019. Surveyweighted Cox regression, restricted cubic spline analysis, and subgroup analysis were applied to investigate relationships between HALP score and risk of mortality. Results: This cohort study comprised 49.2% male and 50.8% female, of which the median age was 47 years old. In multivariate survey-weighted Cox regression adjusting for all confounders, compared with participants with low HALP scores, participants with highest HALP score had a lower risk of all-cause mortality (adjusted HR:0.80, 95% CI: 0.73, 0.89, P < 0.0001) and cardiovascular mortality (adjusted HR:0.61, 95% CI: 0.50, 0.75, P < 0.0001), and mediate HALP score had the lowest risk of all-causemortality (adjusted HR:0.68, 95% CI: 0.62, 0.75, P < 0.0001) and cardiovascular mortality (adjusted HR:0.60, 95% CI: 0.48, 0.75, P < 0.0001). Restricted cubic spline analysis showed a non-linear relationship between HALP score and cardiovascular and all-causemortality (all P values <0.001). Conclusion: HALP score was independently associated with risk of cardiovascular and all-cause mortality, but not cerebrovascular mortality. [ABSTRACT FROM AUTHOR]

Aim: Hyperemesis gravidarum (HG) is one of the most common serious diseases in early pregnancy. This study aimed to investigate the clinical significance of hemoglobin, albumin, lymphocyte, and platelet (HALP) score and systemic immune inflammation (SII) index in the presence and severity of HG. Methods: This retrospective case–control study was conducted in a training and educational university hospital between January 2019 and July 2022. A total of 521 pregnant women, of whom 360 were diagnosed with HG at 6–14 weeks of gestation and 161 were low‐risk pregnancies, were included in the study. Patients' demographic characteristics and laboratory parameters were recorded. Patients with HG were divided into three categories: mild (n = 160), moderate (n = 116), and severe (n = 84), according to disease severity. The modified PUQE scoring was used to determine the severity of HG. Results: The mean age of the patients was 27.6 (16–40) years. We divided the pregnant women into the control group and HG group. The HALP score was significantly lower in the HG group (average, 2.8 ± 1.3), whereas the SII index was found to be significantly higher (average, 895.8 ± 458.1). A negative correlation was found between the increase in the severity of HG and HALP score. The HALP score was the lower in severe HG (mean, 2.16 ± 0.81) and was significantly different from other HG categories (p < 0.01). Moreover, a positive correlation was noted between increased HG severity and SII index levels. The SII index was higher in the severe HG group and was significantly different from the others (1001.2 ± 437.2) (p < 0.01). Conclusions: The HALP score and SII index can be useful, cost‐effective, and easily accessible objective biomarkers to predict the presence and severity of HG. [ABSTRACT FROM AUTHOR]

Aim: The hemoglobin, albumin, lymphocyte, and platelet (HALP) score reflects the immune system and the nutritional status of patients, and prognosis in various cancers. However, the HALP score in hepatocellular carcinoma has not been reported. Methods: Data were analyzed retrospectively from Child–Pugh A patients undergoing hepatic resection for single hepatocellular carcinoma ≤5 cm. For cross‐validation, patients were divided into the training (332 patients) and validation cohort (210 patients). In the training cohort, we divided patients into two groups by appropriate cut‐off value of the HALP score, and univariable and multivariable analyses were conducted for disease‐free and overall survival (OS) between two groups. In the validation cohort, we examined OS by Kaplan–Meier analysis in the same cut‐off value of the HALP score in the training cohort. Results: The HALP‐low group was significantly older (p = 0.0003), had fewer hepatitis B surface antigen‐positive patients (p = 0.0369), higher prothrombin time (p = 0.0141), lower fibrosis‐4 index (p = 0.0206), bigger maximum tumor size (p = 0.0196), and less histological liver fibrosis (p = 0.0077). Multivariate analysis showed that the independent prognostic factors for disease‐free survival were fibrosis‐4 index ≥2.67 (p = 0.0008), simple nodular type with extranodular growth or confluent multinodular type (p = 0.0221), and intrahepatic metastasis (p = 0.0233), and that for OS were fibrosis‐4 index ≥2.67 (p = 0.0020), HALP ≤45.6 (p = 0.0228), and poor differentiation (p = 0.0305). In the validation cohort, Kaplan–Meier analysis revealed the trend toward significantly impaired OS (p = 0.0220) in the HALP‐low group. Conclusion: We showed that a low HALP score is the independent prognostic factor for Child–Pugh A patients undergoing curative hepatic resection for single and small hepatocellular carcinoma. [ABSTRACT FROM AUTHOR]

Peng Jiang,1 Wei Kong,1 Chunxia Gong,2 Yanlin Chen,3 Fenglian Li,1 Lingya Xu,1 Yang Yang,1 Shikai Gou,1 Zhuoying Hu1 1Department of Gynecology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China; 2Department of Obstetrics and Gynecology, Women and Children’s Hospital of Chongqing Medical University, Chongqing, People’s Republic of China; 3Department of Pathology, Women and Children’s Hospital of Chongqing Medical University, Chongqing, People’s Republic of ChinaCorrespondence: Zhuoying Hu, Department of Gynecology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China, Tel +86 2389011092, Fax +86 2389011082, Email huzhuoying@sina.comObjective: The purpose of this study was to evaluate the prognostic value of hemoglobin, albumin, lymphocyte, and platelet (HALP) score in patients with operable cervical cancer, and on this basis, combined with classical clinicopathological parameters to predict the recurrence of patients.Methods: A total of 1580 patients with stage IA-IIA cervical cancer were randomly divided into training cohort (n=1054) and validation cohort (n=526) according to the predefined ratio of 2:1. In the training cohort, the receiver operating characteristic (ROC) curve and Youden index were used to determine the optimal threshold of HALP score for predicting cervical cancer recurrence. On this basis, the independent related factors with cervical cancer recurrence were screened through univariate and multivariate Cox regression analysis, and then a nomogram model was further established. The internal and external validation of the model was carried out in the training cohort and the validation cohort respectively through the consistency index (C-index) and calibration curve.Results: ROC curve and Youden index showed that the optimal threshold of HALP score for predicting cervical cancer recurrence was 39.50. Multivariate analysis confirmed that HALP score and some other classic clinicopathological parameters were independently associated with cervical cancer recurrence. Based on the results of multivariate analysis, a nomogram model for predicting cervical cancer recurrence was successfully constructed. The internal and external calibration curves showed that the fitting degree of the model was good, and the C-index (the C-index of the training cohort and the validation cohort were 0.862 and 0.847, respectively) showed that the prediction accuracy of the model proposed in this study was better than other similar models.Conclusion: HALP score may be a novel predictor for predicting the cervical cancer recurrence. Nomogram model based on HALP score and classical clinicopathological parameters can better predict the recurrence of cervical cancer.Keywords: HALP score, nomogram model, predict, cervical cancer, recurrence

OBJECTIVE: The study aimed to investigate whether the pre-procedural hemoglobin, albumin, lymphocyte, and platelet (HALP) scores can distinguish between benign and malignant causes of obstruction in patients who undergo endoscopic retrograde cholangiopancreatography (ERCP) for extrahepatic biliary obstruction (EBO). PATIENTS AND METHODS: The HALP scores of the patients were calculated according to the values before ERCP. The patients were divided into two groups as malignant and benign according to their diagnosis after ERCP. The HALP scores, demographic characteristics, and some laboratory data of the groups were compared. The cut-off values of the HALP scores were found to detect malignant obstructive causes using the receiver operating characteristic (ROC) curve analysis. RESULTS: A total of 295 patients had benign and 50 had malignant causes of obstruction among the total of 345 patients. The HALP score was found to be lower in the patient group with malignant biliary obstruction (p = 0.013). The ROC curve analysis was used to determine the diagnostic efficiency, and an area under the curve (AUC) of 0.610 was obtained (0.526-0.693, 95% CI) (p = 0.013). For the HALP score, the sensitivity was found to be 82.4% and the specificity was 30% when a cut-off value of <12.54 was used, and the sensitivity was 61.4% and specificity was 52% when the cut-off value was <21.25. CONCLUSIONS: The study showed that a low HALP score can distinguish malignant causes in patients with EBO. We think that the HALP score, which is a low-cost index that can be easily calculated with simple tests, can be used in this patient population because it may allow early diagnosis of malignant causes in patients with EBO. [ABSTRACT FROM AUTHOR]

Objective: This study examined systemic inflammatory indices and “Hemoglobin, Albumin, Lymphocyte, Platelet (HALP) scores” in neonates with hypoxic–ischemic encephalopathy (HIE). Methods: A total of 43 neonates with moderate-to-severe HIE at 36 weeks’ gestation were assessed. Systemic inflammatory markers were measured before HT commenced within 0–6 h after birth and between 60 and 72 h during and after therapy or before adjusting for hypothermia. Results: Platelet counts, hemoglobin levels, and platelet indices in the HIE group were significantly lower at both time points (p = 0.001). Both the neutrophil-to-lymphocyte ratio (NLR) and monocyte-to-lymphocyte ratio (MLR) decreased in the HIE group after hypothermia therapy (p = 0.001). Seizures, PVL, and kidney injuries were associated with higher HALP scores. The AUCs of NLR, PLR, MLR, SII, SIRI, and platelet, neutrophil, monocyte, and lymphocyte Index (PIV) showed significant sensitivity and specified HIE, with area under the curve (AUC) values of 0.654, 0.751, 0.766, 0.700, 0.722, and 0.749, respectively. Conclusions: A significant difference in systemic inflammatory markers was found between the HIE and control groups after hypothermia treatment, with significant reductions in the MLR and NLR. These markers, particularly MLR, were significant predictors of adverse clinical outcomes including seizures, PVL, and kidney damage.

IntroductionAs a composite immunonutritional biomarker, the Hemoglobin, Albumin, Lymphocyte, Platelet (HALP) score has shown promise in assessing a patient's overall health status by integrating several routinely collected laboratory indicators. This biomarker has been examined in many different populations of patients and disease states (i.e., cancer), but an integrated, universal rubric using standardized thresholds has not thus far been developed. Pre-existing large population-based databases represent an ideal source to examine the distribution of HALP and the influence of diverse health statuses on this score.MethodsWe conducted a cross-sectional study using data from the National Health and Nutrition Examination Survey (NHANES) between 2017–2020, evaluating 8,245 participants across numerous demographic, socioeconomic, and health-related variables. Univariate and multivariate linear regression analyses assessed the associations between HALP scores and these factors.ResultsOur findings revealed significant associations between HALP scores and various demographic, socioeconomic, and health conditions. The median HALP score among the representative population was 49.0, with varying median scores across different groups and normal reference ranges for males and females. Multivariate regression analysis showed that anemia treatment, age over 65 years, weak/failing kidneys, and cancer were independent risk factors associated with lower HALP scores. Male participants demonstrated higher HALP scores than female participants, and age was inversely related to HALP. Moreover, HALP scores were negatively associated with the number of comorbidities.Conclusion/discussionThis study set out to explore the HALP score from a population-based perspective, uncovering notable associations that offer vital insights into the score's clinical relevance and future applications. By determining a median HALP score of 49.0 and normal reference ranges within our diverse, representative sample, we establish a robust foundation for researchers to refine optimal HALP applications and thresholds. Considering the growing focus on personalized medicine, HALP holds promise as a prognostic tool, enabling clinicians to comprehend their patients' immunonutritional status better and deliver customized care.