Research Article
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Relationship between HALP score and 28-day mortality in very elderly geriatric critically ill patients with acute ischemic stroke

Year 2023, , 41 - 45, 10.02.2023
https://doi.org/10.47582/jompac.1209078

Abstract

Aim: In this study, we aimed to evaluate the relationship between the HALP score, calculated by hemoglobin, albumin, lymphocyte and platelet values, and 28-day mortality in very elderly geriatric critically ill patients with acute ischemic stroke.

Material and Method: The study was designed retrospectively and patients aged 85 years and older admitted to the general intensive care unit with the diagnosis of acute ischemic stroke were evaluated. Demographic data, laboratory data and HALP scores of these patients were recorded. Patients who died within 28 days in intensive care follow-up were defined as the Non-Survival group, and patients who did not die were defined as the survival group.

Results: There was a statistically significant difference between the groups in terms of hemoglobin values admitted to the intensive care unit (p:0.00). For albumin, patients in the Non-Survival group had lower values, but there was no statistically significant difference between the groups (p: 0.054). Non-Survival group had lower values for lymphocytes and there was a statistically significant difference between the groups (p: 0.00). For platelet value, patients in the Non-Survival group had higher values and there was no statistically significant difference between the groups (p: 0.164). Patients in the Non-Survival group had lower values for HALP score and there was a statistically significant difference between the groups (p: 0.00)

Conclusion: The HALP score is associated with 28-day mortality in very elderly geriatric critically ill patients with acute ischemic stroke. However, it has low sensitivity (30.1%) and specificity (27.9%).

Supporting Institution

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References

  • Bouffioulx E, Arnould, Thonnard JL. Satisfaction with activity and participation and its relationships with body functions, activities, or environmental factors in stroke patients. Arch Phys Med Rehabil 2011; 92: 1404-10.
  • Bonita R. Epidemiology of stroke. Lancet 1992; 339: 342-4.
  • Shichita T, Sakaguchi R, Suzuki M, Yoshimura A. Post-ischemic inflammation in the brain. Front Immunol 2012; 3: 132.
  • Esenwa CC, Elkind MS. Inflammatory risk factors, biomarkers and associated therapy in ischaemic stroke. Nat Rev Neurol 2016; 12: 594-04.
  • FOOD Trial Collaboration. Poor nutritional status on admission predicts poor outcomes after stroke: observational data from the FOOD trial. Stroke 2003; 34: 1450-56.
  • Baird AE. The forgotten lymphocyte: immunity and stroke. Circulation 2006; 113: 2035-6.
  • Reininger AJ, Bernlochner I, Penz SM, et al. A 2-step mechanism of arterial thrombus formation induced by human atherosclerotic plaques. J Am Coll Cardiol 2010; 55: 1147-58.
  • Milionis H, Papavasileiou V, Eskandari A, D'Ambrogio-Remillard S, Ntaios G, Michel P. Anemia on admission predicts short- and long-term outcomes in patients with acute ischemic stroke. Int J Stroke 2015; 10: 224-30.
  • Guo Y, Shi D, Zhang J, et al. The hemoglobin, albumin, lymphocyte, and platelet (HALP) score is a novel significant prognostic factor for patients with metastatic prostate cancer undergoing cytoreductive radical prostatectomy. J Cancer 2019; 10: 81-91.
  • Peng D, Zhang CJ, Tang Q, et al. Prognostic significance of the combination of preoperative hemoglobin and albumin levels and lymphocyte and platelet counts (HALP) in patients with renal cell carcinoma after nephrectomy. BMC Urol 2018; 18: 20.
  • Stroke−1989. Recommendations on stroke prevention, diagnosis, and therapy. Report of the WHO Task Force on Stroke and other Cerebrovascular Disorders. Stroke 1989; 20: 1407-31.
  • Xu SS, Li S, Xu HX, et al. Haemoglobin, albumin, lymphocyte and platelet predicts postoperative survival in pancreatic cancer. World J Gastroenterol 2020; 26: 828-38
  • UpToDate. Initial assessment and management of acute stroke Available online: https://www.uptodate.com/contents/initial-assessment-and-management-of-acute-stroke. 2023
  • Brouns R, De Deyn PP. The complexity of neurobiological processes in acute ischemic stroke. Clin Neurol Neurosurg 2009; 111: 483-95.
  • Kellert L, Martin E, Sykora M, et al. Cerebral oxygen transport failure?: decreasing hemoglobin and hematocrit levels after ischemic stroke predict poor outcome and mortality: STroke: RelevAnt Impact of hemoGlobin, Hematocrit and Transfusion (STRAIGHT)–an observational study. Stroke 2011; 42: 2832-7.
  • Chang JY, Lee JS, Kim BJ, et al. Influence of hemoglobin concentration on stroke recurrence and composite vascular events. Stroke 2020; 51: 1309-12.
  • Barlas RS, Honney K, Loke YK, et al. Impact of hemoglobin levels and anemia on mortality in acute stroke: analysis of UK Regional Registry Data, Systematic Review, and Meta-Analysis. J Am Heart Assoc 2016; 5: e003019.
  • Eckart A, Struja T, Kutz A, et al. Relationship of nutritional status, inflammation, and serum albumin levels during acute illness: a prospective study. Am J Med 2019; 133: 713-22.e7.
  • Dziedzic T, Slowik A, Szczudlik A. Serum albumin level as a predictor of ischemic stroke outcome. Stroke 2004; 35: e156-e8.
  • Kim J, Song TJ, Park JH, et al. Different prognostic value of white blood cell subtypes in patients with acute cerebral infarction. Atherosclerosis 2012; 222: 464-7.
  • Cankar Dal H, Yalnız KY, Tosun D,et al. Platelet-to-lymphocyte ratio and mean platelet volume-to-platelet count ratio for predicting mortality in critical COVID-19 patients. J Health Sci Med 2022; 5: 1512-7.
  • Yang M, Pan Y, Li Z, et al. Platelet count predicts adverse clinical outcomes after ischemic stroke or TIA: subgroup analysis of CNSR II. Front Neurol 2019; 10: 370.

Relationship between hemoglobin, albumin, lymphocyte, and platelet (HALP) score and 28-day mortality in very elderly geriatric critically ill patients with acute ischemic stroke

Year 2023, , 41 - 45, 10.02.2023
https://doi.org/10.47582/jompac.1209078

Abstract

Aim: In this study, we aimed to evaluate the relationship between the HALP score, calculated by hemoglobin, albumin, lymphocyte and platelet values, and 28-day mortality in very elderly geriatric critically ill patients with acute ischemic stroke.
Material and Method: The study was designed retrospectively and patients aged 85 years and older admitted to the general intensive care unit with the diagnosis of acute ischemic stroke were evaluated. Demographic data, laboratory data and HALP scores of these patients were recorded. Patients who died within 28 days in intensive care follow-up were defined as the Non-Survival group, and patients who did not die were defined as the survival group.
Results:There was a statistically significant difference between the groups in terms of hemoglobin values admitted to the intensive care unit (p:0.00). For albumin, patients in the Non-Survival group had lower values, but there was no statistically significant difference between the groups (p: 0.054). Non-Survival group had lower values for lymphocytes and there was a statistically significant difference between the groups (p: 0.00). For platelet value, patients in the Non-Survival group had higher values and there was no statistically significant difference between the groups (p: 0.164). Patients in the Non-Survival group had lower values for HALP score and there was a statistically significant difference between the groups (p: 0.00)
Conclusion: The HALP score is associated with 28-day mortality in very elderly geriatric critically ill patients with acute ischemic stroke. However, it has low sensitivity (30.1%) and specificity (27.9%).

References

  • Bouffioulx E, Arnould, Thonnard JL. Satisfaction with activity and participation and its relationships with body functions, activities, or environmental factors in stroke patients. Arch Phys Med Rehabil 2011; 92: 1404-10.
  • Bonita R. Epidemiology of stroke. Lancet 1992; 339: 342-4.
  • Shichita T, Sakaguchi R, Suzuki M, Yoshimura A. Post-ischemic inflammation in the brain. Front Immunol 2012; 3: 132.
  • Esenwa CC, Elkind MS. Inflammatory risk factors, biomarkers and associated therapy in ischaemic stroke. Nat Rev Neurol 2016; 12: 594-04.
  • FOOD Trial Collaboration. Poor nutritional status on admission predicts poor outcomes after stroke: observational data from the FOOD trial. Stroke 2003; 34: 1450-56.
  • Baird AE. The forgotten lymphocyte: immunity and stroke. Circulation 2006; 113: 2035-6.
  • Reininger AJ, Bernlochner I, Penz SM, et al. A 2-step mechanism of arterial thrombus formation induced by human atherosclerotic plaques. J Am Coll Cardiol 2010; 55: 1147-58.
  • Milionis H, Papavasileiou V, Eskandari A, D'Ambrogio-Remillard S, Ntaios G, Michel P. Anemia on admission predicts short- and long-term outcomes in patients with acute ischemic stroke. Int J Stroke 2015; 10: 224-30.
  • Guo Y, Shi D, Zhang J, et al. The hemoglobin, albumin, lymphocyte, and platelet (HALP) score is a novel significant prognostic factor for patients with metastatic prostate cancer undergoing cytoreductive radical prostatectomy. J Cancer 2019; 10: 81-91.
  • Peng D, Zhang CJ, Tang Q, et al. Prognostic significance of the combination of preoperative hemoglobin and albumin levels and lymphocyte and platelet counts (HALP) in patients with renal cell carcinoma after nephrectomy. BMC Urol 2018; 18: 20.
  • Stroke−1989. Recommendations on stroke prevention, diagnosis, and therapy. Report of the WHO Task Force on Stroke and other Cerebrovascular Disorders. Stroke 1989; 20: 1407-31.
  • Xu SS, Li S, Xu HX, et al. Haemoglobin, albumin, lymphocyte and platelet predicts postoperative survival in pancreatic cancer. World J Gastroenterol 2020; 26: 828-38
  • UpToDate. Initial assessment and management of acute stroke Available online: https://www.uptodate.com/contents/initial-assessment-and-management-of-acute-stroke. 2023
  • Brouns R, De Deyn PP. The complexity of neurobiological processes in acute ischemic stroke. Clin Neurol Neurosurg 2009; 111: 483-95.
  • Kellert L, Martin E, Sykora M, et al. Cerebral oxygen transport failure?: decreasing hemoglobin and hematocrit levels after ischemic stroke predict poor outcome and mortality: STroke: RelevAnt Impact of hemoGlobin, Hematocrit and Transfusion (STRAIGHT)–an observational study. Stroke 2011; 42: 2832-7.
  • Chang JY, Lee JS, Kim BJ, et al. Influence of hemoglobin concentration on stroke recurrence and composite vascular events. Stroke 2020; 51: 1309-12.
  • Barlas RS, Honney K, Loke YK, et al. Impact of hemoglobin levels and anemia on mortality in acute stroke: analysis of UK Regional Registry Data, Systematic Review, and Meta-Analysis. J Am Heart Assoc 2016; 5: e003019.
  • Eckart A, Struja T, Kutz A, et al. Relationship of nutritional status, inflammation, and serum albumin levels during acute illness: a prospective study. Am J Med 2019; 133: 713-22.e7.
  • Dziedzic T, Slowik A, Szczudlik A. Serum albumin level as a predictor of ischemic stroke outcome. Stroke 2004; 35: e156-e8.
  • Kim J, Song TJ, Park JH, et al. Different prognostic value of white blood cell subtypes in patients with acute cerebral infarction. Atherosclerosis 2012; 222: 464-7.
  • Cankar Dal H, Yalnız KY, Tosun D,et al. Platelet-to-lymphocyte ratio and mean platelet volume-to-platelet count ratio for predicting mortality in critical COVID-19 patients. J Health Sci Med 2022; 5: 1512-7.
  • Yang M, Pan Y, Li Z, et al. Platelet count predicts adverse clinical outcomes after ischemic stroke or TIA: subgroup analysis of CNSR II. Front Neurol 2019; 10: 370.
There are 22 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Research Articles [en] Araştırma Makaleleri [tr]
Authors

Veysel Garani Soylu

Publication Date February 10, 2023
Published in Issue Year 2023

Cite

AMA Soylu VG. Relationship between hemoglobin, albumin, lymphocyte, and platelet (HALP) score and 28-day mortality in very elderly geriatric critically ill patients with acute ischemic stroke. J Med Palliat Care / JOMPAC / Jompac. February 2023;4(1):41-45. doi:10.47582/jompac.1209078

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