The Role of Hemoglobin, Albumin, Lymphocyte, Platelet (HALP) Score in Acute Pancreatitis - An Analytical Study

Year 2024, Volume: 14 Issue: 1, 33 - 38, 16.01.2024

Abuzer Özkan , Cansu Duman , Serdar Özdemir

https://doi.org/10.33631/sabd.1283601

Abstract

Aim: The aim of this study is to assess the prognostic ability of Hemoglobin, Albumin, Lymphocyte, and Platelet parameters, as well as the calculated HALP score, in patients with acute pancreatitis. Additionally, it aimed to evaluate their association with prolonged hospitalization.
Material and Methods: This analytical study was designed retrospectively. The study population consisted of patients diagnosed with acute pancreatitis who were followed up in the emergency department between the date of May 15, 2022, and January 31, 2023. Patients were categorized into two groups based on their 30-day mortality, namely survivors and non-survivors. Patients hospitalized for more than eight days were classified as prolonged hospitalizations. HALP score was calculated by using formula of hemoglobin(g/dL) × albumin(g/dL) × lymphocyte(103/µL) / platelet(103/µL). Comparisons between groups were conducted for the HALP score.
Results: A total of 191 patients were included in the study. The rate of prolonged hospitalization was 23.6%. The mortality rate was 7.8%. The median HALP score was 3.1 (25th-75th percentiles: 2-5.4). There was no significant difference in the HALP score between survivors and non-survivors (3.2 (25th-75th percentiles: 2.1-5.4) versus 2.3 (25th-75th percentiles: 1.3-3.4), p = 0.050). However, there was a significant difference in the HALP score between the expected and prolonged hospitalization groups (3.4 (25th-75th percentiles: 2.1-5.7) versus 2.7 (25th-75th percentiles: 1.7-3.5), p=0.028).
Conclusion: The HALP score may not contribute significantly to predicting mortality in patients with acute pancreatitis. Nevertheless, utilizing the HALP score to predict hospitalization duration can enhance the efficiency of healthcare providers in managing patients.

Keywords

Hemoglobin, Albumin, Lymphocyte, Platelet, Acute Pancreatitis

Akut Pankreatitte Hemoglobin, Albümin, Lenfosit, Trombosit (HALP) Skorunun Rolü - Analitik Bir Çalışma

Abstract

Amaç: Bu çalışmada akut pankreatitli hastalarda Hemoglobin, Albümin, Lenfosit, Trombosit parametreleri ile hesaplanan HALP skorunun prognostik yeteneğinin ilişkisini değerlendirmek amaçlandı. Ek olarak belirtilen parametrelerin uzamış hastanede yatışyla ilişkisi araştırıldı.
Gereç ve Yöntemler: Bu analitik çalışma retrospektif olarak tasarlandı. Araştırmanın evrenini 15 Mayıs 2022-31 Ocak 2023 tarihleri arasında acil serviste akut pankreatit tanısı ile takip edilen hastalar oluşturmaktadır. Hastalar 30 günlük mortalite durumlarına göre yaşayanlar ve yaşamayanlar olarak gruplandırıldı. Sekiz günden fazla hastane yatışı olan hastalar uzamış hastane yatışı olarak gruplandırıldı. HALP skoru hemoglobin (g/dL) × albumin (g/dL) × lenfosit sayısı (103/µL) / platelet (103/µL) formulu kullanılarak hesaplandı. Gruplar tüm parametreler ve HALP skoru açısından karşılaştırıldı.
Bulgular: Çalışmaya toplam 191 hasta dahil edildi. Uzamış hastane yatışı oranı %23,6 idi. Ölüm oranı %7,8 idi. Ortanca HALP skoru 3,1 (25.-75. persantil: 2-5.4) olarak hesaplandı. Hayatta kalanlar ve hayatta kalmayanlar arasında HALP skoru açısından anlamlı bir fark yoktu (3,2 (25. -75. yüzdelikler: 2,1-5,4) karşısında 2,3 (25. -75. yüzdelikler: 1,3-3,4), p=0,050). Ancak beklenen ve uzun süreli hastanede yatış grupları arasında HALP skoru açısından anlamlı bir fark vardı (3,4 (25. -75. yüzdelikler: 2,1-5,7) ve 2,7 (25. -75. yüzdelikler: 1,7-3,5), p=0,028).
Sonuç: HALP skoru akut pankreatit hastalarının mortalite öngörülerinde klinisyenlere katkı sağlamayabilir. Yatış süresini öngörmede ise HALP skorundan faydalanmak hekimlerin hasta yönetiminde daha verimli olmasını sağlayacaktır.

Keywords

Hemoglobin, Albümin, Lenfosit, Platelet, Akut Pankreatit

References

• Cervellin G, Mora R, Ticinesi A, Meschi T, Comelli I, Catena F, et al. Epidemiology and outcomes of acute abdominal pain in a large urban emergency department: retrospective analysis of 5,340 cases. Ann Transl Med. 2016; 4(19): 362.
• Doganay F, Ak R, Yilmaz E. Predictive performance of lactate as a mortality predictor in patients with acute pancreatitis. J Coll Physicians Surg Pak. 2022; 32(4): 440-4.
• Chen L, Deng H, Cui H, Fang J, Zuo Z, Deng J, et al. Inflammatory responses and inflammation-associated diseases in organs. Oncotarget. 2017; 9(6): 7204-18.
• İslam MM, Osoydan Satıcı M, Ademoğlu E, Erdil FN, Odabaşı T, Eker A, et al. The role of delta neutrophil index in early identification of severe acute pancreatitis in adult patients: a prospective diagnostic accuracy study. Med Sci Discov. 2023; 10(7): 487-94.
• Özdemir S, Altunok İ, Algın A. Relationship of the systemic immuno-inflammation index and hematological inflammatory index with mortality and hospitalization in acute pancreatitis: a cross-sectional study. Frontiers in Emergency Medicine. 2023 ;7(2): e13.
• Şenlikci A, Ergüder E, Süleyman M, Koşmaz K, Durhan A, Şeneş M, et al. Does monocyte distribution width (MDW) have prognostic value in acute pancreatitis? J Contemp Med. 2021; 11(3): 335-9.
• Emem MK, Ak R, Kılıç M. Investigation of the predictive ability of the ED-SAS scoring system on mortality for acute pancreatitis at the emergency department. South Clin Ist Euras. 2022; 33(3): 257-61.
• Ekinci F, Balcik OY, Oktay E, Erdogan AP. HALP score as a new prognostic index in metastatic renal cell cancer. J Coll Physicians Surg Pak. 2022; 32(3): 313-8.
• Kaya C, Caliskan S, Sungur M, Aydın C. HALP score and albumin levels in men with prostate cancer and benign prostate hyperplasia. Int J Clin Pract. 2021; 75(3): e13766.
• Xu SS, Li S, Xu HX, Li H, Wu CT, Wang WQ, et al. Haemoglobin, albumin, lymphocyte and platelet predicts postoperative survival in pancreatic cancer. World J Gastroenterol. 2020; 26(8): 828-38.
• Kılıç M, Ak R, Alışkan H. The utility of hemoglobin, albumin, lymphocyte and platelet (HALP) score in predicting mortality among COVID-19 patients: a preliminary study. Signa Vitae. 2023; 19(1): 143-7.
• Wang GJ, Gao CF, Wei D, Wang C, Ding SQ. Acute pancreatitis: etiology and common pathogenesis. World J Gastroenterol. 2009; 15(12): 1427-30.
• Akoglu EU, Özdemir S, Ak R, Ozturk TC. The discriminative power of inflammatory markers in patients with mild-to-moderate acute pancreatitis: mean platelet volume, neutrophil-lymphocyte ratio, lymphocyte-monocyte ratio, and neutrophil-monocyte product. South Clin Ist Euras. 2021; 32(2): 159-64.
• Altunok İ, Ozdemir S. Relationship between platelet indices and prolonged hospitalization in patients with acute pancreatitis: a retrospective observational study. J Contemp Med. 2022; 12(5): 743-8.
• Tekyol D, Kılıç M. Usage of the Ranson criteria and neutrophil-lymphocyte ratio measured on presentation to the emergency department in the prediction of mortality in acute pancreatitis. Signa Vitae. 2022: 18(5); 133-7.
• Hong W, Lin S, Zippi M, Geng W, Stock S, Basharat Z, et al. Serum albumin is independently associated with persistent organ failure in acute pancreatitis. Can J Gastroenterol Hepatol. 2017; 2017 :5297143.
• Ocskay K, Vinko Z, Nemeth D, Szabo L, Bajor J, Godi S, et al. Hypoalbuminemia affects one third of acute pancreatitis patients and is independently associated with severity and mortality. Sci Rep. 2021; 11(1): 24158.
• Li S, Zhang Y, Li M, Xie C, Wu H. Serum albumin, a good indicator of persistent organ failure in acute pancreatitis. BMC Gastroenterol. 2017; 17(1): 59.
• Gundpatil DB, Somani BL, Saha TK, Banerjee M. Serum urea: albumin ratio as a prognostic marker in critical patients with non-chronic kidney disease. Indian J Clin Biochem. 2014; 29(1): 97-100.
• Tian M, Li Y, Wang X, Tian X, Pei LL, Wang X, et al. The hemoglobin, albumin, lymphocyte, and platelet (HALP) score is associated with poor outcome of acute ischemic stroke. Front Neurol. 2021; 11: 610318.
• Özdemir S, Algin A. Evaluation of the ability of the C-reactive protein-to-albumin ratio to predict short-term mortality in patients with COVID-19. J Clin Med Kaz. 2021; 18(6): 35-9.
• Ozdemir S, Akca HŞ, Algin A, Eroğlu SE. Can C-reactive protein-to-albumin ratio be a predictor of short-term mortality in community-acquired pneumonia? Ann Clin Anal Med. 2021; 12(9): 1043-8. https://orcid.org/0000-0002-6186-6110
• Wang L, Zeng YB, Chen JY, Luo Q, Wang R, Zhang R, et al. A simple new scoring system for predicting the mortality of severe acute pancreatitis: A retrospective clinical study. Medicine (Baltimore). 2020; 99(23): e20646.