Araştırma Makalesi

HALP Score as a Predictor of Six-Month Mortality in Acute Pulmonary Embolism Patients

Cilt: 36 Sayı: 2026 28 Ekim 2026
PDF İndir
EN TR

HALP Score as a Predictor of Six-Month Mortality in Acute Pulmonary Embolism Patients

Öz

Aim: This study evaluated the prognostic value of the Haemoglobin, Albumin, Lymphocyte, and Platelet (HALP) score for six-month mortality in acute pulmonary thromboembolism (APTE) and its added value over established risk tools.
Materials and Methods: In this retrospective cohort study, 556 patients with APTE confirmed by computed tomography pulmonary angiography (CTPA) were analysed between 2017 and 2024. HALP was calculated as (haemoglobin × albumin × lymphocytes) / platelets. Non-normally distributed variables are given as median (interquartile range) and compared with the Mann–Whitney U test. Independent predictors were identified by logistic regression and discrimination by ROC analysis.  The incremental value of HALP over sPESI was assessed with the integrated discrimination improvement (IDI) and continuous net reclassification improvement (NRI), and internal validity by bootstrap optimism correction.
Results: Mean age was 55 ± 17 years, 42.3% were male, and six-month mortality was 12.2% (n = 68). HALP was lower in non-survivors (median 0.98 vs 3.01; p < 0.001). The AUC was 0.767 (95% CI 0.713–0.822), with an optimal cut-off of 1.91 (sensitivity 79.4%, specificity 65.2%); HALP discriminated mortality better than each of its components (DeLong p < 0.05). In multivariable analysis, HALP (OR 0.66; 95% CI 0.55–0.79; p < 0.001), lactate, pulmonary arterial pressure and age were independent predictors. Adding HALP to sPESI raised the AUC from 0.612 to 0.791 (IDI 0.098; NRI 0.862), and the optimism-corrected AUC was 0.815. HALP remained independent in the malignancy subgroup (OR 0.66; p = 0.008).
Conclusions: A lower HALP score is independently associated with six-month mortality in APTE and may add prognostic information to sPESI. As a simple, low-cost index it could complement guideline-based models. Given its limited specificity and the lack of external validation, these findings are hypothesis-generating pending prospective multicentre confirmation. The proposed HALP cut-off should not be applied in routine clinical practice until it has been externally validated in prospective multicentre cohorts.

Anahtar Kelimeler

Acute Pulmonary Embolism, HALP score, inflammation, prognostic biomarker, six-month mortality

Kaynakça

  1. 1. Freund Y, Cohen-Aubart F, Bloom B. Acute pulmonary embolism: a review. JAMA. 2022;328(13):1336-1345.
  2. 2. Goldhaber SZ, Visani L, De Rosa M. Acute pulmonary embolism: clinical outcomes in the International Cooperative Pulmonary Embolism Registry (ICOPER). Lancet. 1999;353(9162):1386-1389.
  3. 3. Pérez-Burkhardt J, González-Fajardo JA, Suárez-Fernández C, Monreal-Bosch M; Grupo de Trabajo RIETE. Registro informatizado de la enfermedad tromboembólica en España (RIETE). Angiologia. 2003;55(3):228-237.
  4. 4. Dahhan T, Siddiqui I, Tapson VF, Velazquez EJ, Sun S, Davenport CA, et al. Clinical and echocardiographic predictors of mortality in acute pulmonary embolism. Cardiovasc Ultrasound. 2016;14:44.
  5. 5. Zhou XY, Ben SQ, Chen HL, Ni SS. The prognostic value of pulmonary embolism severity index in acute pulmonary embolism: a meta-analysis. Respir Res. 2012;13(1):111.
  6. 6. 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.
  7. 7. Xu H, Zheng X, Ai J, Yang L. Hemoglobin, albumin, lymphocyte, and platelet (HALP) score and cancer prognosis: a systematic review and meta-analysis of 13,110 patients. Int Immunopharmacol. 2023;114:109496.
  8. 8. Pan H, Lin S. Association of hemoglobin, albumin, lymphocyte, and platelet score with risk of cerebrovascular, cardiovascular, and all-cause mortality in the general population: results from the NHANES 1999-2018. Front Endocrinol (Lausanne). 2023;14:1173399.
  9. 9. Sert ET, Kokulu K, Mutlu H, Gönen MÖ. Prognostic importance of the hemoglobin, albumin, lymphocyte, and platelet (HALP) score in patients with acute pulmonary embolism. Cor Vasa. 2024;66(3):312-317.
  10. 10. Yaman M, Orak M, Durgun HM, Tekin V, Ülgüt ŞG, Belek S, et al. The prognostic value of HALP score and sPESI in predicting in-hospital mortality in patients with pulmonary thromboembolism. Postgrad Med J. 2025;101(1191):60-65.

Kaynak Göster

APA
Topaloğlu, İ., Atasoy, Ç., & Erdoğdu, G. (2026). HALP Score as a Predictor of Six-Month Mortality in Acute Pulmonary Embolism Patients. Genel Tıp Dergisi, 36(2026), 1-7. https://doi.org/10.54005/geneltip.1848908
AMA
1.Topaloğlu İ, Atasoy Ç, Erdoğdu G. HALP Score as a Predictor of Six-Month Mortality in Acute Pulmonary Embolism Patients. Genel Tıp Derg. 2026;36(2026):1-7. doi:10.54005/geneltip.1848908
Chicago
Topaloğlu, İhsan, Çağrı Atasoy, ve Gülfem Erdoğdu. 2026. “HALP Score as a Predictor of Six-Month Mortality in Acute Pulmonary Embolism Patients”. Genel Tıp Dergisi 36 (2026): 1-7. https://doi.org/10.54005/geneltip.1848908.
EndNote
Topaloğlu İ, Atasoy Ç, Erdoğdu G (01 Ekim 2026) HALP Score as a Predictor of Six-Month Mortality in Acute Pulmonary Embolism Patients. Genel Tıp Dergisi 36 2026 1–7.
IEEE
[1]İ. Topaloğlu, Ç. Atasoy, ve G. Erdoğdu, “HALP Score as a Predictor of Six-Month Mortality in Acute Pulmonary Embolism Patients”, Genel Tıp Derg, c. 36, sy 2026, ss. 1–7, Eki. 2026, doi: 10.54005/geneltip.1848908.
ISNAD
Topaloğlu, İhsan - Atasoy, Çağrı - Erdoğdu, Gülfem. “HALP Score as a Predictor of Six-Month Mortality in Acute Pulmonary Embolism Patients”. Genel Tıp Dergisi 36/2026 (01 Ekim 2026): 1-7. https://doi.org/10.54005/geneltip.1848908.
JAMA
1.Topaloğlu İ, Atasoy Ç, Erdoğdu G. HALP Score as a Predictor of Six-Month Mortality in Acute Pulmonary Embolism Patients. Genel Tıp Derg. 2026;36:1–7.
MLA
Topaloğlu, İhsan, vd. “HALP Score as a Predictor of Six-Month Mortality in Acute Pulmonary Embolism Patients”. Genel Tıp Dergisi, c. 36, sy 2026, Ekim 2026, ss. 1-7, doi:10.54005/geneltip.1848908.
Vancouver
1.İhsan Topaloğlu, Çağrı Atasoy, Gülfem Erdoğdu. HALP Score as a Predictor of Six-Month Mortality in Acute Pulmonary Embolism Patients. Genel Tıp Derg. 01 Ekim 2026;36(2026):1-7. doi:10.54005/geneltip.1848908