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Assessing the prognostic value of HALP score in peripheral artery disease: Correlation with lesion severity and
Ali Evsen1, Adem Aktan2, Raif Kılıç3
1Department of Cardiology, Dağkapı State Hospital, Diyarbakır, Turkey.
Insights
The HALP score effectively predicts long-term mortality in peripheral artery disease (PAD) patients. Lower HALP scores indicate more severe PAD lesions and reduced life expectancy, highlighting its prognostic value.
Area of Science:
- Cardiovascular Medicine
- Hematology
- Prognostic Biomarkers
Background:
- Peripheral artery disease (PAD) presents a growing clinical challenge, particularly with an aging global population.
- Existing prognostic scoring systems for PAD are varied, necessitating validated tools for risk stratification.
- The HALP (hemoglobin, albumin, lymphocyte, and platelet) score has shown promise in predicting outcomes for other serious conditions.
Purpose of the Study:
- To evaluate the prognostic capability of the HALP score in patients with symptomatic PAD.
- To assess the correlation between the HALP score and the severity of peripheral artery disease lesions.
- To determine the HALP score's association with long-term mortality in PAD patients undergoing endovascular intervention.
Main Methods:
- Retrospective analysis of 305 symptomatic PAD patients who underwent endovascular intervention.
- Calculation of the HALP score using the formula: hemoglobin × albumin × lymphocyte count / platelet count.
- Classification of lesion severity using the TASC-II criteria (TASC AB vs. TASC CD) and collection of mortality data.
Main Results:
- The HALP score was identified as the strongest predictor of long-term mortality via ROC analysis (AUC: 0.736).
- Higher HALP scores were significantly associated with lower long-term mortality (Log-rank: 20.102, p < .001) over a mean follow-up of 48 months.
- Independent predictors of mortality included HALP score, age, diabetes mellitus (DM), and C-reactive protein (CRP).
Conclusions:
- The HALP score is a robust and superior predictor of prognosis in PAD patients compared to its individual components.
- Lower HALP scores correlate with more severe PAD lesions and a reduced life expectancy.
- The HALP score offers valuable prognostic information for managing PAD patients.
Abstract:
IntroductionPeripheral artery disease (PAD) poses a growing clinical challenge due to an aging population, despite advances in treatment methods. Various scoring systems have emerged to predict high-risk patients, including the HALP (hemoglobin, albumin, lymphocyte, and platelet) score, known for predicting prognosis in cancers and stroke. This study assesses the HALP score's relation to lesion severity and long-term mortality in PAD patients.MethodsWe retrospectively analyzed 305 symptomatic PAD patients undergoing endovascular intervention. The following formula was used to calculate the HALP score: hemoglobin (g/L) × albumin (g/L) × lymphocyte count (/L) / platelet count (/L). Lesion severity was classified by TASC-II: TASC AB and TASC CD. Mortality data were obtained from hospital and social security records.ResultsThe study involved 305 patients (mean age 64.4 ± 11.8 years; 72.1% male), divided into survivors (208) and non-survivors (97). ROC analysis identified HALP score as the strongest predictor of long-term mortality (AUC: 0.736; 95% CI: 0.679-0.793; p < .001). HALP score (HR, 0.087; 95% CI, 0.025-1.300; p < .001), age (p < .001), DM (p = .007), and CRP (p = .013) independently predicted mortality. Kaplan-Meier analysis showed higher HALP scores linked to lower long-term mortality (Log-rank: 20.102, p < .001), with an average follow-up of 48 ± 18 months.ConclusionThe HALP score emerged as a robust predictor of PAD prognosis, surpassing individual components and other parameters. Lower HALP scores correlated with more severe lesions and reduced life expectancy.
