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Predictive Value of the CALLY Index for Pocket Hematoma After Cardiac Implantable Electronic Device Procedures

Yunus Emre Özbebek1, Fatih Cihat Büyükbaş1, Mustafa Furkan Dursun1

  • 1Department of Cardiology, Ankara Etlik City Hospital, Ankara, Turkey.

Pacing and Clinical Electrophysiology : PACE
|December 17, 2025
PubMed

Insights

The CALLY index may help identify patients at risk for pocket hematoma after cardiac device implantation. This simple score showed modest predictive ability, unlike the HAS-BLED score, suggesting its potential for pre-procedural risk stratification.

Area of Science:

  • Cardiology
  • Medical Device Technology
  • Patient Safety

Background:

  • Pocket hematoma is a frequent complication following cardiac implantable electronic device (CIED) procedures.
  • This complication increases patient morbidity, necessitating effective risk stratification tools.

Purpose of the Study:

  • To evaluate the predictive performance of the C-reactive protein-albumin-lymphocyte (CALLY) index for pocket hematoma post-CIED implantation.
  • To compare the CALLY index with the HAS-BLED score in identifying patients at high risk for this complication.

Main Methods:

  • A retrospective analysis of 158 patients undergoing CIED implantation was conducted.
  • Patients who developed pocket hematoma (n=35) were compared to those who did not (n=123).
  • The CALLY index and HAS-BLED score were calculated; logistic regression and ROC curve analyses were performed.

Main Results:

  • The CALLY index showed a modest discriminatory power (AUC 0.629) for pocket hematoma, with a high negative predictive value (92.1%).
  • Factors like warfarin use, elevated HbA1c, reduced GFR, and higher proBNP were associated in univariate analysis but not in multivariate analysis.
  • The HAS-BLED score did not demonstrate significant predictive ability for pocket hematoma.

Conclusions:

  • The CALLY index is associated with pocket hematoma risk after CIED implantation.
  • This readily available index may assist in pre-procedural risk assessment.
  • Further prospective multicenter studies are required to confirm the CALLY index's clinical utility.
Abstract

Keywords:
CALLY indexHAS‐BLED scorebleeding riskcardiac implantable electronic devicepocket hematoma

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