Prognostic value of the CALLY index in predicting mortality in patients with infective endocarditis

This study aimed to investigate the predictive value of the C-reactive protein-albumin-lymphocyte (CALLY) index for mortality in patients diagnosed with Infective Endocarditis (IE).

We retrospectively analyzed 100 patients diagnosed with IE based on Duke criteria between 2016 and 2024. The CALLY index was calculated at admission using the formula: [(albumin × lymphocyte count)/CRP]. Demographic, clinical, laboratory, and echocardiographic data were collected.

Mortality occurred in 55% of patients. The deceased group had significantly lower CALLY index values compared to survivors (median: 1.7 vs. 6.9, p < 0.001). Multivariate analysis identified male sex (OR 3.791, p = 0.043), diabetes mellitus (OR 4.126, p = 0.022), and a lower CALLY index (OR 0.824, p = 0.005) as independent predictors of mortality, with lower CALLY values being associated with a higher risk of death. The CALLY index demonstrated moderate discriminative power (AUC = 0.792) with a cutoff value of 3.3, which yielded 68.9% sensitivity and 69.1% specificity.

The CALLY index, an accessible and cost-effective biomarker, is independently associated with mortality and may serve as a hypothesis-generating tool for risk stratification in IE patients. Its incorporation into routine clinical assessment may enhance early risk stratification and guide management strategies.