Can the HALP Score Be Used as a Prognostic Marker in Paediatric Patients With Cystic Fibrosis?

Cystic fibrosis (CF) is characterised by chronic inflammation and malnutrition, significantly affecting disease progression and prognosis. The haemoglobin-albumin-lymphocyte-platelet (HALP) score reflects inflammatory and nutritional status, and has prognostic associations in various chronic diseases; its role in paediatric CF is unclear.

To evaluate the association between HALP measured during clinical stability and (i) baseline disease severity at the index assessment (FEV₁, MSKS, and BMI z-score), and (ii) subsequent 12-month outcomes (hospitalisation-requiring pulmonary exacerbations, PICU admission, and mortality) in children with CF.

Retrospective single-centre cohort study of 152 children with CF aged 2-18 years. HALP was calculated at clinical stability. Associations with index severity and 12-month outcomes were analysed; logistic regression for low FEV₁ was restricted to participants with acceptable spirometry.

Lower HALP was associated with low FEV₁ (< 70% predicted) at the index assessment (p < 0.001) and with a higher 12-month burden of hospitalisation -requiring pulmonary exacerbations (p < 0.001). PICU admission and mortality were infrequent and analysed exploratorily; HALP was lower in these groups (PICU p < 0.001; mortality p = 0.004). In adjusted logistic regression among participants with spirometry (n = 101), HALP remained associated with low FEV₁, although the effect size was modest and precision limited (adjusted OR 0.886, 95% CI 0.788-0.996; p = 0.043).

HALP, reflecting nutritional and inflammatory status, may offer prognostic information in paediatric CF. Calculation from routine blood tests could make it a practical tool for identifying higher-risk individuals and informing clinical decision-making. Further large-scale studies are needed to validate its clinical utility in CF management.