HALP score adds prognostic information beyond STS for 2-year mortality after transcatheter aortic valve implantation: a two-center retrospective cohort study

Conventional risk scores such as the Society of Thoracic Surgeons (STS) score are widely used for risk assessment in patients undergoing transcatheter aortic valve implantation (TAVI), yet they may not fully capture systemic inflammatory and nutritional burden. The hemoglobin-albumin-lymphocyte-platelet (HALP) score is an integrated biomarker reflecting inflammation and nutritional reserve.

To investigate the association between HALP and 2-year mortality after TAVI and to evaluate whether HALP provides incremental prognostic information beyond STS.

This two-center retrospective cohort included 544 consecutive TAVI patients. The primary endpoint was all-cause death within 2 years after TAVI (binary outcome: yes/no). Independent predictors were assessed using multivariable logistic regression (HALP scaled per 10-unit increase). Discrimination was evaluated by receiver operating characteristic (ROC) analyses for HALP, STS, and a combined STS+HALP model.

Within 2 years, 154 patients (28.3%) died. Patients who died had higher STS scores and lower HALP scores. HALP showed weak negative correlations with STS and EuroSCORE II (r ≈ - 0.11). In multivariable analysis, HALP remained independently associated with mortality (per 10-unit increase: OR 0.859, 95% CI 0.770-0.960; p = 0.007), while STS score was also independent (OR 1.112, 95% CI 1.045-1.184; p = 0.001). Discrimination was modest for HALP (AUC 0.591) and STS (AUC 0.622), and higher for the combined model (AUC 0.663).

HALP is independently associated with 2-year all-cause mortality after TAVI and yielded a higher AUC when incorporated into the STS model, suggesting incremental prognostic information beyond conventional risk assessment.