Effects of HALP Score, C-Reactive Protein/Albumin Ratio, and Platelet/Lymphocyte Ratio on Predicting Mortality in Geriatric Patients in the Respiratory Intensive Care Unit.

Abstract

Aim: This study aims to evaluate the effects of the hemoglobin, albumin, lymphocyte, and platelet (HALP) score, C-reactive protein/albumin ratio (CAR), and platelet/lymphocyte ratio (PLR) on predicting mortality in geriatric patients admitted to the respiratory intensive care unit (ICU).

Materials and methods: In this retrospective observational cohort study, data of patients followed up in the respiratory ICU between 01.07.2021 and 31.12.2023 were evaluated. Age, gender, HALP score, hemoglobin, albumin, lymphocyte, platelet, and C-reactive protein (CRP) levels, along with PLR, CAR, and patient prognosis (exitus/discharge), were recorded from patient files and the hospital data processing system.

Results: The study included 405 patients (140 women and 265 men) over 65 years of age. In multivariate analysis, higher PLR and CAR values were associated with a higher mortality rate, whereas patients with a higher HALP score had a lower mortality rate (p<0.001). In the ROC analysis, a statistically significant cut-off value was found for the HALP score in predicting mortality (p<0.001). HALP score ≤ 9.94 indicates mortality, with a sensitivity of 67.25%, specificity of 53%, PPV (positive predictive value) of 64.98%, and NPV (negative predictive value) of 55%. CAR value ≥ 30.13 indicates mortality, with a sensitivity of 69.87%, specificity of 61.36%, PPV of 70.18% and NPV of 61.02%. There was no statistically significant cut-off value for PLR in predicting mortality (p=0.076).

Conclusion: We found that the HALP score, PLR value, and CAR value are important scores that may be useful in determining mortality and treatment modality in geriatric patients treated in the ICU.