Prognostic Value of Hemoglobin, Albumin, Lymphocyte, and Platelet Score in Predicting Mortality in Patients With Aortic Dissection: A Retrospective Single-Center Study Based on ROC Curve Analysis.

Abstract

Background: Aortic dissection (AD) is a life-threatening cardiovascular emergency associated with high mortality. Early risk stratification through reliable biomarkers is critical for guiding clinical decisions. The hemoglobin, albumin, lymphocyte, and platelet (HALP) score is a novel composite index reflecting inflammation, nutritional status, and hematologic balance. Although it has shown prognostic relevance in several disease states, its utility in predicting mortality in AD remains unknown. This study aimed to investigate the prognostic value of the HALP score and other hematologic markers in patients with AD.

Methods: This retrospective study included 51 patients diagnosed with AD between January 2020 and December 2024 using contrast-enhanced thoracoabdominal computed tomography. Patients were grouped as survivors or nonsurvivors. Hematologic parameters (hemoglobin, hematocrit, red blood cell, platelet count, and mean platelet volume) and inflammatory indices (neutrophil-to-lymphocyte ratio [NLR], platelet-to-lymphocyte ratio [PLR], systemic immune-inflammation index [SII], and HALP score) were recorded. The Shapiro-Wilk test assessed normality; Student's t-test or the Mann-Whitney U test was applied accordingly. ROC analysis was performed to evaluate the predictive power of each parameter. Statistical significance was defined as p < 0.05. The primary outcome was in-hospital mortality.

Results: Overall mortality was 33.3%. Nonsurvivors were older and had significantly lower levels of hemoglobin, hematocrit, RBC, and platelet count (p < 0.001). The HALP score was lower in the exitus group, though not statistically significant in direct comparison (p = 0.549). ROC analysis revealed that the HALP score had an AUC of 0.715 (95% CI: 0.572-0.857, p = 0.003), with 55.9% sensitivity and 82.4% specificity at a cutoff of 4.05. Classical parameters such as RBC (AUC = 0.824), Hgb (AUC = 0.802), and Htc (AUC = 0.811) demonstrated stronger predictive capacity. The in-hospital mortality rate was 33.3%.

Conclusions: The HALP score demonstrated high specificity and moderate sensitivity in predicting mortality in AD, suggesting its potential as a complementary biomarker. Its ease of use and accessibility make it suitable for emergency clinical settings. Prospective multicenter studies are needed to confirm its prognostic validity and routine application in AD management.