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

Kamuran Uluç,1 Esra Akkütük Öngel,2 Şükran Merve Çolakoğlu,2 Nazan Köylü İlkaya,2 Özkan Devran,2 Ahmet Oğuzhan Küçük,3 Hatice Kutbay Özçelik2 1Department of Critical Care Medicine, University of Health Sciences Turkey, Istanbul Başakşehir Çam and Sakura City Hospital, Istanbul, Turkey; 2Department of Critical Care Medicine, University of Health Sciences Turkey, Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey; 3Department of Pulmonary Medicine, Division of Intensive Care Medicine, School of Medicine, Karadeniz Technical University, Trabzon, TurkeyCorrespondence: Kamuran Uluç, Department of Critical Care Medicine, University of Health Sciences Turkey, Istanbul Başakşehir Çam and Sakura City Hospital, Istanbul, Turkey, Tel +90 507 786 74 34, Email [email protected]: 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. Keywords: HALP score, CRP/albumin ratio, platelet/lymphocyte ratio, geriatric patients, intensive care units