HALP score predicts 30-day readmission risk in patients with acute exacerbation of chronic obstructive pulmonary disease: a single-center retrospective study

Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality worldwide, with acute exacerbations (AECOPD) significantly contributing to disease burden and healthcare costs. This study aimed to explore the predictive role of the hemoglobin, albumin, lymphocyte, and platelet (HALP) score in 30-day readmission risk in AECOPD patients. AECOPD patients were categorized into Rehospitalization and N-Rehospitalization groups based on 30-day COPD-related readmission. The HALP score on the day of ICU admission (acute phase) was calculated as (hemoglobin × albumin × lymphocyte count)/platelet count. Spearman correlation analysis was performed to evaluate associations of acute-phase HALP scores with acute-phase APACHE IV scores and stable-phase FEV₁/FVC. ROC curves were plotted to compare HALP and CRP in predicting 30-day readmission. COX regression was conducted to identify independent risk factors for readmission. The Rehospitalization group exhibited significantly lower HALP scores. Acute-phase HALP scores were negatively correlated with acute-phase APACHE IV and positively with stable-phase FEV₁/FVC. HALP scores declined progressively with higher GOLD grades. HALP scores demonstrated superior predictive accuracy for 30-day readmission compared to CRP. Multivariate analysis confirmed HALP as an independent predictor of 30-day readmission. Overall, HALP score reduction correlates with AECOPD severity and independently predicts 30-day readmission, serving as a valuable biomarker for short-term rehospitalization risk.