Relationship between mortality and HALP score in femoral neck fractures treated with hemiarthroplasty

Abstract

Objectives: This study aims to investigate the predictive value of the Hemoglobin, Albumin, Lymphocyte, and Platelet (HALP) score for six-month mortality in patients undergoing hemiarthroplasty for femoral neck fractures (FNFs).

Patients and methods: Between March 2019 and March 2022, a total of 60 patients (32 males, 28 females; mean age: 83.2±6.3 years; range, 67 to 95 years) who underwent hemiarthroplasty for FNFs were retrospectively analyzed. Complete blood count and albumin levels were analyzed in venous blood samples at the time of hospital admission. The neutrophil/lymphocyte ratio (NLR), monocyte/lymphocyte ratio (MLR), platelet/lymphocyte ratio (PLR), prognostic nutritional index (PNI), systemic immune-inflammation index (SII), and HALP scores were calculated. The six-month mortality rates of the patients were recorded.

Results: At six-month follow-up, 22 (36.6%) patients died and 38 (63.4%) survived. In logistic regression analysis, only HALP score was found to be associated with six-month mortality independently of other parameters (p=0.001 odds ratio [OR]=1.09, 95% confidence interval [CI]: 1.06-1.13). The six-month survival increased 1.09-fold for each unit increase in HALP score. In the receiver operating characteristics (ROC) curve analysis, the HALP score showed 71.1% sensitivity and 72.7% specificity using a cut-off value of 19.95 (area under the curve [AUC]: 0.804, 95% CI: 0.687-0.921).

Conclusion: Our study results show that low HALP score is associated with six-month mortality in this patient group. Based on these findings, we suggest that the clinical use of the HALP score as a prognostic marker in hip fracture patients.