Low hemoglobin, albumin, lymphocyte, and platelet score increases symptomatic intracranial hemorrhage risk in thrombectomy patients

BackgroundThe HALP index, a composite biomarker integrating hemoglobin, albumin, lymphocyte, and platelet parameters, reflects both immunological competence and nutritional status. We therefore conducted this retrospective analysis to assess the correlation between HALP score and the risk symptomati...

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Main Authors: Shuaiyu Chen, Zhihang Huang, Jingwen Qi, Bin Wei, Yan E, Chunmei Liu, Yingdong Zhang, Xiaohao Zhang
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-08-01
Series:Frontiers in Neurology
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Online Access:https://www.frontiersin.org/articles/10.3389/fneur.2025.1588875/full
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author Shuaiyu Chen
Zhihang Huang
Jingwen Qi
Bin Wei
Yan E
Chunmei Liu
Yingdong Zhang
Xiaohao Zhang
author_facet Shuaiyu Chen
Zhihang Huang
Jingwen Qi
Bin Wei
Yan E
Chunmei Liu
Yingdong Zhang
Xiaohao Zhang
author_sort Shuaiyu Chen
collection DOAJ
description BackgroundThe HALP index, a composite biomarker integrating hemoglobin, albumin, lymphocyte, and platelet parameters, reflects both immunological competence and nutritional status. We therefore conducted this retrospective analysis to assess the correlation between HALP score and the risk symptomatic intracranial hemorrhage (sICH) risk in patients receiving mechanical thrombectomy (MT).MethodsThis retrospective study included patients with acute ischemic stroke due to anterior circulation large vessel occlusion who underwent MT between October 2019 and July 2024. The HALP index was calculated based on admission laboratory parameters. The sICH was diagnosed according to Heidelberg Bleeding Classification criteria within 72 h post-procedure. Multivariate logistic regression analysis was performed to identify independent association between pretreatment HALP score and sICH risk after adjusting for covariates.ResultsA total of 735 patients (mean age, 71.3 ± 10.9 years; 423 male) were enrolled in this study. sICH was diagnosed in 82 patients (11.2%) during hospitalization. After adjusting for demographic characteristics and other covariates, multivariate logistic regression analysis revealed that a low HALP index was significantly associated with an elevated risk of sICH (odds ratio: 1.058, 95% confidence interval: 1.024–1.094, p = 0.001). findings were obtained when the HALP score was analyzed as a categorical variable. Additionally, the restricted cubic spline analysis confirmed a linear inverse relationship between the HALP index and the risk of sICH following MT (p = 0.551 for non-linearity).ConclusionOur data confirmed a significant inverse correlation between the HALP score and the sICH risk in patients treated with MT. This suggests that the HALP score may serve as a valuable tool for monitoring and managing sICH risk in ischemic stroke patients following reperfusion therapy.
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spelling doaj-art-c3df5d9d5b024b73b31cb91c4dc20b9d2025-08-04T06:15:53ZengFrontiers Media S.A.Frontiers in Neurology1664-22952025-08-011610.3389/fneur.2025.15888751588875Low hemoglobin, albumin, lymphocyte, and platelet score increases symptomatic intracranial hemorrhage risk in thrombectomy patientsShuaiyu ChenZhihang HuangJingwen QiBin WeiYan EChunmei LiuYingdong ZhangXiaohao ZhangBackgroundThe HALP index, a composite biomarker integrating hemoglobin, albumin, lymphocyte, and platelet parameters, reflects both immunological competence and nutritional status. We therefore conducted this retrospective analysis to assess the correlation between HALP score and the risk symptomatic intracranial hemorrhage (sICH) risk in patients receiving mechanical thrombectomy (MT).MethodsThis retrospective study included patients with acute ischemic stroke due to anterior circulation large vessel occlusion who underwent MT between October 2019 and July 2024. The HALP index was calculated based on admission laboratory parameters. The sICH was diagnosed according to Heidelberg Bleeding Classification criteria within 72 h post-procedure. Multivariate logistic regression analysis was performed to identify independent association between pretreatment HALP score and sICH risk after adjusting for covariates.ResultsA total of 735 patients (mean age, 71.3 ± 10.9 years; 423 male) were enrolled in this study. sICH was diagnosed in 82 patients (11.2%) during hospitalization. After adjusting for demographic characteristics and other covariates, multivariate logistic regression analysis revealed that a low HALP index was significantly associated with an elevated risk of sICH (odds ratio: 1.058, 95% confidence interval: 1.024–1.094, p = 0.001). findings were obtained when the HALP score was analyzed as a categorical variable. Additionally, the restricted cubic spline analysis confirmed a linear inverse relationship between the HALP index and the risk of sICH following MT (p = 0.551 for non-linearity).ConclusionOur data confirmed a significant inverse correlation between the HALP score and the sICH risk in patients treated with MT. This suggests that the HALP score may serve as a valuable tool for monitoring and managing sICH risk in ischemic stroke patients following reperfusion therapy.https://www.frontiersin.org/articles/10.3389/fneur.2025.1588875/fullHALP indexlarge vascular occlusive strokesymptomatic intracranial hemorrhagemechanical thrombectomypredictor
spellingShingle Shuaiyu Chen
Zhihang Huang
Jingwen Qi
Bin Wei
Yan E
Chunmei Liu
Yingdong Zhang
Xiaohao Zhang
Low hemoglobin, albumin, lymphocyte, and platelet score increases symptomatic intracranial hemorrhage risk in thrombectomy patients
Frontiers in Neurology
HALP index
large vascular occlusive stroke
symptomatic intracranial hemorrhage
mechanical thrombectomy
predictor
title Low hemoglobin, albumin, lymphocyte, and platelet score increases symptomatic intracranial hemorrhage risk in thrombectomy patients
title_full Low hemoglobin, albumin, lymphocyte, and platelet score increases symptomatic intracranial hemorrhage risk in thrombectomy patients
title_fullStr Low hemoglobin, albumin, lymphocyte, and platelet score increases symptomatic intracranial hemorrhage risk in thrombectomy patients
title_full_unstemmed Low hemoglobin, albumin, lymphocyte, and platelet score increases symptomatic intracranial hemorrhage risk in thrombectomy patients
title_short Low hemoglobin, albumin, lymphocyte, and platelet score increases symptomatic intracranial hemorrhage risk in thrombectomy patients
title_sort low hemoglobin albumin lymphocyte and platelet score increases symptomatic intracranial hemorrhage risk in thrombectomy patients
topic HALP index
large vascular occlusive stroke
symptomatic intracranial hemorrhage
mechanical thrombectomy
predictor
url https://www.frontiersin.org/articles/10.3389/fneur.2025.1588875/full
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