The preoperative HALP index is an independent predictor of in-hospital mortality after type A aortic dissection surgery with CPB, with good discriminatory performance, and a combined model including HALP achieved the best predictive performance (AUC = 0.79).
The in-hospital mortality rate among patients undergoing type A aortic dissection surgery with CPB was 12.8%.
Patients who died in-hospital had significantly lower preoperative HALP scores than survivors.
Multivariate logistic regression identified four independent predictors of in-hospital mortality: age, chronic kidney disease (CKD), reduced left ventricular ejection fraction (LVEF), and low HALP index.
ROC analysis showed the HALP index outperformed individual predictors (age, CKD, LVEF) in discriminating in-hospital mortality.
The preoperative HALP index was identified as a simple, low-cost biomarker that supplements traditional risk scoring systems for preoperative risk stratification.
This research suggests that a blood-test-based score called the HALP index — which combines measurements of haemoglobin, albumin, lymphocytes, and platelets — can help predict which patients are at higher risk of dying in the hospital after emergency surgery to repair a type A aortic dissection (a life-threatening tear in the main artery from the heart). The study followed 750 patients who had this surgery over five years at a single hospital, finding that about 1 in 8 patients (12.8%) died before leaving the hospital. Patients who died had notably lower HALP scores before surgery compared to those who survived. When combined with other risk factors — older age, kidney disease, and reduced heart pumping function — the HALP index formed a model that predicted death with reasonably good accuracy (AUC of 0.79, where 1.0 would be perfect prediction). This research suggests that calculating the HALP index before surgery is a practical and inexpensive way to identify high-risk patients, since it uses blood tests that are already routinely ordered. The HALP score was a better predictor on its own than any single factor like age or kidney disease, and it added meaningful information when combined with those other factors. Because a low HALP score may reflect poor nutritional status and immune function, the authors suggest it could help surgical teams proactively prepare — for example, by having more blood products ready or planning for closer monitoring after surgery. The study's main limitation is that it was conducted at a single centre and used a retrospective design, meaning data were collected from existing medical records rather than through a prospectively planned experiment. This means the findings may not apply equally to all hospitals or patient populations, and the proposed cut-off values and clinical recommendations would benefit from validation in larger, multi-centre studies before being widely adopted in clinical practice.
Chen Z, Lin Z, Liu Q, Chen P, Chen H. (2026). Preoperative HALP index as a predictor of in-hospital mortality after type A aortic dissection surgery: a retrospective cohort study.. Annals of medicine. https://doi.org/10.1080/07853890.2026.2726579