Jie Fu,1 Xiu Chen,1 Jinglun Li,1 Benbing Rong,1 Lilei Peng2 

1Department of Neurology, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, People’s Republic of China; 2Department of Neurosurgery, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, People’s Republic of China

Correspondence: Lilei Peng; Benbing Rong, Email lilei.peng@swmu.edu.cn; rongbenb@126.com

Objective: The hemoglobin, albumin, lymphocyte, and platelet (HALP) score has been indicated to be a novel indicator that reflects systemic inflammation and is associated with the functional outcome in various neurological diseases. Since inflammation is closely involved in the pathogenesis of status epilepticus (SE), this study aimed to explore the predictive value of HALP for the prognosis of SE patients.
Methods: In the retrospective study, we investigated and validated the predictive value of HALP for the prognosis of adult SE patients. We collected patient’s clinical characteristics and laboratory test data. Information of 30-day mortality after SE onset was obtained, and modified Rankin scale (mRS) scores were used to evaluate the clinical outcomes. Multivariable logistic regression models were applied to explore the association between HALP and SE prognosis. Receiver operating characteristic (ROC) curve analysis was performed to determine the optimal cutoff of HALP to predict 30-day mortality in SE patients.
Results: We first analyzed the discovery cohort of 116 patients with SE. We observed that 19.0% (22/116) of the patients died within 30 days after SE onset, and 26.3% (20/76) had poor outcomes during the 6-month follow-up. Multivariate logistic regression analysis indicated that lower HALP on admission was an independent predictor of 30-day mortality (odds ratio: 0.980; 95% confidence interval, 0.962– 0.999; P = 0.044). In ROC analysis, a HALP of 20.32 was identified as the optimal cutoff value to predict 30-day mortality in SE patients. Furthermore, multivariate logistic regression analysis showed that HALP < 20.32 was related to an increased risk of poor SE outcomes (odds ratio: 27.051; 95% confidence interval, 3.589– 203.909; P = 0.001), which was validated in the external cohort.
Conclusion: Lower HALP is independently associated with an increased risk of 30-day mortality and poor functional outcomes in patients with SE. Our findings suggest that HALP may be a promising biomarker for predicting SE prognosis.

Keywords: status epilepticus, HALP score, inflammation, prognosis, biomarker