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Tortum F, Tekin E, Gur A. Predictive value of the Hemoglobin, Albumin, Lymphocyte and Platelet score for mortality in geriatric patients presenting to the emergency department. Geriatr Gerontol Int 2025. [PMID: 39838526 DOI: 10.1111/ggi.15082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2024] [Revised: 11/26/2024] [Accepted: 01/06/2025] [Indexed: 01/23/2025]
Abstract
AIM The Hemoglobin, Albumin, Lymphocyte and Platelet (HALP) score, calculated as hemoglobin × albumin × lymphocytes / platelets, serves as a novel biomarker that can provide insights into a patient's nutritional status, anemia status and inflammatory processes. This study aimed to investigate the predictive value of the HALP score for mortality among geriatric patients presenting to the emergency department. METHODS This retrospective study was carried out at the emergency department of a tertiary hospital. Patients aged ≥65 years who presented to the emergency department between 1 January 2018 and 1 January 2024 were included in the study. A total of 62 262 patients who visited our emergency department were enrolled. Patient data, including hemoglobin, albumin, lymphocyte and platelet values; age; sex, the reason for hospital presentation; and outcome (mortality or discharge) were obtained from electronic medical records. HALP scores were calculated for the patients, and statistical analyses were carried out. RESULTS Of the patients, 32 410 were men, and the mean age was 73 years. Within this cohort, in-hospital mortality occurred in 3093 of the patients. The HALP score was significantly lower in patients who died compared with those who were discharged (P < 0.001). CONCLUSION Due to its cost-effectiveness and ease of calculation, the HALP score appears to be more feasible in predicting mortality in the emergency department compared with other scoring systems. Geriatr Gerontol Int 2025; ••: ••-••.
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Affiliation(s)
- Fatma Tortum
- Department of Emergency Medicine, School of Medicine, Ataturk University, Erzurum, Turkey
| | - Erdal Tekin
- Department of Emergency Medicine, School of Medicine, Ataturk University, Erzurum, Turkey
| | - Ali Gur
- Department of Emergency Medicine, School of Medicine, Ataturk University, Erzurum, Turkey
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Mikulski D, Kędzior MK, Mirocha G, Jerzmanowska-Piechota K, Witas Ż, Woźniak Ł, Pawlak M, Kościelny K, Kośny M, Robak P, Gołos A, Robak T, Fendler W, Góra-Tybor J. Predictors and Profile of Severe Infectious Complications in Multiple Myeloma Patients Treated with Daratumumab-Based Regimens: A Machine Learning Model for Pneumonia Risk. Cancers (Basel) 2024; 16:3709. [PMID: 39518146 PMCID: PMC11545561 DOI: 10.3390/cancers16213709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2024] [Revised: 11/01/2024] [Accepted: 11/01/2024] [Indexed: 11/16/2024] Open
Abstract
BACKGROUND Daratumumab (Dara) is the first monoclonal antibody introduced into clinical practice to treat multiple myeloma (MM). It currently forms the backbone of therapy regimens in both newly diagnosed (ND) and relapsed/refractory (RR) patients. However, previous reports indicated an increased risk of infectious complications (ICs) during Dara-based treatment. In this study, we aimed to determine the profile of ICs in MM patients treated with Dara-based regimens and establish predictors of their occurrence. METHODS This retrospective, real-life study included MM patients treated with Dara-based regimens between July 2019 and March 2024 at our institution. Infectious events were evaluated using the Terminology Criteria for Adverse Events (CTCAE) version 5.0. RESULTS The study group consisted of a total of 139 patients, including 49 NDMM and 90 RRMM. In the RR setting, the majority (60.0%) of patients received the Dara, bortezomib, and dexamethasone (DVd) regimen, whereas ND patients were predominantly (98%) treated with the Dara, bortezomib, thalidomide, and dexamethasone (DVTd) regimen. Overall, 55 patients (39.6%) experienced ICs. The most common IC was pneumonia (37.5%), followed by upper respiratory tract infections (26.8%). Finally, twenty-five patients had severe ICs (grade ≥ 3) and required hospitalization, and eight patients died due to ICs. In the final multivariable model adjusted for setting (ND/RR) and age, hemoglobin level (OR 0.77, 95% CI: 0.61-0.96, p = 0.0037), and Eastern Cooperative Oncology Group (ECOG) >1 (OR 4.46, 95% CI: 1.63-12.26, p = 0.0037) were significant factors influencing severe IC occurrence. Additionally, we developed predictive models using the J48 decision tree, gradient boosting, and random forest algorithms. After conducting 10-fold cross-validation, these models demonstrated strong performance in predicting the occurrence of pneumonia during treatment with daratumumab-based regimens. CONCLUSIONS Simple clinical and laboratory assessments, including hemoglobin level and ECOG scale, can be valuable in identifying patients vulnerable to infections during Dara-based regimens, facilitating personalized prophylactic strategies.
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Affiliation(s)
- Damian Mikulski
- Department of Biostatistics and Translational Medicine, Medical University of Lodz, 92-215 Lodz, Poland; (D.M.); (K.K.); (W.F.)
- Department of Hematooncology, Provincial Multi-Specialized Oncology and Trauma Center, 93-513 Lodz, Poland; (M.K.K.); (K.J.-P.); (M.K.); (P.R.); (A.G.)
| | - Marcin Kamil Kędzior
- Department of Hematooncology, Provincial Multi-Specialized Oncology and Trauma Center, 93-513 Lodz, Poland; (M.K.K.); (K.J.-P.); (M.K.); (P.R.); (A.G.)
| | - Grzegorz Mirocha
- Department of Biostatistics and Translational Medicine, Medical University of Lodz, 92-215 Lodz, Poland; (D.M.); (K.K.); (W.F.)
| | - Katarzyna Jerzmanowska-Piechota
- Department of Hematooncology, Provincial Multi-Specialized Oncology and Trauma Center, 93-513 Lodz, Poland; (M.K.K.); (K.J.-P.); (M.K.); (P.R.); (A.G.)
- Department of Hematology, Medical University of Lodz, 90-419 Lodz, Poland; (Ż.W.); (Ł.W.); (M.P.); (T.R.)
| | - Żaneta Witas
- Department of Hematology, Medical University of Lodz, 90-419 Lodz, Poland; (Ż.W.); (Ł.W.); (M.P.); (T.R.)
| | - Łukasz Woźniak
- Department of Hematology, Medical University of Lodz, 90-419 Lodz, Poland; (Ż.W.); (Ł.W.); (M.P.); (T.R.)
| | - Magdalena Pawlak
- Department of Hematology, Medical University of Lodz, 90-419 Lodz, Poland; (Ż.W.); (Ł.W.); (M.P.); (T.R.)
| | - Kacper Kościelny
- Department of Biostatistics and Translational Medicine, Medical University of Lodz, 92-215 Lodz, Poland; (D.M.); (K.K.); (W.F.)
| | - Michał Kośny
- Department of Hematooncology, Provincial Multi-Specialized Oncology and Trauma Center, 93-513 Lodz, Poland; (M.K.K.); (K.J.-P.); (M.K.); (P.R.); (A.G.)
- Department of Hematology, Medical University of Lodz, 90-419 Lodz, Poland; (Ż.W.); (Ł.W.); (M.P.); (T.R.)
| | - Paweł Robak
- Department of Hematooncology, Provincial Multi-Specialized Oncology and Trauma Center, 93-513 Lodz, Poland; (M.K.K.); (K.J.-P.); (M.K.); (P.R.); (A.G.)
- Department of Hematology, Medical University of Lodz, 90-419 Lodz, Poland; (Ż.W.); (Ł.W.); (M.P.); (T.R.)
| | - Aleksandra Gołos
- Department of Hematooncology, Provincial Multi-Specialized Oncology and Trauma Center, 93-513 Lodz, Poland; (M.K.K.); (K.J.-P.); (M.K.); (P.R.); (A.G.)
- Department of Hematology, Medical University of Lodz, 90-419 Lodz, Poland; (Ż.W.); (Ł.W.); (M.P.); (T.R.)
| | - Tadeusz Robak
- Department of Hematology, Medical University of Lodz, 90-419 Lodz, Poland; (Ż.W.); (Ł.W.); (M.P.); (T.R.)
- Department of General Hematology, Copernicus Memorial Hospital, 93-513 Lodz, Poland
| | - Wojciech Fendler
- Department of Biostatistics and Translational Medicine, Medical University of Lodz, 92-215 Lodz, Poland; (D.M.); (K.K.); (W.F.)
| | - Joanna Góra-Tybor
- Department of Hematooncology, Provincial Multi-Specialized Oncology and Trauma Center, 93-513 Lodz, Poland; (M.K.K.); (K.J.-P.); (M.K.); (P.R.); (A.G.)
- Department of Hematology, Medical University of Lodz, 90-419 Lodz, Poland; (Ż.W.); (Ł.W.); (M.P.); (T.R.)
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