The Role of the CALLY Index in 30-Day Mortality Prediction for Acute Mesenteric Ischemia: A Retrospective Cohort Study

TL;DR

This study evaluated the CALLY index as a predictor of 30-day mortality in patients with acute mesenteric ischemia, finding it had modest but not strong predictive value.

Contribution

The study is the first to evaluate the CALLY index for predicting mortality in acute mesenteric ischemia patients.

Findings

The CALLY index showed a statistically significant but modest ability to predict 30-day mortality (AUC = 0.64).

Lower CALLY index values were associated with higher mortality in univariate analysis.

The CALLY index did not remain an independent predictor of mortality in multivariate analysis.

Abstract

Background and Objectives: Acute mesenteric ischemia (AMI) lacks reliable prognostic biomarkers, and the prognostic performance of the C-reactive protein–albumin–lymphocyte (CALLY) index in this population has not been previously evaluated. This study aimed to assess the predictive value of the CALLY index for 30-day mortality in patients presenting to the emergency department (ED) with AMI. Materials and Methods: This retrospective cohort study included patients aged ≥18 years who presented to the ED with AMI over a 4-year period. Demographic and clinical data were collected. The CALLY index, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and CRP-to-lactate ratio were calculated. The primary outcome was 30-day mortality. Univariate and multivariate logistic regression analyses were performed to identify predictors of mortality. A receiver operating characteristic (ROC) curve analysis was used to assess predictive performance. A p-value < 0.05 was considered statistically significant. Results: A total of 111 patients were included (mean age, 69.2 ± 11.8 years; 52.3% male). The most common comorbidities were hypertension and coronary artery disease (45% each). The 30-day mortality rate was 55.9%. In a univariate analysis, lower CALLY index values were associated with higher mortality (p = 0.011). However, the CALLY index did not remain independently associated with mortality in multivariate logistic regression analysis (p = 0.773). The ROC analysis indicated that the CALLY index had a modest but statistically significant ability to predict 30-day mortality (AUC = 0.64, 95% CI: 0.54–0.74, p = 0.011). At a cut-off value of 0.0015, the CALLY index showed a sensitivity of 55% and a specificity of 77%. Conclusions: The CALLY index had modest predictive value for 30-day mortality in patients with AMI.

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