# Correlation and Prognostic Significance of the Hemoglobin, Albumin, Lymphocyte, and Platelet (HALP) Score in Acute Ischemic Stroke Survivors

## TL;DR

This study shows that a blood-based HALP score can predict outcomes in stroke patients, with lower scores linked to worse recovery and higher death rates.

## Contribution

The HALP score is introduced as a novel prognostic tool for acute ischemic stroke survivors.

## Key findings

- Lower HALP scores correlate with greater stroke severity and worse outcomes.
- HALP independently predicts poor functional recovery and in-hospital mortality.
- HALP is positively associated with functional independence and negatively with NIHSS scores.

## Abstract

Background: Acute ischemic stroke (AIS) remains a leading cause of death and long-term disability worldwide. Early identification of high-risk patients is crucial for improving outcomes.

Objective: This study aimed to determine the correlation and prognostic significance of the Hemoglobin, Albumin, Lymphocyte, and Platelet (HALP) score in patients with AIS.

Methodology: This cross-sectional analytical study was conducted at the Liaquat College of Medicine and Dentistry, Karachi, Pakistan, from June 2024 to September 2025. A total of 355 patients diagnosed with AIS were enrolled using non-probability consecutive sampling. Hemoglobin, serum albumin, lymphocyte count, and platelet count were obtained within 24 hours of admission, and the HALP score was calculated as (hemoglobin × albumin × lymphocyte count)/platelet count.

Results: The mean age of participants was 60.8 ± 11.9 years, with 58.6% males. The mean HALP score was 32.6 ± 16.4. Patients with favorable outcomes (modified Rankin Scale (mRS): 0-2) had significantly higher HALP scores (39.8 ± 14.1) than those with poor outcomes (mRS: 3-6; 22.9 ± 12.6; p < 0.001). HALP was negatively correlated with the National Institutes of Health Stroke Scale (NIHSS) (r = −0.62; p < 0.001) and positively associated with functional independence (r = 0.55; p < 0.001). In multivariate logistic regression, HALP independently predicted poor functional outcome (adjusted odds ratio (OR) = 0.91; 95% CI: 0.87-0.95; p < 0.001) and in-hospital mortality (adjusted OR = 0.89; 95% CI: 0.82-0.96; p = 0.002).

Conclusion: A lower HALP score is strongly associated with greater stroke severity, worse functional recovery, and higher mortality in patients with AIS.