Incremental prognostic value of the hemoglobin, albumin, lymphocyte, and platelet score and b-type natriuretic peptide for 30-day mortality after elective on-pump coronary artery bypass grafting

BACKGROUND: This study evaluated whether preoperative hemoglobin-albumin-lymphocyte-platelet (HALP) score and B-type natriuretic peptide (BNP) were associated with 30-day mortality after elective on-pump coronary artery bypass grafting (CABG) and whether they improved prognostic assessment beyond EuroSCORE II. METHODS: Among 492 eligible patients, 466 with complete data on 30-day mortality and the prespecified primary predictors constituted the primary analytic cohort. Associations were examined using Firth penalized logistic regression, and internal validation was performed with bootstrap resampling. RESULTS: Twenty-one patients (4.5%) died within 30 days. Lower HALP and higher BNP were independently associated with mortality after adjustment for EuroSCORE II. The optimism-corrected area under the curve improved from 0.879 for EuroSCORE II alone to 0.974 after addition of HALP and to 0.979 after further addition of BNP. CONCLUSIONS: Lower HALP and higher BNP were associated with 30-day mortality after elective on-pump CABG and may provide incremental prognostic information beyond EuroSCORE II. These findings should be considered exploratory.