Relationship between mortality and HALP score in femoral neck fractures treated with hemiarthroplasty
Fatih Tahak1
, Haluk Yaka2, Alper Kırılmaz3, Ahmet Fevzi Kekeç2, Tahsin Sami Çolak2, Mustafa Özer2
1Department of Orthopedics and Traumatology, Karapınar State Hospital, Konya, Türkiye
2Department of Orthopedics and Traumatology, Necmettin Erbakan University Faculty of Medicine, Konya, Türkiye
3Department of Orthopedics and Traumatology, Konya City Hospital, Konya, Türkiye
Keywords: Femoral neck fracture, HALP score, hip fracture, immune biomarkers mortality, nutritional biomarkers, prognostic scores.
Abstract
Objectives: This study aims to investigate the predictive value of the Hemoglobin, Albumin, Lymphocyte, and Platelet (HALP) score for six-month mortality in patients undergoing hemiarthroplasty for femoral neck fractures (FNFs).
Patients and methods: Between March 2019 and March 2022, a total of 60 patients (32 males, 28 females; mean age: 83.2±6.3 years; range, 67 to 95 years) who underwent hemiarthroplasty for FNFs were retrospectively analyzed. Complete blood count and albumin levels were analyzed in venous blood samples at the time of hospital admission. The neutrophil/lymphocyte ratio (NLR), monocyte/lymphocyte ratio (MLR), platelet/lymphocyte ratio (PLR), prognostic nutritional index (PNI), systemic immune-inflammation index (SII), and HALP scores were calculated. The six-month mortality rates of the patients were recorded.
Results: At six-month follow-up, 22 (36.6%) patients died and 38 (63.4%) survived. In logistic regression analysis, only HALP score was found to be associated with six-month mortality independently of other parameters (p=0.001 odds ratio [OR]=1.09, 95% confidence interval [CI]: 1.06-1.13). The six-month survival increased 1.09-fold for each unit increase in HALP score. In the receiver operating characteristics (ROC) curve analysis, the HALP score showed 71.1% sensitivity and 72.7% specificity using a cut-off value of 19.95 (area under the curve [AUC]: 0.804, 95% CI: 0.687-0.921).
Conclusion: Our study results show that low HALP score is associated with six-month mortality in this patient group. Based on these findings, we suggest that the clinical use of the HALP score as a prognostic marker in hip fracture patients.
Citation: Tahak F, Yaka H, Kırılmaz A, Kekeç AF, Çolak TS, Özer M. Relationship between mortality and HALP score in femoral neck fractures treated with hemiarthroplasty. Jt Dis Relat Surg 2025;36(3):i-vii. doi: 10.52312/jdrs.2025.2093.