Predictive value of HALP index for clinical outcomes of mechanical ventilation in patients with acute exacerbation of chronic obstructive pulmonary disease complicated with pulmonary encephalopathy

An Qiaohe; Hao Yufang; Ding Shuai; Chang Jing

doi:10.3969/j.issn.1671-6450.2025.01.008

Abstract：Objective To investigate the value of hemoglobin,albumin,lymphocyte and platelet(HALP)index in predicting the clinical outcome of mechanical ventilation in patients with acute exacerbation of chronic obstructive pulmona-ry disease(AECOPD)complicated with pulmonary encephalopathy.Methods A total of 102 patients with AECOPD com-bined with pulmonary encephalopathy were selected as the observation group and 69 patients with AECOPD without pul-monary encephalopathy were selected as the control group from January 2020 to December 2022 in the Department of Seri-ous Medicine,Yulin Hospital,the First Affiliated Hospital of Xi'an Jiaotong University.All patients in the observation group received mechanical ventilation.Hemoglobin,albumin,lymphocyte count and platelet count were measured before treatment,and HALP index was calculated.According to the treatment results,patients were divided into successful subgroup(30 ca-ses)and failed subgroup(72 cases).Multivariate Logistic regression analysis of NPPV treatment failure in patients with AE-COPD and pulmonary encephalopathy.The value of receiver operating characteristic(ROC)curve analysis of HALP index in predicting NPPV treatment failure in patients with AECOPD and pulmonary encephalopathy.Results HALP index of obser-vation group was lower than that of control group(t/P=6286/＜0.001).The scores of acute physiology and chronic health evaluation Ⅱ(APACHEⅡ)in failure subgroup were higher than those in success subgroup(t/P=3.834/＜0.001).Baseline Glasgow Coma Scale(GCS)scores and HALP index were lower than those of successful subgroups(t/P=10.765/＜0.001,11.152/＜0.001).HALP index was negatively correlated with APACHEⅡ score(r=-0.415,P＜0.001),and positively correla-ted with GCS score(r=0.368,P=0.009).Low baseline GCS score and HALP index were risk factors for NPPV treatment fail-ure in patients with AECOPD and pulmonary encephalopathy[OR(95％CI)=2.782(1.138-6.799),2.130(1.126-4.027)].HALP index predicted NPPV failure in AECOPD patients with pulmonary encephalopathy with an area under the curve of 0.811(95％CI:0.722-0.882),critical value of 32.19,sensitivity of 86.67％,specificity of 79.17％,and Jorden index of 0.658.Conclusion The decrease of HALP index in patients with AECOPD combined with pulmonary encephalopathy is associat-ed with NPPV treatment failure,and can predict the risk of NPPV treatment failure.