Abstract: Objective To explore the predictive effects of hemoglobin-albumin-lymphocyte-platelet (HALP) score on the onset of frailty in the elderly patients with ischemic stroke. Methods A total of 257 elderly patients with ischemic stroke were enrolled from Department of General Practice, Hefei Second People’s Hospital from January 2019 to December 2024. The baseline characteristics were collected and HALP score was calculated. After 90 days of follow-up, Tilburg Frailty Indicator (TFI) was applied to evaluate the status of frailty, and Modified Rankin Scale (mRS) was applied to evaluate the recovery of neurological function of the patients. Univariate and multivariate logistic regression analyses were used to assess the association between HALP score and frailty onset (TFI≥5) and poor prognosis (mRS≥3) in the elderly patients with ischemic stroke. Receiver operating characteristic (ROC) curve was drawn to analyze the predictive effects of HALP score on the onset of frailty in the elderly patients with ischemic stroke. Results Ninety days after follow-up, there were 119 patients (43.6%) suffering from frailty and 130 patients (50.6%) had poor prognosis. ROC curve analysis showed that the optimal cut-off value of HALP score predicting frailty was 44.5 with a sensitivity of 87.8% and a specificity of 81.5% (the area under ROC curve was 0.869, P<0.001). Univariate regression analysis showed that malnutrition, platelet count, National Institute of Health Stroke Scale (NIHSS) score, albumin level, hemoglobin level, lymphocyte count, and HALP score were risk factors of frailty in the elderly patients with ischemic stroke; while male, platelet count, C-reactive protein, NIHSS score, and HALP score were risk factors of poor prognosis in the elderly patients with ischemic stroke. Further multiple logistic regression analysis demonstrated that after adjusting for these confounders, low HALP score (<44.5) remained a significant risk factor for frailty (adjusted OR=25.08, 95%CI:10.39-60.53, P<0.001) and for poor prognosis (adjusted OR=2.39, 95%CI:1.37-4.19, P=0.002) in the elderly patients with ischemic stroke. Conclusions Low HALP score (<44.5) is associated with the risk of frailty and poor prognosis in the elderly patients with ischemic stroke. HALP score might serve as a novel potential biomarker for the prediction of frailty onset in the elderly patients with ischemic stroke.    

Key words: ischemic stroke, aged, frailty, HALP score, poor prognosis