ASSOCIATION OF THE PROGNOSTIC NUTRITIONAL INDEX AND HEMOGLOBIN–ALBUMIN–LYMPHOCYTE–PLATELET SCORE WITH 7-DAY MORTALITY IN PATIENTS ADMITTED TO THE INTENSIVE CARE UNIT AFTER GENERAL SURGERY OPERATIONS: A RETROSPECTIVE OBSERVATIONAL STUDY

Abstract

Objective: This study aimed to evaluate the association of the Prognostic Nutritional Index (PNI) and Hemoglobin–Albumin–Lymphocyte–Platelet (HALP) score with 7-day mortality in adult general surgery patients admitted to the postoperative intensive care unit and to investigate their predictive performance for early postoperative mortality. Methods: This single-center retrospective observational study included adult patients who underwent general surgery between July 1 and December 31, 2024, and were admitted to the postoperative intensive care unit. PNI and HALP were calculated from routine laboratory parameters obtained at intensive care unit admission. The primary outcome was 7-day postoperative mortality. Multiple logistic regression and receiver operating characteristic (ROC) curve analyses were performed. Results: A total of 436 patients were included, of whom 31 (7.1%) died within 7 days after surgery. Non-survivors had significantly lower PNI and HALP values than survivors. After adjustment for age and lactate level, both PNI and HALP were independently associated with 7-day mortality. PNI demonstrated good discriminatory performance, with an area under the curve (AUC) of 0.870 (95% confidence interval: 0.804–0.937; p<0.001) and an optimal cut-off value of ≤31.45. HALP showed acceptable discriminatory performance, with an AUC of 0.762 (95% confidence interval: 0.677–0.846; p<0.001) and an optimal cut-off value of ≤16.2. Conclusion: PNI and HALP were independently associated with 7-day mortality in adult patients admitted to the postoperative intensive care unit following general surgery. These findings suggest that these routinely derived indices may represent readily available and low-cost markers that could assist early postoperative risk stratification.