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Prognostic value of C-reactive protein-albumin-lymphocyte (CALLY) score and CRP-albumin ratio on mortality in patients diagnosed with pulmonary thromboembolism

Ahmet Mert Aydemir
Oct 2026 · Frontiers in Medicine · 0 citations · 26 references

Abstract

<jats:sec> <jats:p>Acute pulmonary embolism (PE) requires rapid risk stratification to predict early mortality. We aimed to evaluate the prognostic value of the C-reactive protein-albumin-lymphocyte (CALLY) index and C-reactive protein-to-albumin ratio (CAR) in predicting in-hospital mortality among patients with PE.</jats:p> </jats:sec> <jats:sec> <jats:p>This retrospective, single-center Study Included 399 Patients Diagnosed with Acute PE Between 2021 and 2025. the Clinical Characteristics and Baseline Laboratory Parameters Were Analyzed. Receiver Operating Characteristic (ROC) Curves Were Used to Determine the Optimal Biomarker cut-offs. Univariate and Multivariate Logistic Regression Models Were Constructed to Evaluate the Independent Predictors of Mortality</jats:p> </jats:sec> <jats:sec> <jats:p> Non-survivors ( <jats:inline-formula> <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="IM1"> <mml:mi>n</mml:mi> <mml:mo>=</mml:mo> <mml:mn>88</mml:mn> <mml:mo>,</mml:mo> <mml:mn>22.0</mml:mn> <mml:mtext>%</mml:mtext> </mml:math> </jats:inline-formula> ) had significantly lower CALLY indices ( <jats:inline-formula> <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="IM2"> <mml:mn>0.71</mml:mn> </mml:math> </jats:inline-formula> vs. <jats:inline-formula> <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="IM3"> <mml:mn>1.56</mml:mn> <mml:mo>,</mml:mo> <mml:mi>p</mml:mi> <mml:mo><</mml:mo> <mml:mn>0.001</mml:mn> </mml:math> </jats:inline-formula> ) and higher CAR values ( <jats:inline-formula> <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="IM4"> <mml:mn>2.37</mml:mn> </mml:math> </jats:inline-formula> vs. <jats:inline-formula> <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="IM5"> <mml:mn>0.93</mml:mn> <mml:mo>,</mml:mo> <mml:mi>p</mml:mi> <mml:mo><</mml:mo> <mml:mn>0.001</mml:mn> </mml:math> </jats:inline-formula> ) than survivors ( <jats:inline-formula> <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="IM6"> <mml:mi>n</mml:mi> <mml:mo>=</mml:mo> <mml:mn>311</mml:mn> <mml:mo>,</mml:mo> <mml:mn>78.0</mml:mn> <mml:mtext>%</mml:mtext> </mml:math> </jats:inline-formula> ). The AUC was <jats:inline-formula> <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="IM7"> <mml:mn>0.655</mml:mn> </mml:math> </jats:inline-formula> for CALLY ( <jats:inline-formula> <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="IM8"> <mml:mo><</mml:mo> <mml:mn>1.17</mml:mn> </mml:math> </jats:inline-formula> cut-off; <jats:inline-formula> <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="IM9"> <mml:mn>69.1</mml:mn> <mml:mtext>%</mml:mtext> </mml:math> </jats:inline-formula> sensitivity, <jats:inline-formula> <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="IM10"> <mml:mn>57.7</mml:mn> <mml:mtext>%</mml:mtext> </mml:math> </jats:inline-formula> specificity, <jats:inline-formula> <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="IM11"> <mml:mn>86.4</mml:mn> <mml:mtext>%</mml:mtext> </mml:math> </jats:inline-formula> NPV) and <jats:inline-formula> <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="IM12"> <mml:mn>0.643</mml:mn> </mml:math> </jats:inline-formula> for CAR ( <jats:inline-formula> <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="IM13"> <mml:mo>></mml:mo> <mml:mn>3.28</mml:mn> </mml:math> </jats:inline-formula> cut-off; <jats:inline-formula> <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="IM14"> <mml:mn>42.0</mml:mn> <mml:mtext>%</mml:mtext> </mml:math> </jats:inline-formula> sensitivity, <jats:inline-formula> <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="IM15"> <mml:mn>83.2</mml:mn> <mml:mtext>%</mml:mtext> </mml:math> </jats:inline-formula> specificity, <jats:inline-formula> <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="IM16"> <mml:mn>83.2</mml:mn> <mml:mtext>%</mml:mtext> </mml:math> </jats:inline-formula> NPV) (DeLong test, <jats:inline-formula> <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="IM17"> <mml:mi>p</mml:mi> <mml:mo>=</mml:mo> <mml:mn>0.582</mml:mn> </mml:math> </jats:inline-formula> ). In multivariate models adjusted for age, sex, and serum creatinine, both a low CALLY index ( <jats:inline-formula> <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="IM18"> <mml:mo><</mml:mo> <mml:mn>1.17</mml:mn> </mml:math> </jats:inline-formula> ; <jats:inline-formula> <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="IM19"> <mml:mrow> <mml:mi mathvariant="normal">aOR</mml:mi> </mml:mrow> <mml:mo>=</mml:mo> <mml:mn>2.54</mml:mn> <mml:mo>,</mml:mo> <mml:mn>95</mml:mn> <mml:mtext>%</mml:mtext> <mml:mrow> <mml:mspace width="thickmathspace"/> <mml:mi mathvariant="normal">CI</mml:mi> <mml:mo>:</mml:mo> <mml:mspace width="thickmathspace"/> </mml:mrow> <mml:mn>1.46</mml:mn> <mml:mo>−</mml:mo> <mml:mn>4.50</mml:mn> <mml:mo>,</mml:mo> <mml:mi>p</mml:mi> <mml:mo>=</mml:mo> <mml:mn>0.001</mml:mn> </mml:math> </jats:inline-formula> ) and a high CAR ( <jats:inline-formula> <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="IM20"> <mml:mo>></mml:mo> <mml:mn>3.28</mml:mn> </mml:math> </jats:inline-formula> ; <jats:inline-formula> <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="IM21"> <mml:mrow> <mml:mi mathvariant="normal">aOR</mml:mi> </mml:mrow> <mml:mo>=</mml:mo> <mml:mn>3.02</mml:mn> <mml:mo>,</mml:mo> <mml:mn>95</mml:mn>

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