Evaluation of the C-reactive protein–albumin–lymphocyte (CALLY) index as a prognostic marker in patients with sepsis
Year: 2025
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Sepsis remains a leading cause of mortality worldwide, and early identification of high-risk patients is essential. The C-reactive protein–albumin–lymphocyte (CALLY) index has emerged as a potential prognostic biomarker but has not been widely studied in emergency department (ED) populations. METHODS: We conducted a retrospective cohort study including adult patients diagnosed with sepsis upon ED admission. The CALLY index was calculated as (albumin × lymphocyte count) / C-reactive protein (CRP), using laboratory values obtained at presentation. The primary outcome was 30-day all-cause mortality. Predictive performance was assessed using multivariable logistic regression with least absolute shrinkage and selection operator (LASSO) variable selection, calibration metrics, and Receiver Operating Characteristic (ROC) curve analyses. RESULTS: A total of 669 patients were included, with a 30-day mortality rate of 23% (n = 156). Non-survivors had significantly higher CRP (107.30 ± 40.97 vs. 94.01 ± 28.09 mg/L, p = 0.002), lower albumin (2.81 ± 0.30 vs. 3.59 ± 0.22 g/dL, p < 0.001), and lower lymphocyte count (0.71 ± 0.31 vs. 1.30 ± 0.40 × 10⁹/L, p < 0.001). The mean CALLY index was markedly elevated in deceased patients (69.7 ± 54.2 vs. 23.1 ± 15.6, p < 0.001). The area under the ROC of the CALLY index was 0.906 (95% CI, 0.879–0.934). At the threshold yielding the maximum Youden Index (31.32), the sensitivity was 0.853, specificity was 0.854, and accuracy was 0.852. CONCLUSION: The CALLY index is a simple and accessible biomarker independently associated with 30-day mortality in ED patients with sepsis and may support early risk stratification in acute care. CLINICAL TRIAL NUMBER: Not applicable.
Source: BMC Emergency Medicine
Authors: Erdal Yılmaz, Rohat Ak
Institution: Dr Lütfi Kırdar Kartal Eğitim ve Araştırma Hastanesi
Language: English
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,790
OpenAlex ID: W4414609148