Work

Prognostic significance of the C-reactive protein–albumin–lymphocyte index and the pan-immune-inflammation value in ischemic and hemorrhagic stroke: a comparative analysis of subtypes

Year: 2026

Type: article

Abstract: Background Cerebrovascular events are major causes of global mortality and disability. Inflammation, immune response, and nutritional status play crucial roles in stroke pathophysiology. The C-reactive protein–albumin–lymphocyte (CALLY) index and the pan-immune-inflammation value (PIV) are novel composite biomarkers reflecting these mechanisms. This study compared their prognostic performance between ischemic and hemorrhagic stroke. Methods This retrospective, single-center cohort included 357 patients diagnosed with ischemic or hemorrhagic stroke between January 2020 and December 2024. Demographic, clinical, and laboratory data were retrieved from electronic records. Indices including CALLY, PIV, HALP, SII, and MII were calculated from blood samples obtained within 24 h of admission. Group comparisons, multivariate logistic regression, and receiver operating characteristic (ROC) analyses identified independent predictors and diagnostic performance. Results Among 357 patients (mean age 67 ± 14 years; 56.6% ischemic, 43.4% hemorrhagic), the CALLY index was significantly higher in hemorrhagic cases ( p < 0.001). Multivariate analysis identified CALLY (odds ratio = 1.255), PIV (odds ratio = 1.001), and HALP (odds ratio = 1.258) as independent predictors (all p < 0.001). CALLY showed the highest discriminative ability (area under the ROC curve = 0.756). In hemorrhagic stroke, lower CALLY values were associated with in-hospital mortality (AUC = 0.646, p = 0.002). Conclusion The CALLY index demonstrated superior prognostic value compared with other inflammatory markers and may serve as a simple, low-cost tool for early stroke risk assessment. Prospective, multicenter studies are warranted to validate these findings and to establish standardized cutoff values.

Source: Frontiers in Neurology

DOI: 10.3389/fneur.2025.1724077

Authors: Canan Şahin, Yahya Şahin

Institution: Ahi Evran University

Language: English

Topic: Inflammatory Biomarkers in Disease Prognosis

Subfield: Oncology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,801