Abstract
Objective
To evaluate the predictive value of the preoperative haemoglobin-albumin-lymphocyte-platelet (HALP) index for in-hospital mortality in patients undergoing cardiopulmonary bypass (CPB)-assisted type A aortic dissection surgery.Methods
This single-centre retrospective cohort study enrolled 750 adult patients who underwent type A aortic dissection surgery with CPB at a tertiary hospital from January 2021 to December 2025. The HALP index was calculated using preoperative laboratory data, with in-hospital mortality as the primary endpoint. Variables with p Results
The in-hospital mortality rate was 12.8%. Patients in the mortality group had significantly lower HALP scores than survivors (49.27 ± 15.06 vs. 71.53 ± 25.98). Multivariate analysis identified age (OR = 1.06), chronic kidney disease (CKD) (OR = 2.71), reduced left ventricular ejection fraction (LVEF) (OR = 0.92) and low HALP (OR = 2.87) as independent predictors. ROC analysis showed that HALP (area under the curve (AUC) = 0.74) outperformed individual indicators (age, CKD, LVEF: AUC 0.60-0.65), and the combined model achieved the best predictive performance (AUC = 0.79).Conclusions
The preoperative HALP index is an independent predictor of in-hospital mortality after type A aortic dissection surgery with CPB, with good discriminatory performance. As a simple and low-cost biomarker, it effectively supplements traditional risk scoring systems and supports preoperative risk stratification and clinical decision-making. Specifically, patients with low HALP values at admission may benefit from proactive blood product preparation, early nutritional support and intensified postoperative monitoring, thereby optimizing perioperative management and improving outcomes.