Prognostic Impact of the Neutrophil-to-Lymphocyte Ratio and HALP Score on Long-Term Mortality in Patients with Peripheral Artery Disease: A Retrospective Cohort Study in a Tertiary Hospital in Turkey

Background: Systemic inflammation and impaired nutritional status are important drivers of adverse outcomes in peripheral artery disease (PAD). The hemoglobin–albumin–lymphocyte–platelet index (HALP) represents a multidimensional marker reflecting the interaction between hematologic, nutritional, and inflammatory status. Aim: This study evaluated the independent prognostic value of HALP score and neutrophil-lymphocyte ratio (NLR) in determining mortality in PAD patients. Methods: This retrospective cohort study consisted of 638 individuals with a first-time diagnosis of PAD. Patients were categorized as deceased (n = 241) and survivors (n = 397). Clinical characteristics, laboratory findings, inflammatory indices, NLR and HALP scores were analyzed. Survival probabilities were assessed using Kaplan–Meier curves, and independent determinants of mortality were examined through logistic regression analysis. Results: The mean follow-up period was 36.17 months for deceased patients and 71.69 months for survivors. Deceased patients exhibited significantly lower HALP scores (34.6 ± 2.1 vs. 51.9 ± 2.2, P = 0.047). While the HALP score demonstrated weak discriminative capacity in ROC analysis, Cox regression showed that lower HALP levels were independently associated with decreased survival status (Hazard ratio (HR) 0.46; 95% confidence interval (CI): 0.35–0.60; P P Conclusion: Lower HALP scores are related to increased long-term mortality in PAD. The HALP score provides complementary prognostic information and may enhance holistic risk stratification in PAD.