The C-reactive protein–albumin–lymphocyte (CALLY) index in early hospital presentation and intravenous thrombolysis in acute ischemic stroke : A retrospective study
- 1Department of Emergency Medicine, University of Health Sciences, İstanbul Kanuni Sultan Suleyman Training and Research Hospital, İstanbul, Turkey
- 2Department of Emergency Medicine, University of Health Sciences, Haseki Training and Research Hospital, Istanbul, Turkey.
Abstract
The C-reactive protein–albumin–lymphocyte (CALLY) index reflects systemic inflammation and immune and nutritional status. We investigated whether admission CALLY was associated with early hospital presentation or receipt of intravenous thrombolysis (IVT) in adults with acute ischemic stroke. This single-center retrospective study included 197 adults with acute ischemic stroke admitted between September 2018 and September 2024. All 98 patients who received IVT were included; 99 non-thrombolyzed controls were selected by computer-generated random sampling from a pool constructed using group-level frequency matching. CALLY was calculated as albumin (g/L) × lymphocyte count (×109/L)/[C-reactive protein (mg/L) × 10]. Early presentation was defined as onset-to-door time ≤4.5 hours. Multivariable logistic regression adjusted for age, sex, and National Institutes of Health Stroke Scale (NIHSS) score assessed associations of ln(CALLY) with early presentation and receipt of IVT. Patients who received IVT had higher NIHSS scores (median, 7 vs 1; P < .001) and lower CALLY values (median, 1.37 vs 2.64; P = .050); however, the CALLY difference was not significant after multiplicity correction (q = 0.122). CALLY was inversely correlated with NIHSS score (Spearman ρ = −0.29; P < .001). After adjustment, ln(CALLY) was not associated with receipt of IVT (adjusted odds ratio = 1.34; 95% confidence interval = 0.98–1.82; P = .063). Its borderline association with early presentation (adjusted odds ratio = 1.34; 95% confidence interval = 1.02–1.77; P = .036) was not consistent across sensitivity analyses. CALLY did not differ significantly between early and late presenters (P = .100). Lower CALLY values among patients receiving IVT were largely explained by greater stroke severity. No consistent independent association was found between CALLY and either outcome. These findings do not support using CALLY to guide thrombolytic decision-making.
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BibTeX
@article{kalafat2026creactive,
title = {{The C-reactive protein–albumin–lymphocyte (CALLY) index in early hospital presentation and intravenous thrombolysis in acute ischemic stroke : A retrospective study}},
author = {Ayşe Fethiye Basa Kalafat and Muhammed Güner and Elif Gizem Olcay and Feyza Karadeniz and Bilal Yeniyurt and Salih Fettahoğlu and Rabia Birsen Tapkan and Hilmi Kaya and Süreyya Tuba Fettahoğlu and Utku Murat Kalafat},
journal = {Medicine},
year = {2026},
month = oct,
doi = {10.1097/md.0000000000051419},
url = {https://europepmc.org/article/PMC/PMC13727240},
note = {CC BY},
}
RIS
TY - JOUR
TI - The C-reactive protein–albumin–lymphocyte (CALLY) index in early hospital presentation and intravenous thrombolysis in acute ischemic stroke : A retrospective study
AU - Ayşe Fethiye Basa Kalafat
AU - Muhammed Güner
AU - Elif Gizem Olcay
AU - Feyza Karadeniz
AU - Bilal Yeniyurt
AU - Salih Fettahoğlu
AU - Rabia Birsen Tapkan
AU - Hilmi Kaya
AU - Süreyya Tuba Fettahoğlu
AU - Utku Murat Kalafat
PY - 2026
DA - 2026/10/30
JO - Medicine
DO - 10.1097/md.0000000000051419
UR - https://europepmc.org/article/PMC/PMC13727240
AB - The C-reactive protein–albumin–lymphocyte (CALLY) index reflects systemic inflammation and immune and nutritional status. We investigated whether admission CALLY was associated with early hospital presentation or receipt of intravenous thrombolysis (IVT) in adults with acute ischemic stroke. This single-center retrospective study included 197 adults with acute ischemic stroke admitted between September 2018 and September 2024. All 98 patients who received IVT were included; 99 non-thrombolyzed controls were selected by computer-generated random sampling from a pool constructed using group-level frequency matching. CALLY was calculated as albumin (g/L) × lymphocyte count (×109/L)/[C-reactive protein (mg/L) × 10]. Early presentation was defined as onset-to-door time ≤4.5 hours. Multivariable logistic regression adjusted for age, sex, and National Institutes of Health Stroke Scale (NIHSS) score assessed associations of ln(CALLY) with early presentation and receipt of IVT. Patients who received IVT had higher NIHSS scores (median, 7 vs 1; P < .001) and lower CALLY values (median, 1.37 vs 2.64; P = .050); however, the CALLY difference was not significant after multiplicity correction (q = 0.122). CALLY was inversely correlated with NIHSS score (Spearman ρ = −0.29; P < .001). After adjustment, ln(CALLY) was not associated with receipt of IVT (adjusted odds ratio = 1.34; 95% confidence interval = 0.98–1.82; P = .063). Its borderline association with early presentation (adjusted odds ratio = 1.34; 95% confidence interval = 1.02–1.77; P = .036) was not consistent across sensitivity analyses. CALLY did not differ significantly between early and late presenters (P = .100). Lower CALLY values among patients receiving IVT were largely explained by greater stroke severity. No consistent independent association was found between CALLY and either outcome. These findings do not support using CALLY to guide thrombolytic decision-making.
SN - 0304-5412
SN - 1536-5964
SN - 0025-7974
ER -