Perioperative Dynamics of the Hemoglobin–Albumin–Lymphocyte–Platelet (HALP) Score and Early Morbidity After Curative Esophagectomy
4 affiliations
- 1Department of Anesthesiology, Basaksehir Cam and Sakura City Hospital, Istanbul 34480, Türkiye
- 2Department of General Surgery, Basaksehir Cam and Sakura City Hospital, Istanbul 34480, Türkiye
- 3Department of Gastroenterological Surgery, Basaksehir Cam and Sakura City Hospital, Istanbul 34480, Türkiye
- 4Department of Anesthesiology, Acibadem Mehmet Ali Aydinlar University, Istanbul 34638, Türkiye
Abstract
Background/Objectives: The hemoglobin–albumin–lymphocyte–platelet (HALP) score is an immune–nutritional biomarker associated with oncological outcomes. We evaluated perioperative HALP trajectories and their association with early postoperative complications after curative esophagectomy. Methods: In this retrospective single-center cohort study, 129 patients undergoing esophagectomy between June 2020 and March 2025 were included. HALP was calculated preoperatively and on postoperative days 1 and 7. Trajectories were analyzed using generalized estimating equations. Discriminative performance was assessed using receiver operating characteristic (ROC) analysis, and independent associations were evaluated using multivariable logistic regression. Results: HALP declined markedly after surgery (median, 28.93 preoperatively, 10.11 on postoperative day 1, and 10.53 on postoperative day 7; p < 0.001). Patients with major complications, anastomotic leakage, or intensive care unit readmission had lower postoperative day 7 HALP values. Postoperative day 7 HALP discriminated intensive care unit readmission (area under the curve [AUC] = 0.769), anastomotic leakage (AUC = 0.734), major complications (AUC = 0.733), and overall complications (AUC = 0.697). Each doubling of postoperative day 7 HALP was independently associated with lower odds of overall complications (odds ratio [OR] = 0.473), major complications (OR = 0.351), anastomotic leakage (OR = 0.383), and intensive care unit readmission (OR = 0.374; all p ≤ 0.002). Preoperative HALP showed limited discriminative performance. Bootstrap-corrected AUCs for the models including age, ASA, and POD7 HALP ranged from 0.696 to 0.737. Conclusions: HALP demonstrates a distinct perioperative trajectory after esophagectomy, with persistent impairment on postoperative day 7 associated with early postoperative morbidity. The potential clinical role of serial HALP assessment requires prospective evaluation.
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BibTeX
@article{gokduman2026perioperative,
title = {{Perioperative Dynamics of the Hemoglobin–Albumin–Lymphocyte–Platelet (HALP) Score and Early Morbidity After Curative Esophagectomy}},
author = {Hürü Ceren Gökduman and Oğuzhan Aytepe and Yiğit Düzköylü and Sercan Yüksel and Hüsnü Ozan Şevik and Taner Abdullah and Mert Şentürk and Funda Gümüş Özcan},
journal = {Journal of Clinical Medicine},
year = {2026},
month = nov,
doi = {10.3390/jcm15218716},
url = {https://www.mdpi.com/2077-0383/15/21/8716},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Perioperative Dynamics of the Hemoglobin–Albumin–Lymphocyte–Platelet (HALP) Score and Early Morbidity After Curative Esophagectomy
AU - Hürü Ceren Gökduman
AU - Oğuzhan Aytepe
AU - Yiğit Düzköylü
AU - Sercan Yüksel
AU - Hüsnü Ozan Şevik
AU - Taner Abdullah
AU - Mert Şentürk
AU - Funda Gümüş Özcan
PY - 2026
DA - 2026/11/08
JO - Journal of Clinical Medicine
DO - 10.3390/jcm15218716
UR - https://www.mdpi.com/2077-0383/15/21/8716
AB - Background/Objectives: The hemoglobin–albumin–lymphocyte–platelet (HALP) score is an immune–nutritional biomarker associated with oncological outcomes. We evaluated perioperative HALP trajectories and their association with early postoperative complications after curative esophagectomy. Methods: In this retrospective single-center cohort study, 129 patients undergoing esophagectomy between June 2020 and March 2025 were included. HALP was calculated preoperatively and on postoperative days 1 and 7. Trajectories were analyzed using generalized estimating equations. Discriminative performance was assessed using receiver operating characteristic (ROC) analysis, and independent associations were evaluated using multivariable logistic regression. Results: HALP declined markedly after surgery (median, 28.93 preoperatively, 10.11 on postoperative day 1, and 10.53 on postoperative day 7; p < 0.001). Patients with major complications, anastomotic leakage, or intensive care unit readmission had lower postoperative day 7 HALP values. Postoperative day 7 HALP discriminated intensive care unit readmission (area under the curve [AUC] = 0.769), anastomotic leakage (AUC = 0.734), major complications (AUC = 0.733), and overall complications (AUC = 0.697). Each doubling of postoperative day 7 HALP was independently associated with lower odds of overall complications (odds ratio [OR] = 0.473), major complications (OR = 0.351), anastomotic leakage (OR = 0.383), and intensive care unit readmission (OR = 0.374; all p ≤ 0.002). Preoperative HALP showed limited discriminative performance. Bootstrap-corrected AUCs for the models including age, ASA, and POD7 HALP ranged from 0.696 to 0.737. Conclusions: HALP demonstrates a distinct perioperative trajectory after esophagectomy, with persistent impairment on postoperative day 7 associated with early postoperative morbidity. The potential clinical role of serial HALP assessment requires prospective evaluation.
SN - 2077-0383
ER -