Prognostic value of the C-reactive protein–albumin–lymphocyte index for predicting one-year mortality in acute pulmonary embolism
- 1Cardiology, Samsun City Hospital
- 2Cardiology, Samsun City Hospital, Samsun University
Abstract
Background and objectives: Acute pulmonary embolism (APE) is associated with substantial mortality despite advances in diagnosis and treatment. Biomarkers reflecting inflammation, immune status, and nutritional reserve may improve risk stratification. This study aimed to evaluate the prognostic significance of the C-reactive protein–albumin–lymphocyte (CALLY) index for predicting one-year mortality in patients with APE and to compare its performance with the Prognostic Nutritional Index (PNI) and Systemic Immune-Inflammation Index (SII).
Methods: This retrospective single-center study included 471 consecutive patients diagnosed with APE between July 2021 and December 2024. The primary endpoint was one-year all-cause mortality. CALLY, PNI, and SII were calculated using admission laboratory parameters. Receiver operating characteristic (ROC) analysis and Cox regression models were performed to evaluate the prognostic performance of these indices.
Results: During one-year follow-up, 102 patients (21.7%) died. CALLY values were significantly lower in non-survivors than in survivors ( p < 0.001). CALLY demonstrated the highest discriminatory performance for one-year mortality (AUC 0.787, 95% CI 0.732–0.842), compared with PNI (AUC 0.728) and SII (AUC 0.643). CALLY remained independently associated with one-year mortality after multivariable adjustment (HR 0.904, 95% CI 0.856–0.955; p < 0.001). Furthermore, adding CALLY to a baseline model including age, sPESI ≥1, elevated cardiac troponin, and sPAP increased the C-statistic from 0.700 to 0.739 and significantly improved model fit (likelihood-ratio p < 0.001).
Conclusions: The CALLY index was independently associated with one-year all-cause mortality in patients with APE and demonstrated higher discriminatory performance than PNI and SII. As a simple index derived from routinely available laboratory parameters, CALLY may provide additional prognostic information for long-term risk assessment in APE.
Related
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BibTeX
@article{kara2026prognostic,
title = {{Prognostic value of the C-reactive protein–albumin–lymphocyte index for predicting one-year mortality in acute pulmonary embolism}},
author = {Abdulkadir Kara and Güney Erdoğan and Serkan Sivri and Mustafa Yenerçağ and Faruk Boyacı and Onur Osman Şeker and Ahmet Karagöz and Enes Furkan Öztürk and Süleyman Mert Aşcı},
journal = {Frontiers in Cardiovascular Medicine},
year = {2026},
month = oct,
doi = {10.3389/fcvm.2026.1928531},
url = {https://www.frontiersin.org/articles/10.3389/fcvm.2026.1928531/full},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Prognostic value of the C-reactive protein–albumin–lymphocyte index for predicting one-year mortality in acute pulmonary embolism
AU - Abdulkadir Kara
AU - Güney Erdoğan
AU - Serkan Sivri
AU - Mustafa Yenerçağ
AU - Faruk Boyacı
AU - Onur Osman Şeker
AU - Ahmet Karagöz
AU - Enes Furkan Öztürk
AU - Süleyman Mert Aşcı
PY - 2026
DA - 2026/10/19
JO - Frontiers in Cardiovascular Medicine
DO - 10.3389/fcvm.2026.1928531
UR - https://www.frontiersin.org/articles/10.3389/fcvm.2026.1928531/full
AB - Background and objectives: Acute pulmonary embolism (APE) is associated with substantial mortality despite advances in diagnosis and treatment. Biomarkers reflecting inflammation, immune status, and nutritional reserve may improve risk stratification. This study aimed to evaluate the prognostic significance of the C-reactive protein–albumin–lymphocyte (CALLY) index for predicting one-year mortality in patients with APE and to compare its performance with the Prognostic Nutritional Index (PNI) and Systemic Immune-Inflammation Index (SII). Methods: This retrospective single-center study included 471 consecutive patients diagnosed with APE between July 2021 and December 2024. The primary endpoint was one-year all-cause mortality. CALLY, PNI, and SII were calculated using admission laboratory parameters. Receiver operating characteristic (ROC) analysis and Cox regression models were performed to evaluate the prognostic performance of these indices. Results: During one-year follow-up, 102 patients (21.7%) died. CALLY values were significantly lower in non-survivors than in survivors ( p < 0.001). CALLY demonstrated the highest discriminatory performance for one-year mortality (AUC 0.787, 95% CI 0.732–0.842), compared with PNI (AUC 0.728) and SII (AUC 0.643). CALLY remained independently associated with one-year mortality after multivariable adjustment (HR 0.904, 95% CI 0.856–0.955; p < 0.001). Furthermore, adding CALLY to a baseline model including age, sPESI ≥1, elevated cardiac troponin, and sPAP increased the C-statistic from 0.700 to 0.739 and significantly improved model fit (likelihood-ratio p < 0.001). Conclusions: The CALLY index was independently associated with one-year all-cause mortality in patients with APE and demonstrated higher discriminatory performance than PNI and SII. As a simple index derived from routinely available laboratory parameters, CALLY may provide additional prognostic information for long-term risk assessment in APE.
SN - 2297-055X
ER -