
==== Front
Medicine (Baltimore)
Medicine (Baltimore)
MD
Medicine
0025-7974
1536-5964
Lippincott Williams & Wilkins Hagerstown, MD

MD-D-24-06137
00005
10.1097/MD.0000000000039643
3
3400
Research Article
Observational Study
The relationship of pan-immune-inflammation value (PIV) and HALP score with prognosis in patients with atrial fibrillation
https://orcid.org/0000-0003-2740-1966
Eyiol Azmi MD a*
a Department of Cardiology, Beyhekim Training and Research Hospital, University of Health Sciences, Konya, Turkey.
* Correspondence: Azmi Eyiol, Department of Cardiology, Beyhekim Training and Research Hospital, University of Health Sciences, Konya, 42060, Turkey (e-mail: azmieyiol@yahoo.com).
06 9 2024
06 9 2024
103 36 e3964303 6 2024
18 8 2024
20 8 2024
Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.
2024
https://creativecommons.org/licenses/by-nc/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4.0 (CCBY-NC), where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal.

Because earlier studies have proven a link between hemoglobin, albumin, lymphocyte, and platelet (HALP) and pan-immune-inflammation value (PIV) scores and inflammation, we examined if these 2 markers had predictive value in patients with atrial fibrillation (AF). In the intensive care unit, 444 patients with and without AF were retrospectively analyzed. Patients with and without AF were compared with regard to their HALP and PIV scores. High and low categories of HALP and PIV scores were established based on the cutoff values. Furthermore, using receiver operating characteristic analysis, the mortality predictive efficacy of these scores was assessed in 230 patients with AF. Patients with AF had a significantly higher PIV score than those without AF; however, the HALP score found to be lower (P < .05 for all groups). The receiver operating characteristic analysis revealed that the HALP score exhibited a sensitivity of 66.7% and a specificity of 75.3% at a cutoff value of 2.037 (AUC: 0.753, P < .001). The PIV score cutoff value was 1062.7, but the sensitivity and specificity were both 55.7% and 55.8%, respectively (AUC: 0.571, P < .05). The mechanical ventilation requirement and in-hospital mortality rate were significantly higher in the high PIV (PIV > 1062.7) and low HALP (HALP ≤ 2.037) groups. There is a significant association between the HALP and PIV scores assessed upon admission and critically ill patients with AF. Although the HALP score serves as a powerful prognostic factor for these patients, the PIV lacks the capability to predict mortality.

atrial fibrillation
HALP score
intensive care unit
pan-immune-inflammation value
prognosis
OPEN-ACCESSTRUE
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pmc1. Introduction

Atrial fibrillation (AF), which is frequently seen among patients in intensive care units (ICUs), is one of the most common arrhythmias that can lead to significant cardio-cerebrovascular complications. Furthermore, AF might result in longer hospitalization and higher mortality rates.[1] Thus far, fibrosis, inflammation, and oxidative stress have been shown as factors that impact several cardiovascular diseases. Cardiac tissue inflammation and circulatory processes can influence the mechanisms that trigger and maintain AF.[2] Hence, early detecting individuals with AF will lead to more efficient treatment and increased rates of survival.[3]

Inflammation plays a significant role in the development and progression of AF. Many studies have found that different inflammatory markers are linked with the existence or results of AF.[2,4] Inflammation leads to an increase in platelet and neutrophil proliferation, while causing a reduction in lymphocyte count. A study indicated that patients with postoperative AF had greater platelet/lymphocyte ratio (PLR) and neutrophil/lymphocyte ratio (NLR).[5] An abnormal level of hemoglobin concentration is a risk factor that increases the likelihood of negative cardiovascular outcomes.[6] Serum albumin levels are recognized as a significant marker for various inflammatory processes and cardiovascular diseases.[7]

The hemoglobin, albumin, lymphocyte, and platelet (HALP) score, which includes HALP, is now being utilized to assess the general state of nutrition and systemic inflammation in patients.[8] There is evidence that indicating that the HALP score has the ability to accurately predict mortality in individuals with coronary artery diseases (CAD).[9,10] The pan-immune-inflammation value (PIV), a new inflammation marker, has demonstrated the ability to predict the severity of CAD.[11] Unfortunately, the literature does not provide any information on the prognostic efficacy of these 2 markers in patients with AF. Hence, our study aimed to examine the correlation between PIV and HALP score and the prognosis of patients with AF.

2. Materials and methods

2.1. Study design and patient population

A retrospective examination was conducted on patients who were admitted to the ICU from the emergency department (ED) for various causes over the period from January 01 to April 01, 2024. Patients over the age of 18 who were male or female and who had AF as diagnosed by electrocardiography were included in the study. Furthermore, a control group was established consisting of individuals of the same age who had a regular sinus rhythm. The study excluded patients who had cancer, were pregnant, had hematological, rheumatological, or oncological diseases, were undergoing immunosuppressive treatment, or had incomplete laboratory data. The study utilized epicrisis data from the hospital system to examine the relationship between patients’ age, gender, hemogram, and albumin levels at the time of admission to the ED, whether mechanical ventilation (MV) is needed during hospitalization, the length of hospital stay, the length of stay in ICU (LOS-ICU), and the outcomes (discharge/exitus). The PIV: neutrophil count (103/mL) × monocyte count (%) × platelet count (109/L)/lymphocyte count (103/mL). HALP score was calculated using the hemoglobin (g/L) × albumin (g/L) × lymphocyte count (103/mL)/platelet count (109/L) method.[9,10] The evaluation of mortality was determined only by the occurrence of death during the patient’s hospital stay. The PIV and HALP scores were divided into 2 groups based on cutoff values, and a comparative analysis was conducted on the data of patients with AF between both groups. In addition, the PIV and HALP scores were compared across patient groups with and without AF. The variables potentially linked to mortality were analyzed using receiver operating characteristic (ROC) analysis. The study received approval from the Local Ethics Committee of Necmettin Erbakan University Faculty of Medicine, dated 03/05/2024, with the reference number 2024/4929 (19166).

2.2. Hematological and biochemical analysis

During admission to the ED, blood samples were collected to assess the levels of white blood cell (WBC), neutrophil, monocyte, lymphocyte, platelet, hemoglobin, and albumin. The Hemogram markers were measured using the Mindray auto hematology analyzer BC-6800 device (Shenzhen, China). The albumin analysis was conducted using the Mindray BS-2000M chemistry analyzer device (Shenzhen, China).

2.3. Statistical analysis

Statistical analysis in the study was performed using SPSS 27.0 (IBM Inc, Chicago) program. Kolmogorov–Smirnov test, histogram analysis, skewness/kurtosis data and Q–Q plots were used to evaluate the assumptions of normal distribution. Qualitative parameters were expressed as frequency and percentage (%). Descriptive statistics of scale data were expressed as IQR (median [minimum–maximum]) or mean ± standard deviation according to distribution pattern. Relationships between the 2 groups are evaluated with independent t test or Mann–Whitney U test. Relationships between nominal parameters were detailed with Pearson chi-square test. ROC analysis was performed to reveal the predictive values and determine the cutoff values for the desired markers. In the entire study, the type-I error rate was taken as 5% (α = 0.05) and P < .05 was accepted as the significant limit.

3. Results

The demographic, laboratory, and clinical findings of patients with and without AF are presented in Table 1. Compared to those without AF, patients with AF have significantly higher levels of age, PIV score, monocyte count, platelet count, LOSH, and LOS-ICU. In contrast, patients with AF have significantly lower HALP score, albumin levels, neutrophil count, lymphocyte count, hemoglobin levels, and need for MV support (P < .05 for all). There was no significant relationship observed between these 2 groups in terms of gender, NLR, PLR WBC, and in-hospital mortality (P > .05 for all).

Table 1 Comparison of demographic, clinical, and laboratory findings between AF and non-AF patients.

Variables	AF patients (n = 230, 51.8%)	Non-AF patients (n = 214, 48.2%)	P value	
Age, yr	75.0 ± 12.0	70.0 ± 14.0	<.001 *	
Gender				
 Male, n (%)	113 (49.1%)	123 (57.5%)	.078***	
 Female, n (%)	117 (50.9%)	91 (42.5%)	
Laboratory parameters				
 HALP score	2.15 (0.19–11.83)	2.79 (0.22–13.21)	<.001 **	
 PIV score	1082.91 (48.85–25,884.49)	904.81 (2.73–9268.08)	.043 **	
 NLR	8.45 (0.82–91.5)	6.9 (0.63–92)	.144**	
 PLR	175.59 (32.89–1290)	172.89 (29.29–1368.75)	.693**	
 Albumin (g/L)	33.4 (15.9–43.8)	38.2 (18.7–50.2)	<.001 **	
 Monocyte (%)	0.76 (0.16–2.75)	0.59 (0.02–8.72)	<.001 **	
 Neutrophil (103/mL)	8.65 ± 3.82	10.23 ± 5.43	<.001 *	
 Lymphocyte (103/mL)	1.24 ± 0.78	1.4 ± 0.62	.019 *	
 Platelet (109/L)	195.0 ± 83.0	225.0 ± 75.0	<.001 *	
 Hemoglobin (g/dL)	12.0 ± 2.3	13.2 ± 2.3	<.001 *	
 WBC (109/L)	11.57 ± 4.27	12.28 ± 5.6	.134*	
Clinical findings				
 LOSH, d	15 (1–45)	12 (1–70)	<.001	
 LOS-ICU, d	9 (1–45)	6 (1–70)	<.001	
MV support, n (%)				
 No	145 (63%)	100 (46.7%)	<.001 ***	
 Yes	85 (37%)	114 (53.3%)	
In-hospital mortality				
 No	159 (69.1%)	135 (63.1%)	.178***	
 Yes	71 (30.9%)	79 (36.9%)	
Bold values indicate statistically significant P-values.

AF = atrial fibrillation, HALP = hemoglobin, albumin, lymphocyte, and platelet score, ICU = intensive care unit, LOSH = length of stay in hospital, LOS-ICU = length of stay in intensive care unit, MV = mechanical ventilation, NLR = neutrophil/lymphocyte ratio, PIV = pan-immune-inflammation value, PLR = platelet/lymphocyte ratio, WBC = white blood cell.

* Independent t test.

** Mann–Whitney U test.

*** Pearson chi-squared test.

Table 2 shows the general characteristics of patients with AF based on their HALP scores. In comparison to the high HALP (HALP > 2.037) group, the low HALP (HALP ≤ 2.037) group had significantly higher PIV score, NLR, PLR, need for MV support, and in-hospital mortality rate. However, albumin, lymphocyte, platelet, hemoglobin, and LOSH were found to be significantly lower (P < .05 for all). There were no significant differences between the 2 groups in terms of age, gender, monocytes, neutrophils, WBC, and LOS-ICU (P > .05 for all).

Table 2 Characteristics of patients with AF according to HALP score.

Variables	Low group†
(HALP ≤ 2.037)
(n = 108, 47.0%)	High group†
(HALP > 2.037)
(n = 122, 53.0%)	P value	
Age, yr	76.0 ± 13.0	74.0 ± 11.0	.190*	
Gender				
 Male, n (%)	48 (44.4%)	65 (53.3%)	.181***	
 Female, n (%)	60 (55.6%)	57 (46.7%)	
Laboratory parameters				
 PIV score	1633.76 (103.45–25,884.49)	664.07 (48.85–4522.39)	<.001 **	
 NLR	11.37 (2.15–91.5)	4.21 (0.82–30.03)	<.001 **	
 PLR	259.8 (91.11–1290)	111.58 (32.89–275)	<.001 **	
 Albumin (g/L)	28.7 (15.9–43.2)	35.2 (22.3–43.8)	<.001 **	
 Monocyte (%)	0.69 (0.16–2.73)	0.8 (0.17–2.75)	.198**	
 Neutrophil (103/mL)	8.96 ± 3.28	8.43 ± 4.27	.288*	
 Lymphocyte (103/mL)	0.69 ± 0.36	1.73 ± 0.73	<.001 *	
 Platelet (109/L)	181.0 ± 89.0	207.0 ± 77.0	.015 *	
 Hemoglobin (g/dL)	11.0 ± 2.3	12.8 ± 1.9	<.001 *	
 WBC (109/L)	11.94 ± 3.71	11.24 ± 4.7	.206*	
Clinical findings				
 LOSH, d	14 (1–34)	16 (1–45)	<.001 **	
 LOS-ICU, d	9 (1–34)	9 (1–45)	.856**	
MV support, n (%)				
 No	46 (42.6%)	99 (81.1%)	<.001 ***	
 Yes	62 (57.4%)	23 (18.9%)	
In-hospital mortality				
 No	54 (50%)	105 (86.1%)	<.001 ***	
 Yes	54 (50%)	17 (13.9%)	
AF = atrial fibrillation, HALP = hemoglobin, albumin, lymphocyte, and platelet score, ICU = intensive care unit, LOSH = length of stay in hospital, LOS-ICU = length of stay in intensive care unit, MV = mechanical ventilation, NLR = neutrophil/lymphocyte ratio, PIV = pan-immune-inflammation value, PLR = platelet/lymphocyte ratio, WBC = white blood cell.

* Independent t test.

** Mann–Whitney U test.

*** Pearson chi-squared test.

† ROC analysis for performed to determine the cutoff value for HALP.

Table 3 shows the general characteristics of patients with AF based on their PIV score. In comparison to the low PIV (PIV ≤ 1062.7) group, the high PIV (PIV > 1062.7) group had a significantly higher NLR, PLR, monocyte, neutrophil, WBC, need for MV support, and in-hospital mortality rate, whereas the HALP score, lymphocyte, and LOSH were found to be significantly lower (P < .05 for all). There was no significant relationship between the 2 groups in terms of age, gender, albumin, platelet, hemoglobin, or LOS-ICU (P > .05 for all).

Table 3 Characteristics of patients with AF according to PIV score.

Variables	Low group†
(PIV ≤ 1062.7)
(n = 113, 49.1%)	High group†
(PIV > 1062.7)
(n = 117, 50.9%)	P value	
Age, yr	73.0 ± 12.0	76.0 ± 12.0	.061*	
Gender				
 Male, n (%)	56 (49.6%)	57 (48.7%)	.899***	
 Female, n (%)	57 (50.4%)	60 (51.3%)	
Laboratory parameters				
 HALP	3.01 (0.75–11.83)	1.58 (0.19–7.75)	<.001 **	
 NLR	4.02 (0.82–51.05)	11.77 (4.3–91.5)	<.001 **	
 PLR	137.5 (32.89–458.82)	242.86 (52.96–1290)	<.001 **	
 Albumin (g/L)	34.8 (18.2–42.9)	32.1 (15.9–43.8)	.081**	
 Monocyte (%)	0.6 (0.16–1.77)	1.21 (0.26–2.75)	<.001 **	
 Neutrophil (103/mL)	6.42 ± 2.41	10.86 ± 3.7	<.001 *	
 Lymphocyte (103/mL)	1.58 ± 0.81	0.92 ± 0.6	<.001 *	
 Platelet (109/L)	201.0 ± 82.0	189.0 ± 85.0	.242*	
 Hemoglobin (g/dL)	12.2 ± 2.2	11.7 ± 2.3	.085*	
 WBC (109/L)	9.23 ± 2.98	13.82 ± 4.12	<.001 *	
Clinical findings				
 LOSH, d	16 (2–45)	14 (1–34)	.005 **	
 LOS-ICU, d	9 (2–45)	9 (1–34)	.958**	
MV support, n (%)				
 No	81 (71.7%)	64 (54.7%)	.008 ***	
 Yes	32 (28.3%)	53 (45.3%)	
In-hospital mortality				
 No	87 (77%)	72 (61.5%)	.011 ***	
 Yes	26 (23%)	45 (38.5%)	
AF = atrial fibrillation, HALP = hemoglobin, albumin, lymphocyte, and platelet score, ICU = intensive care unit, LOSH = length of stay in hospital, LOS-ICU = length of stay in intensive care unit, MV = mechanical ventilation, NLR = neutrophil/lymphocyte ratio, PIV = pan-immune-inflammation value, PLR = platelet/lymphocyte ratio, WBC = white blood cell.

* Independent t test.

** Mann–Whitney U test.

*** Pearson chi-squared test.

† ROC analysis for performed to determine the cutoff value for PIV.

Table 4 and Figures 1 and 2 show the ROC analysis results for HALP, PIV, NLR, PLR, neutrophil, lymphocyte, monocyte, platelet, albumin, and hemoglobin in their ability to predict mortality. Among the parameters examined, albumin exhibited the most significant predictive value, as indicated by an AUC value of 0.922. Conversely, hemoglobin demonstrated the lowest predictive value, with an AUC value of 0.186 (P < .001). There was no significant relationship in PLR and neutrophils (P = .444, .503). The HALP score cutoff value was 2.037, with a sensitivity of 66.7% and a specificity of 75.3% (AUC: 0.753, P < .001). The HALP score did not demonstrate higher predictive ability for mortality compared to albumin, lymphocyte, and platelet alone (AUC: 0.753, 0.922, 0.800, 0.882, respectively). The PIV score cutoff was 1062.7, with 55.7% sensitivity and 55.8% specificity (AUC: 0.571, P < .05). The PIV score did not provide higher predictive value for mortality compared to monocytes, platelets, and lymphocytes alone (AUC: 0.571, 0.588, 0.882, and 0.800, respectively).

Table 4 ROC analysis of parameters in the prediction of mortality in patients with AF*.

	AUC	95% CI	Cutoff	Sensitivity (%)	Specificity (%)	P	
		Lower limit	Upper limit				
HALP score†	0.753	0.704	0.802	2.037	66.7	75.3	<.001	
PIV score	0.571	0.51	0.633	1062.7	55.7	55.8	.023	
NLR	0.722	0.67	0.774	9.79	59.7	76.4	<.001	
PLR	0.523	0.464	0.581	172.76	48.7	48.6	.444	
Neutrophil	0.52	0.461	0.579	9.95	40.9	67.0	.503	
Lymphocyte†	0.800	0.754	0.846	0.93	68.7	84.9	<.001	
Monocyte	0.588	0.523	0.652	0.665	57.3	58.2	.008	
Platelet†	0.882	0.849	0.915	192.5	82.7	76.2	<.001	
Albumin†	0.922	0.893	0.951	31.3	86.0	91.8	<.001	
Hemoglobin†	0.186	0.144	0.228	11.55	60.7	89.5	<.001	
Bold values indicate statistically significant P-values.

AUC = area under the curve, CI = confidence interval, HALP = hemoglobin, albumin, lymphocyte, and platelet score, NLR = neutrophil/lymphocyte ratio, PIV = pan-immune-inflammation value, PLR = platelet/lymphocyte ratio, ROC = receiver operating characteristic.

* Determination based on Youden-J index.

† Lower values are associated with positive (mortality) cases.

Figure 1. ROC analysis for score and ratio values in predicting mortality. HALP = hemoglobin, albumin, lymphocyte and platelet, NLR = neutrophil/lymphocyte ratio, PIV = pan-immune-inflammation value, PLR = platelet/lymphocyte ratio, ROC = receiver operating characteristic.

Figure 2. ROC analysis for laboratory results in predicting mortality. ROC = receiver operating characteristic.

4. Discussion

AF is a cardiovascular illness characterized by a high incidence of health complications and the progressive decline of cardiac function. The inflammatory response plays a crucial role in the development and upkeep of AF. Several recent investigations have revealed a correlation between hemogram markers and the prognosis of patients with AF.[2,4,5,12,13] Inflammation and coagulation are closely interconnected and mutually reliant processes. Neutrophils, in particular, have a significant impact on the development of atherosclerosis and blood clot formation. Neutrophil counts reflect the length of inflammation, while lymphocyte numbers represent the specific mechanisms engaged in immune regulation.[14] Inflammatory events result in elevated numbers of neutrophils, monocytes, and platelets, while simultaneously reducing lymphocyte counts.[15] The decrease in lymphocytes after acute inflammation is linked to the prognosis of cardiovascular illnesses. Additionally, platelets also contribute to the acute and chronic inflammatory process of CAD.[9] A recent study indicated that the NLR and PLR in the AF group were greater than those in the control group. The study highlighted that these 2 indices could be valuable in predicting the early development of AF.[12] In a separate investigation involving 4562 individuals diagnosed with AF, it was found that both NLR and PLR were linked to a higher likelihood of all-cause mortality.[14] In our investigation, we found no statistically significant correlation between the NLR and PLR in the group of patients with AF compared to those without AF. Furthermore, it was found that only NLR, and not PLR, have the capability to accurately forecast mortality in individuals with AF. Hence, it is imperative to conduct large and expansive studies on PLR in order to accurately forecast mortality rates among these individuals.

Multiple studies in the literature concluded that the new marker, the HALP score could potentially be valuable in the diagnosis and prognosis s of various conditions characterized by inflammation.[16–19] As already known, hemoglobin and albumin levels are indicative of the body’s nutritional status, while lymphocytes and platelets are associated with the immunological status.[8] Inflammation reduces the synthesis of albumin, while the rise in cytokines prevents erythrocyte maturation, potentially resulting in anemia.[9] Prognosis in cardiovascular disease has been linked to malnutrition and anemia.[20] Albumin plays an important role in cardiovascular health due to its anti-inflammatory, antioxidant, and antithrombotic characteristics.[4] Research has demonstrated a correlation between albumin and a higher likelihood of developing AF.[21] Bonde et al reported that 13% to 34% of patients with non-valvular AF are anemic and may indicate poor prognosis.[6] Recent studies have indicated that the HALP score can also be used to predict the likelihood of mortality in individuals with cardiovascular disease.[22,23] According to Zheng et al, patients with a HALP score ≤ 69.68 had a higher risk of all-cause mortality. Furthermore, the HALP score has a sensitivity of 0.510 on cardiovascular disease prognosis, a specificity of 0.654, and an AUC value of 0.610, which is greater than albumin, lymphocyte, and platelet.[9] Karakayali et al conducted a study on patients with CAD and found that the HALP score was independently linked with in-hospital mortality, as determined by Cox proportional hazard analysis.[10] In our study, we observed that the HALP score was significantly lower in the group of patients with AF compared to the group without AF. In the low HALP group, the need for MV support and in-hospital mortality rate were significantly higher. In addition, the AUC value of the HALP score in predicting mortality was determined to be 0.753 with 66.7% sensitivity and 75.3% specificity. Thus, the HALP score appears to be a marker that can be utilized to predict mortality in the AF group.

PIV, an indicator which includes the 4 main hemogram parameters – neutrophil, monocyte, platelet, and lymphocyte counts – is a recently developed index and is utilized to assess the severity of inflammation.[15,24] Recent studies have verified that PIV holds predictive importance in different inflammatory diseases.[25–27] A study on patients with segment-elevation myocardial infarction highlighted that the mortality prediction ability of PIV was better than that of NLR and PLR.[28] The study conducted by Wu et al demonstrated that PIV is a suitable marker for assessing the prognosis of cardiovascular death.[29] Cetinkaya et al reported that while the PIV cutoff value was 568.2, it could predict serious coronary lesions with 91% sensitivity and 81.1% specificity.[11] Our study found that the PIV score was significantly higher in the group of patients with AF compared to the group without AF. Within the high PIV group, the need for MV support and the in-hospital mortality rate were found significantly higher. Nevertheless, based on the ROC analysis, the PIV score exhibited low sensitivity, specificity, and AUC values in its ability to predict mortality. The reason for these decreases may be attributed to the advanced age and presence of severe illnesses within our patient group. Hence, based on the findings of our study, it may be concluded that PIV is not a powerful prognostic indicator for critically ill patients with AF.

5. Limitation

The study has a few limitations. First, because it is a retrospective, single-center study with a limited sample size, it may be biased. Second, because this study included critically ill patients in the ICU, the NLR, PLR, HALP, and PIV scores could have been influenced by many conditions that may impact the inflammatory system. As a result, additional studies are required to validate our results. Despite these limitations, our study is the first to demonstrate a significant relationship between HALP, PIV score, and critically ill patients with AF.

6. Conclusion

The HALP and PIV scores obtained at admission are significantly linked with critically ill patients with AF. Although the HALP score is a strong prognostic marker in these patients, the predictive ability of PIV for predicting mortality was determined inadequate.

Author contributions

Conceptualization: Azmi Eyiol.

Data curation: Azmi Eyiol.

Formal analysis: Azmi Eyiol.

Funding acquisition: Azmi Eyiol.

Investigation: Azmi Eyiol.

Methodology: Azmi Eyiol.

Project administration: Azmi Eyiol.

Resources: Azmi Eyiol.

Software: Azmi Eyiol.

Supervision: Azmi Eyiol.

Validation: Azmi Eyiol.

Visualization: Azmi Eyiol.

Writing – original draft: Azmi Eyiol.

Writing – review & editing: Azmi Eyiol.

Abbreviations:

AF atrial fibrillation

CAD coronary artery diseases

ED emergency department

HALP hemoglobin, albumin, lymphocyte, and platelet

ICU intensive care unit

LOS-ICU length of intensive care unit stay

MV mechanical ventilation

NLR neutrophil/lymphocyte ratio

PIV pan-immune-inflammation value

PLR platelet/lymphocyte ratio

ROC receiver operating characteristic,

WBC white blood cell

The authors have no funding and conflicts of interest to disclose.

Due to the retrospective nature of the study, patient permission and informed consent were not required for the study.

The study was approved by Necmettin Erbakan University Faculty of Medicine Local Ethics Committee (date: May 03, 2024 and No. 2024/4929 [19166]).

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

How to cite this article: Eyiol A. The relationship of pan-immune-inflammation value (PIV) and HALP score with prognosis in patients with atrial fibrillation. Medicine 2024;103:36(e39643).
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