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Background <p>Sepsis remains a leading cause of mortality worldwide, and early identification of high-risk patients is essential. The C-reactive protein–albumin–lymphocyte (CALLY) index has emerged as a potential prognostic biomarker but has not been widely studied in emergency department (ED) populations.</p> Methods <p>We conducted a retrospective cohort study including adult patients diagnosed with sepsis upon ED admission. The CALLY index was calculated as (albumin × lymphocyte count) / C-reactive protein (CRP), using laboratory values obtained at presentation. The primary outcome was 30-day all-cause mortality. Predictive performance was assessed using multivariable logistic regression with least absolute shrinkage and selection operator (LASSO) variable selection, calibration metrics, and Receiver Operating Characteristic (ROC) curve analyses.</p> Results <p>A total of 669 patients were included, with a 30-day mortality rate of 23% (<i>n</i> = 156). Non-survivors had significantly higher CRP (107.30 ± 40.97 vs. 94.01 ± 28.09&#xa0;mg/L, <i>p</i> = 0.002), lower albumin (2.81 ± 0.30 vs. 3.59 ± 0.22&#xa0;g/dL, <i>p</i> &lt; 0.001), and lower lymphocyte count (0.71 ± 0.31 vs. 1.30 ± 0.40 × 10⁹/L, <i>p</i> &lt; 0.001). The mean CALLY index was markedly elevated in deceased patients (69.7 ± 54.2 vs. 23.1 ± 15.6, <i>p</i> &lt; 0.001). The area under the ROC of the CALLY index was 0.906 (95% CI, 0.879–0.934). At the threshold yielding the maximum Youden Index (31.32), the sensitivity was 0.853, specificity was 0.854, and accuracy was 0.852.</p> Conclusion <p>The CALLY index is a simple and accessible biomarker independently associated with 30-day mortality in ED patients with sepsis and may support early risk stratification in acute care.</p> Clinical trial number <p>Not applicable.</p>

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Evaluation of the C-reactive protein–albumin–lymphocyte (CALLY) index as a prognostic marker in patients with sepsis

  • 期刊论文

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  • 发表日期：

    2025年9月29日

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  • Erdal Yılmaz,
  • Rohat Ak

摘要

Background

Sepsis remains a leading cause of mortality worldwide, and early identification of high-risk patients is essential. The C-reactive protein–albumin–lymphocyte (CALLY) index has emerged as a potential prognostic biomarker but has not been widely studied in emergency department (ED) populations.

Methods

We conducted a retrospective cohort study including adult patients diagnosed with sepsis upon ED admission. The CALLY index was calculated as (albumin × lymphocyte count) / C-reactive protein (CRP), using laboratory values obtained at presentation. The primary outcome was 30-day all-cause mortality. Predictive performance was assessed using multivariable logistic regression with least absolute shrinkage and selection operator (LASSO) variable selection, calibration metrics, and Receiver Operating Characteristic (ROC) curve analyses.

Results

A total of 669 patients were included, with a 30-day mortality rate of 23% (n = 156). Non-survivors had significantly higher CRP (107.30 ± 40.97 vs. 94.01 ± 28.09 mg/L, p = 0.002), lower albumin (2.81 ± 0.30 vs. 3.59 ± 0.22 g/dL, p < 0.001), and lower lymphocyte count (0.71 ± 0.31 vs. 1.30 ± 0.40 × 10⁹/L, p < 0.001). The mean CALLY index was markedly elevated in deceased patients (69.7 ± 54.2 vs. 23.1 ± 15.6, p < 0.001). The area under the ROC of the CALLY index was 0.906 (95% CI, 0.879–0.934). At the threshold yielding the maximum Youden Index (31.32), the sensitivity was 0.853, specificity was 0.854, and accuracy was 0.852.

Conclusion

The CALLY index is a simple and accessible biomarker independently associated with 30-day mortality in ED patients with sepsis and may support early risk stratification in acute care.

Clinical trial number

Not applicable.