Deans' stroke musings: Low hemoglobin-albumin-lymphocyte-platelet score as a risk marker for stroke-associated pneumonia in acute ischemic stroke: a retrospective cohort study

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Tuesday, September 8, 2026

Low hemoglobin-albumin-lymphocyte-platelet score as a risk marker for stroke-associated pneumonia in acute ischemic stroke: a retrospective cohort study

'Associations' TELL YOU NOTHING ON HOW TO GET RECOVERED!

Smart researchers would create pneumonia prevention protocols!

You've known of the problem for years and DONE NOTHING; YOU'RE FIRED!

11% Stroke-associated pneumonia (18 posts to October 2020)

Low hemoglobin-albumin-lymphocyte-platelet score as a risk marker for stroke-associated pneumonia in acute ischemic stroke: a retrospective cohort study

Zhaoping Wu 1
Q
Qiruo Sun 2
J
Jianmei Zhan 1
Ming Yang 1
Tingting Duan 1
H
Hong Pan 3† *
Jiameng Xu 3† ‡ *

1. Department of Neurology, Quzhou People’s Hospital, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou, China
2. Department of Ophthalmology, Quzhou People’s Hospital, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou, China

Abstract

Background:

Stroke-associated pneumonia (SAP) is a common and serious complication of acute ischemic stroke (AIS). The hemoglobin, albumin, lymphocyte, and platelet (HALP) score reflects nutritional, inflammatory, and immune status, but its association with SAP remains unclear.

Methods:

We retrospectively analyzed 1,766 consecutive AIS patients admitted between January 2019 and December 2023. HALP was calculated from blood tests obtained within 48 h of admission. Multivariable logistic regression, receiver operating characteristic analysis, subgroup analysis, generalized additive modeling, and two-piecewise logistic regression were used to evaluate the association between HALP and SAP and to explore threshold effects.

Results:

SAP occurred in 376 patients (21.3%). HALP was significantly lower in patients with SAP than in those without SAP [35.08 (18.59–51.86) vs. 44.55 (31.29–63.25), p < 0.001]. After full adjustment, each 1-unit increase in log2-HALP was associated with a 29% lower SAP risk (OR = 0.71, 95% CI: 0.62–0.83, p < 0.001). The highest HALP quartile was associated with a lower SAP risk than the lowest quartile (OR = 0.62, 95% CI: 0.41–0.95; P for trend = 0.018). A non-linear association was identified, with an exploratory threshold at HALP approximately 27.7. Below this threshold, each log2-unit increase in HALP was associated with a 53% lower SAP risk (OR = 0.47, 95% CI: 0.35–0.63, p < 0.001), whereas no significant association was observed above it. Adding HALP to the A2DS2 score produced a statistically significant but modest improvement in discrimination (AUC: 0.758 vs. 0.779, p = 0.004).

Conclusion:

Low HALP score was independently and non-linearly associated with SAP in AIS, with an exploratory threshold near 27.7 that may help inform future risk-stratification research.