Objective:

To investigate the association between the hemoglobin-albumin-lymphocyte-platelet (HALP) score and early neurological deterioration (END) in individuals with stroke and to develop an exploratory prediction model for END.

Approach:

• Study Design: Retrospective analysis of clinical data from 595 patients with acute ischemic stroke (AIS) admitted to the Affiliated Hospital of Xuzhou Medical University.
• Data Analysis: Patients were divided into training and validation sets. Multivariable logistic regression was used to identify END risk factors and build a predictive model.
• Model Evaluation: Model performance was assessed using ROC curves and the Hosmer–Lemeshow goodness-of-fit test, along with clinical decision curve analysis (DCA) and SHAP method for predictor importance.

Key Findings:

• 31.3% of patients developed early neurological deterioration (END).
• Independent determinants for END included large artery atherosclerosis (LAA) subtype, elevated baseline NIHSS score, and lower HALP score.
• The association between HALP score and END remained significant after adjusting for various factors.
• A nomogram incorporating HALP score, LAA subtype, and baseline NIHSS score showed moderate discrimination.

Interpretation:

A lower HALP score is associated with increased risk of END in patients with AIS, and the developed nomogram may aid in early risk stratification.

Limitations:

• The study is retrospective and conducted at a single center.
• The prediction model requires validation in a larger, prospective clinical study.

Conclusion:

The HALP score may serve as a useful tool for predicting early neurological deterioration in acute ischemic stroke patients.