ORIGINAL RESEARCH article
Front. Neurol.
Sec. Neurological Biomarkers
This article is part of the Research TopicInflammation as a fundamental mechanism of strokeView all 3 articles
Prognostic Significance of the C-Reactive Protein–Albumin–Lymphocyte Index and the Pan-Immune-Inflammation Value in Ischemic and Hemorrhagic Stroke: A Comparative Analysis of Subtypes
Provisionally accepted
Canan Şahin*
Yahya Şahin- Ahi Evran Universitesi Tip Fakultesi, Kırşehir, Türkiye
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
ABSTRACT Background: Cerebrovascular events are major causes of global mortality and disability. Inflammation, immune response, and nutritional status play crucial roles in stroke pathophysiology. The C-reactive protein–albumin–lymphocyte (CALLY) index and the pan-immune-inflammation value (PIV) are novel composite biomarkers reflecting these mechanisms. This study compared their prognostic performance between ischemic and hemorrhagic stroke. Methods: This retrospective, single-center cohort included 357 patients diagnosed with ischemic or hemorrhagic stroke between January 2020 and December 2024. Demographic, clinical, and laboratory data were retrieved from electronic records. Indices including CALLY, PIV, HALP, SII, and MII were calculated from blood samples obtained within 24 hours of admission. Group comparisons, multivariate logistic regression, and receiver operating characteristic (ROC) analyses identified independent predictors and diagnostic performance. Results: Among 357 patients (mean age 67 ± 14 years; 56.6% ischemic, 43.4% hemorrhagic), the CALLY index was significantly higher in hemorrhagic cases (p < 0.001). Multivariate analysis identified CALLY (odds ratio = 1.255), PIV (odds ratio = 1.001), and HALP (odds ratio = 1.258) as independent predictors (all p < 0.001). CALLY showed the highest discriminative ability (area under the ROC curve = 0.756). In hemorrhagic stroke, lower CALLY values were associated with in-hospital mortality (AUC = 0.646, p = 0.002). Conclusion: The CALLY index demonstrated superior prognostic value compared with other inflammatory markers and may serve as a simple, low-cost tool for early stroke risk assessment. Prospective,
Keywords: biomarker, CALLY index, Inflammation, PIV, prognosis, Stroke subtypes
Received: 13 Oct 2025; Accepted: 22 Dec 2025.
Copyright: © 2025 Şahin and Şahin. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Canan Şahin
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.