Association Between the C-Reactive Protein-Albumin-Lymphocyte (CALLY) Index and Length of Hospital Stay in Patients With Heart Failure

Angiology. 2026 Jul;77(6):772-778. doi: 10.1177/00033197251338416. Epub 2025 May 15.

Abstract

Prolonged hospital stays for patients with heart failure (HF) are associated with increased morbidity and mortality. In this study, we investigated the relationship between the C-reactive protein (CRP)-albumin-lymphocyte (CALLY) index, a new marker in patients with decompensated HF, and the length of hospital stay. Consecutive patients (n = 4745) who were hospitalized with decompensated HF between January 2016 and January 2024 (COVID-19 period was excluded) were included in the study. The CALLY index ([albumin × lymphocyte]/[CRP × 104]) was calculated. A relationship was found between the CALLY index and the length of hospital stay in the patients with HF in linear regression analysis. Also, the CALLY index was an independent predictive variable of the length of hospital stay (odds ratio: 0.327; 95% CI: 0.278-0.385; P < .001). CALLY index value of 0.258 can predict long-term hospitalization with 69.2% sensitivity and 70.1% specificity (area under the curve [AUC]: 0.729, 95% CI = 0.714-0.743, P < .001). In addition, the CALLY index was negatively correlated with the length of hospital stay (r = -.47, P < .001). In conclusion, the CALLY index, an inexpensive and easily measured laboratory variable, may be a valuable for estimating the length of hospital stay in decompensated HF.

Keywords: C-reactive protein; CALLY index; albumin; heart failure; length of hospital stay; lymphocyte.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Biomarkers / blood
  • C-Reactive Protein* / analysis
  • C-Reactive Protein* / metabolism
  • Female
  • Heart Failure* / blood
  • Heart Failure* / diagnosis
  • Heart Failure* / therapy
  • Humans
  • Length of Stay* / statistics & numerical data
  • Lymphocyte Count
  • Lymphocytes*
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Retrospective Studies
  • Serum Albumin* / analysis

Substances

  • C-Reactive Protein
  • Biomarkers
  • Serum Albumin