Background/Objectives: Sepsis remains a leading cause of mortality worldwide, necessitating the development of effective prognostic markers for early risk stratification. The C-reactive protein–albumin–lymphocyte (CALLY) index is a novel biomarker that integrates inflammatory, nutritional, and immunological parameters. This study aimed to evaluate the association between the CALLY index and 30-day all-cause mortality in sepsis patients. Methods: This retrospective cohort study included adult patients diagnosed with sepsis in the emergency department between 1 January 2022, and 1 January 2025. The CALLY index was calculated as (CRP × absolute lymphocyte count)/albumin. The primary outcome was 30-day all-cause mortality. Five machine learning models—extreme gradient boosting (XGBoost), multilayer perceptron, random forest, support vector machine, and generalized linear model—were developed for mortality prediction. Four feature selection strategies (gain score, SHAP values, Boruta, and LASSO regression) were used to evaluate predictor consistency. The clinical utility of the CALLY index was assessed using decision curve analysis (DCA). Results: A total of 1644 patients were included, of whom 345 (21.0%) died within 30 days. Among the five machine learning models, the XGBoost model achieved the highest performance (AUC: 0.995, R²: 0.867, MAE: 0.063, RMSE: 0.145). In gain-based feature selection, the CALLY index emerged as the top predictor (gain: 0.187), followed by serum lactate (0.185) and white blood cell count (0.117). The CALLY index also ranked second in SHAP analysis (mean value: 0.317) and first in Boruta importance (mean importance: 37.54). DCA showed the highest net clinical benefit of the CALLY index within the 0.10–0.15 risk threshold range. Conclusions: This study demonstrates that the CALLY index is a significant predictor of 30-day mortality in sepsis patients. Machine learning analysis further reinforced the prognostic value of the CALLY index.

Introduction: Acute appendicitis (AA) is the predominant condition responsible for acute abdominal pain across all age demographics. The purpose of this research is to determine if the hemoglobin, albumin, lymphocyte, and platelet (HALP) and modified HALP (m-HALP) scores differ between complicated and uncomplicated appendicitis in patients diagnosed with AA who have applied to the emergency department (ED). Additionally, this study aims to investigate whether HALP and m-HALP scores are superior to other biomarkers. Materials and methods: The retrospective analysis included adult patients, aged eighteen or older, who were diagnosed with AA, and sought treatment at the ED of a tertiary hospital. Patients were divided into two groups: complicated appendicitis (CA) and uncomplicated appendicitis (UCA). The cut-off in diagnostic value measurements was determined using the receiver operating characteristic analysis. Results: A total of 436 patients (CA: 126, UCA: 310) were included. Neutrophil-to-lymphocyte ratio (NLR), neutrophil-to-albumin ratio, systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), and pan-immune inflammation value (PIV) were found to have acceptable diagnostic power in CA detection (area under the curve [AUC]: 0.735–0.783). In detecting UCA, HALP and m-HALP were of fair diagnostic power (AUC: 0.64, 0.68, respectively). Conclusions: In this study, we found that although PIV, SIRI, SII, and NLR had acceptable diagnostic values in distinguishing CA and UCA, HALP and m-HALP had fair diagnostic values.

Background: Acute pulmonary embolism (APE) is a cardiovascular emergency that has a high morbidity and mortality probability. The aim of this study is to investigate the clinical value of the systemic immune inflammation index (SII) in predicting high-risk patients admitted to the emergency department with a diagnosis of Acute pulmonary embolism (APE). Materials and Methods: This clinical study, which was conducted according to a cross-sectional study design, included 193 patients diagnosed with APE who presented to the emergency department of a tertiary hospital. According to the guideline, patients with Pulmonary Embolism Severity Index (PESI) class III–V or sPESI ≥I were identified as high risk. ROC (Area Under the Curve) analysis was used to determine the cut-off in predicting high-risk APE. Results: In our research, 71 of the patients had high-risk APE. In detecting high-risk APE, SII was found to have excellent diagnostic power (AUC: 0.84), while neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), and monocyte to lymphocyte (MLR) were found to have acceptable diagnostic power (AUC: 0.76-0.78), red cell distribution width (RDW) to lymphocyte (RLR) was of fair diagnostic power (AUC: 0.68). Conclusion: We have shown that SII can be a valuable and useful potential biomarker to identify high-risk patients in patients with APE. We also found that MLR and RLR are biomarkers that can be used to predict severe APE.

Background: Even with immediate surgical intervention, acute aortic dissection (AAD) is a cardiovascular emergency with a high mortality rate. The purpose of this study was to look at the relationship between in-hospital mortality and red cell distribution width (RDW)/lymphocyte ratio (RLR), monocyte/lymphocyte ratio (MLR), and systemic immune inflammation index (SII) in patients with type B acute aortic dissection (BAAD). Materials and methods: 59 BAAD patients who presented to the emergency room of a tertiary hospital were included in this cross-sectional study. The predictive ability and cut-off value of biomarkers for mortality were evaluated using Receiver Operating Characteristic (ROC) analysis. The variables believed to be connected to in-hospital mortality were subjected to multiple regression analysis, and the odds ratio was calculated. Results: The study consisted of 59 patients in total, 44 of whom (74.6%) were male. 17 of these patients died in the hospital. In terms of predicting in-hospital mortality in BAAD patients, MLR, and neutrophil/lymphocyte ratio (NLR) have excellent diagnostic power (AUC: 0.826, 0.822, respectively), while platelet/lymphocyte ratio (PLR), RLR, and SII have acceptable diagnostic power (AUC: 0.758-0.786). Increased NLR, PLR, MLR, RLR, and SII were found to be independent predictors of in-hospital mortality in patients with BAAD (odss ratio: 9.16, 7.68, 9.33, 6, 8.57, respectively). Conclusion: MLR, RLR, and SII are valuable parameters for estimating in-hospital mortality in adult BAAD patients. Increased NLR, PLR, MLR, RLR, and SII in BAAD patients are independent predictors of in-hospital mortality.