Nevin Fazlıoğlu1 2Department of Biochemistry, Faculty of Medicine, Tekirdag Namik Kemal University, Tekirdag, Türkiye
3Department of Thoracic Surgery, Faculty of Medicine, Tekirdag Namik Kemal University, Tekirdag, Türkiye
Abstract
Background and Aim:The CALLY index which unites CRP albumin and lymphocyte values serves as a predictive tool for cancer and inflammatory disease patients. The CALLY index has not received evaluation for its application in idiopathic pulmonary fibrosis (IPF) diagnosis. The study examined how CALLY scores relate to acute exacerbations and death rates in IPF patients and their connection to lung function assessment results.
Methods: The researchers studied 129 IPF patients who received their diagnosis between Janu-ary 2020 and December 2023 by reviewing their demographic information and test results and pulmonary function assessments. Patients were enrolled from both outpatient and inpatient ser-vices at a single tertiary center. The CALLY index calculation used the formula albumin (g/dL) / [CRP (mg/dL) × NLR] with NLR standing for neutrophil-to-lymphocyte ratio. Acute exacerba-tions of IPF (AE-IPF) and all-cause mortality information was obtained from longitudinal fol-low-up records. The study participants received follow-up care for a median period of 36 months which spanned from 6 months to 48 months.
Results: Of the 129 patients analyzed, 30 (23.3%) died and 10 (7.8%) experienced AE-IPF during follow-up. The CALLY score was significantly lower in patients who experienced AE-IPF compared to those who did not (1.41 ± 1.58 vs. 3.48 ± 3.93, p = 0.012), and similarly low-er in deceased patients than in survivors (1.85 ± 2.11 vs. 3.79 ± 4.14, p = 0.014). ROC curve analysis demonstrated fair discriminatory capacity of the CALLY index for AE-IPF (AUC: 0.72, cut-off: 0.66, sensitivity: 50.0%, specificity: 85.0%) and mortality (AUC: 0.69, cut-off: 1.19, sensitivity: 58.0%, specificity: 76.0%). The GAP index showed comparable performance with AUCs of 0.73 for AE-IPF and 0.75 for mortality, with no significant difference between the two indices (p = 0.88 for AE-IPF; p = 0.45 for mortality). Among pulmonary function pa-rameters, only DLCO% showed a significant positive correlation with the CALLY index (r = 0.265, p = 0.0024).
Conclusion: The CALLY index provides an effective method to evaluate functional deteriora-tion and negative results in IPF patients while serving as a useful predictive instrument. The CALLY index provides similar prognostic value to the GAP index through the use of standard laboratory tests. Additional prospective validation research should be conducted.
