Elevated C-Reactive Protein-Albumin-Lymphocyte Index Is Associated With Reduced Mortality in Chronic Inflammatory Airway Diseases: A Population-Based Observational Study.

BACKGROUND: The C-reactive protein-albumin-lymphocyte (CALLY) index, a novel composite marker derived from lymphocyte count, serum albumin, and C-reactive protein (CRP) levels, is commonly used to assess nutritional and inflammatory status. However, existing studies have not clarified the association between the CALLY index and prognosis in patients with chronic inflammatory airway diseases (CIADs). This study aims to elucidate the relationship between the CALLY index and the risks of all-cause and cardiovascular mortality among CIAD patients in the United States. METHODS: This investigation included 4128 patients with CIAD from the National Health and Nutrition Examination Survey (NHANES, 1999-2010). The CALLY index was measured only at baseline. We employed weighted Cox proportional hazards regression models to assess the association between the CALLY index and risks of all-cause and cardiovascular mortality across three progressively adjusted models. To evaluate potential nonlinear dose-response relationships, we applied restricted cubic spline (RCS) models. Additionally, subgroup analyses and sensitivity analyses were conducted to verify the robustness of our findings. RESULTS: Multivariable-adjusted Model 3 demonstrated that, compared with the lowest quartile, the highest CALLY index quartile showed a significant inverse association with both all-cause and cardiovascular mortality, with corresponding HRs of 0.36 (95% CI: 0.27-0.47) and 0.33 (95% CI: 0.21-0.51), respectively (both p  < 0.05). CONCLUSIONS: The CALLY index showed a significant inverse association with all-cause and cardiovascular mortality among U.S. adults with CIAD, suggesting its potential value as a prognostic tool for risk stratification in this group.