To investigate the correlation between the severity of liver cirrhosis in chronic hepatitis B (CHB) and C-reactive protein-albumin-lymphocyte (CALLY) index, and to identify the influencing factors of adverse prognosis.

Total of 112 patients with CHB-related cirrhosis admitted in Xiaogan Hospital Affiliated to Wuhan University of Science and Technology from January 1st, 2023 to January 1st, 2024 were enrolled, retrospectively. According to the median CALLY index at admission (1.35), patients were divided into high-CALLY group and low-CALLY group, with 56 cases in each group. Baseline characteristics were compared between the two groups. The correlation between CALLY index and Child-Pugh grades were assessed by Spearman rank correlation analysis. The prognostic performance of CALLY index was evaluated by receiver operating characteristic (ROC) curve analysis. The overall survival between the two groups were compared by Kaplan-Meier analysis and Log-rank test, and the influencing factors of prognosis in patients with CHB-related cirrhosis were identifed by Cox proportional hazards regression.

The levels of C-reactive protein (Z=4.106, P＜0.001), serum free cortisol (t=－2.140, P=0.035), copeptin (t=－3.873, P＜0.001), neutrophil count (t=－3.606, P＜0.001), albumin (t=－7.917, P<0.001), serum total bilirubin (t=4.923, P＜0.001), prolongation of prothrombin time (t=8.120, P<0.001) and Child-Pugh grade (Z=－1.994, P=0.046) were significantly different between patients with CHB-related liver cirrhosis in high-CALLY group and low-CALLY group. The area under the ROC curve (AUC) of the CALLY index for predicting 2-year all-cause mortality was 0.714 (95%CI: 0.581-0.834), with an optimal cutoff value of 1.23, the sensitivity and specificity were 71.4% and 62.6%, respectively. The CALLY index was negatively correlated with Child-Pugh grade (r=－0.610, P＜0.001). The 2-year overall survival rates were 91.1% and 71.4% in high-CALLY and low-CALLY groups, respectively, with significant difference (Log-rank χ²=7.323, P=0.007). Multivariable Cox regression analysis showed that monocyte count (HR=1.18, 95%CI: 1.03-1.36, P=0.018) and Child-Pugh grade (HR=2.17, 95%CI: 1.07-4.40, P=0.032) were both risk factors for poor prognosis of CHB-related liver cirrhosis, whereas the standardized CALLY score was not an independent influencing factor of all-cause mortality (HR=0.69, 95%CI: 0.30-1.60, P=0.386).

The CALLY index exhibits a certain association with the severity of liver cirrhosis and survival outcomes; it can serve as an auxiliary risk stratification parameter complementing conventional clinical indicators, although its independent prognostic value still requires further validation.