摘要
Abstract
Objective To screen risk factors for poor prognosis in elderly patients with severe traumatic brain injury(STBI)based on nutritional indicators and construct a nomogram prediction model.Methods Patients with STBI treated in People's Hospital of Hai'an City from March 1,2019 to June 1,2023 were enrolled.At 6 months after surgery,the patients were evaluated using Glasgow Coma Scale(GCS).Those with a GCS score of ≤ 3 or death were defined as poor prognosis(set as the poor prognosis group),and those with a GCS score of ≥3 were defined as good prognosis(set as the good progno-sis group).The general clinical data,nutritional indicators,and metabolic serum markers were compared between the two groups.Multivariate Logistic regression analysis was performed to identify independent prognostic factors,and a nomogram model was established.Results Multivariate Logistic regression analysis revealed that preoperative GCS score and the Prog-nostic Nutritional Index(PNI)were independent protective factors for good prognosis in elderly STBI patients(OR＜1,P＜0.05),while time from injury to surgery,serum lactate(LAC)level,and age were independent risk factors for poor prognosis(OR＞1,P＜0.05).The nomogram model constructed based on these factors demonstrated strong predictive performance,with a maximum deviation of 0.063 between the calibration curve and ideal curve,and an area under the ROC curve(AUC)of 0.934.Conclusion Preoperative GCS score and PNI are independent protective factors for good prognosis in elderly STBI pa-tients,while time from injury to surgery,serum LAC level,and age are independent risk factors for poor prognosis.The no-mogram model established based on these prognostic factors may have good predictive performance.关键词
老年/重型颅脑损伤/预后营养指数/预后Key words
elderly/severe traumatic brain injury/prognostic nutritional index/prognosis
