Objective To explore the predictive value of prognostic nutritional index (PNI) and controlling nutritional status (CONUT) score in the prognosis of elderly patients with severe traumatic brain injury (TBI).

Methods A total of 108 elderly TBI patients treated at Hai'an People's Hospital from January 2019 to December 2020 were included. The patients were divided into the good prognosis group (modified Rankin Scale, mRS < 3; n＝46) and the poor prognosis group (mRS≥3; n＝62). Patients' demographics, clinical data, PNI and CONUT score were calculated and collected. The binary logistic regression model was used to analyze risk factors for patient neurological functional outcome. The receiver operating characteristic (ROC) curve was used to analyze the optimal cut-off value and area under the curve (AUC) for PNI and CONUT to discriminate patient outcome at 6 months.

Results Compared with patients with good prognosis, patients in poor prognosis group presented with significantly older age, increased Glasgow score, higher CONUT score and lower PNI score (P < 0.05). Binary logistic regression analysis showed that PNI (OR=0.64, P=0.007), CONUT score (OR=1.44, P=0.04), patient age (OR=1.37, P=0.002) and the Glasgow score (OR=0.05, P=0.001) were significantly associated with the neurological functional outcome at 6 months after onset of TBI. The optimal cut-off value for PNI and CONUT to distinguish neurological functional outcome at 6 months were 48 and 3, respectively, with a corresponding AUC of 0.79 and 0.69.

Conclusion PNI and CONUT score have certain predictive value for the prognosis of elderly patients with severe TBI.