Objective To investigate the influencing factors for the prognosis of patients with traumatic brain injury and their correlation with preoperative thrombin-antithrombin （TAT） complex.Methods A retrospective analysis was performed for 70 patients with traumatic brain injury who were treated in our hospital from January 2019 to January 2021， and according to whether they died within 30 days after surgery， they were divided into survival group with 48 patients and death group with 22 patients. A logistic regression analysis was used to investigate the risk factors for death in patients with traumatic brain injury， and the correlation between preoperative TAT complex and various risk factors was analyzed， as well as the value of preoperative TAT complex in predicting the death of patients with traumatic brain injury were analyzed.Results Age ≥60 years， time from injury to surgery <10 hours， Glasgow coma scale （GCS） score <5 on admission， preoperative TAT complex >100 ng/mL， fasting blood glucose （FBG） >10 mmol/L， and time of operation ≥3 hours were risk factors for death in patients with traumatic brain injury （P <0.05）. Preoperative TAT complex level was positively correlated with the patient’s age， FBG level， and time of operation （P <0.05） and was negatively correlated with the time from injury to surgery and GCS score on admission （P <0.05）. Preoperative TAT complex level had an area under the ROC curve of 0.79 （95% confidence interval： 0.723-0.913， P <0.001）， with a sensitivity of 80.32% and a specificity of 74.06% at the optimal cut-off value of 100 ng/mL， suggesting that preoperative TAT complex level had a relatively good predictive value.Conclusions TAT complex is a influence factor for death in patients with traumatic brain injury and is correlated with various influence factor. It has a relatively good value in predicting the death of patients with traumatic brain injury.