海安市人民医院
1.Hai'2.'3.an People'4.s Hospital
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目的 本研究旨在PNI、NIHSS评分以及其他临床因子中筛选重型颅脑损伤老年患者预后因子，对老年患者的预后进行分层评估。方法 本研究回顾性分析了2019年3月至2024年3月期间在海安市人民医院神经外科住院的重型颅脑损伤老年患者的临床资料。采用多因素COX回归分析筛选独立预后危险因素。结果 多因素COX分析表明，NIHSS是重型颅脑损伤老年患者预后不良的独立危险因素（HR>1, P<0.05）。PNI是重型颅脑损伤老年患者预后良好的独立保护因素（HR<1, P<0.05）。高NHISS评分的患者预后较低NHISS的患者预后差（P<0.05）。高PNI患者预后较低PNI的患者预后好（P<0.05）。低NHISS评分且高PNI的患者预后最好，高NHISS评分且低PNI的患者预后最差。结论 NIHSS评分和PNI是重型颅脑损伤老年患者预后不良的独立危险因素和预后良好的独立保护因素。NHISS评分和PNI可以联合用于指导重型颅脑损伤老年患者预后风险分层，有助于识别预后差的患者，并在损伤早期阶段提供个性化治疗。
Objective The purpose of this study was to screen prognostic factors in elderly patients with severe craniocerebral injury from PNI, NIHSS scores and other clinical factors, and to evaluate the prognosis of elderly patients by stratification. Methods This study retrospectively analyzed the clinical data of elderly patients with severe craniocerebral injury who were admitted to the neurosurgery department of Hai'an People's Hospital from March 2019 to March 2024. Multivariate COX regression analysis was used to screen independent prognostic risk factors. Results Multivariate COX analysis showed that NIHSS was an independent risk factor for poor prognosis in elderly patients with severe craniocerebral injury (HR>1, P<0.05). PNI was an independent protective factor for good prognosis in elderly patients with severe craniocerebral injury (HR<1, P<0.05). Patients with high NHISS score had a worse prognosis than those with low NHISS (P<0.05). Patients with high PNI had a better prognosis than those with low PNI (P<0.05). Patients with low NHISS score and high PNI had the best prognosis, while patients with high NHISS score and low PNI had the worst prognosis. Conclusion NIHSS score and PNI are independent risk factors for poor prognosis and independent protective factors for good prognosis in elderly patients with severe craniocerebral injury. The NHISS score and PNI can be used in combination to guide prognostic risk stratification in older patients with severe craniocerebral injury, help identify patients with poor prognosis, and provide personalized treatment at an early stage of injury.
