【Abstract】Objective To investigate the effects of T lymphocyte subsets and nutritional status on the prognosis of elderly patients after severe craniocerebral injury. Methods The clinical data of 109 elderly patients with severe craniocerebral injury admitted to our hospital between May 2022 to December 2023 were retrospectively collected and analyzed. According to the Glasgow outcome scale (GOS) in three months after discharge, they were divided into good prognosis group (n=56) and poor prognosis group (n=53). The clinical data were compared between the two groups, including basic data, T lymphocyte subsets and nutritional status [nutritional risk screening 2002 (NRS2002) score and serum albumin (ALB) levels]. SPSS statistics 26.0 was used for statistical analysis, and t test or χ² test was employed for intergroup comparison depending on data type. Multivariate logistic regression analysis was utilized to identify the factors affecting the prognosis of these elderly patients. Results The poor prognosis group had significantly smaller percentage of CD4⁺ T lymphocytes but larger percentage of CD8⁺ T cells, and lower CD4⁺/CD8⁺ level than the good prognosis group (all P<0.05). Obviously larger ratio of the patients with NRS2002 score ≥3 points, higher NRS2002 score, and lower ALB level were observed in the poor prognosis group when compared with the good prognosis group (all P<0.05). The Glasgow coma scale (GCS) was notably lower, and the intracranial hematoma, blood glucose level, systolic blood pressure (SBP) and diastolic blood pressure (DBP) at admission were markedly higher in the poor prognosis group than the good prognosis group (all P<0.05). Multivariate logistic regression analysis showed that CD4⁺/CD8⁺ (OR=2.849,95%CI 1.329-6.107), NRS2002 score (OR=0.312,95%CI 0.131-0.742), ALB level (OR=3.959,95%CI 1.434-10.927), baseline GCS score (OR=3.607,95%CI 1.538-8.462), intracranial hematoma (OR=0.330,95%CI0.150-0.724), baseline blood glucose (OR=0.370,95%CI 0.177-0.774) and SBP at admission (OR=0.298,95%CI 0.132-0.673) were influencing factors for prognosis of elderly patients with severe craniocerebral injury (P<0.05). Conclusion T lymphocyte subset and nutritional status are influencing factors for the prognosis of elderly patients with severe craniocerebral injury. Enhancing the immune function and nutritional status may improve prognosis of the patients.

This work was supported by the Science and Technology Development Project of Dazu District of Chongqing ( DZKI2023-JSYJKWXM1036).