Influence of prognostic nutritional index and controlling nutritional status on the prognosis of patients with acute traumatic spinal cord injury

Abstract Objectives: The aim of this study was to define the risk factors affecting the prognosis of patients with acute traumatic spinal cord injury (tSCI), and to discuss the value of prognostic nutritional index (PNI) and controlling nutritional status (COUNT) score in predicting the prognosis of patients with acute tSCI.Methods: We retrospectively analyzed the clinical data of 75 patients with acute tSCI. The optimal cutoff value was obtained through the receiver operating characteristic curve (ROC), and the value of PNI and COUNT score were 45.05 and 3.5 respectively. Patients were divided into high PNI groups and low PNI groups, high COUNT groups and low COUNT groups respectively based on cutoff values. The differences of outcome indexes such as American spinal injury association impairment scale (AIS), exercise score, Bathel index score and light touch score were analyzed, and the prognostic factors of tSCI patients were analyzed. A improved outcome was defined as improvement of AIS grade ≥ 1.Results: Compared with the improvement group, the non-improvement group had lower serum albumin and PNI, higher COUNT score, longer hospital stay and higher postoperative infection rate (P < 0.05). PNI and COUNT score were closely related to the AIS grade (r = 0.629, P < 0.001; r = -0.855, P < 0.001). After adjusting for confounding factors, the odds ratios of PNI and COUNT score for predicting improved outcomes in patients with acute tSCI were 1.396 (95%CI: 1.141-1.709） and 0.284 (95%CI: 0.136-0.0.594）, respectively. The area under the curve (AUC) of PNI and count scores for predicting improved outcomes were 0.752 (95% CI: 0.641 ~ 0.862, P < 0.001) and 0.766 (95% CI: 0.654 ~ 0.879, P < 0.001), respectively. Conclusion: PNI and count scores may be independent predictors of improved outcomes in patients with acute tSCI.