Objective To investigate the value of blood clean egg level and Braden assessment results in the early prediction of pressure ulcer in elderly patients with stroke, and the effect on the prediction of adverse prognosis. Methods 103 elderly stroke patients hospitalized in our hospital from January 2022 to June 2024 were selected as the study objects. Baseline data were collected. Blood clean egg level was detected, the pressure ulcer risk of patients was assessed by Braden pressure ulcer risk assessment scale, and the patients were divided into pressure ulcer group and non-pressure ulcer group. The incidence of adverse outcomes with cognitive impairment was assessed during a 6-month follow-up. The baseline data of the pressure ulcer group and the non-pressure ulcer group were analyzed and compared. The correlation of ALB, BMI, fasting blood glucose and Braden score was analyzed. To analyze the prognostic factors of cognitive dysfunction in senile stroke patients. Results 22 patients (21.36%) with pressure ulcers were included in the pressure ulcers group, and 81 patients (78.64%) without pressure ulcers were included in the non-pressure ulcers group. Compared with the non-pressure sore group, the ALB level and Braden score of the patients with pressure sore were significantly decreased. BMI level and fasting blood glucose level were significantly increased (P<0.05). There were no significant differences in gender, age, blood pressure and lipid levels between the two groups (P > 0.05). ALB was positively correlated with BMI, fasting blood glucose and Braden score, and BMI was positively correlated with fasting blood glucose and Braden score (P<0.05). ALB, Braden score, BMI level and fasting blood glucose level had certain predictive effects on the occurrence of pressure ulcer, among which ALB increased (OR=3.161), Braden score increased (OR=3.333), BMI increased (OR=12.317) and fasting blood glucose level increased (OR=10.859). Conclusion Low serum ALB level has a certain predictive value for pressure ulcers during hospitalization and cognitive dysfunction in the short term in elderly patients with ischemic stroke. Patients" BMI, fasting blood glucose, and blood pressure levels were also associated with the prognosis of pressure ulcers and cognitive impairment.