Four Distinct Dynamic Intracranial Pressure Trajectories and Their Prognostic Implications in Acute Brain Injury: A Multicenter Cohort Study.

ABSTRACT:

Background

Acute brain injury (ABI) often elevates intracranial pressure (ICP), yet static measurements miss dynamic risk. We evaluated the prognostic value of early ICP trajectories.

Methods

We formed a multicenter ICU cohort from MIMIC-IV (2008-2022), eICU (2014-2015), and NSICU (2024-2025). Latent class growth modeling identified ICP trajectories over the first 120 h. Associations with in-hospital mortality were tested with Cox models, and incremental value beyond baseline clinical variables was quantified by AUC, integrated discrimination improvement (IDI), and net reclassification improvement (NRI). Sensitivity analyses were performed across datasets and age groups.

Results

Among 1700 patients with ABI, four trajectories emerged-Severe Progressive, Stabilized Ele

SUBMITTER: Wang J 

PROVIDER: S-EPMC12759305 | biostudies-literature | 2026 Jan

REPOSITORIES: biostudies-literature