biostudies-literatureWang JChun-Hua HangPenglai Zhaoe70735https://www.ebi.ac.uk/biostudies/studies/S-EPMC12759305biostudies-literatureUnknown32(1)<h4>Background</h4>Acute brain injury (ABI) often elevates intracranial pressure (ICP), yet static measurements miss dynamic risk. We evaluated the prognostic value of early ICP trajectories.<h4>Methods</h4>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.<h4>Results</h4>Among 1700 patients with ABI, four trajectories emerged-Severe Progressive, Stabilized EleCNS neuroscience & therapeuticsFour Distinct Dynamic Intracranial Pressure Trajectories and Their Prognostic Implications in Acute Brain Injury: A Multicenter Cohort Study.PMC127593052022-YJ-085-J-Z-ZZ-026LCYJ-PY-38YXJL-2022-0351-04212024-LCYJ-MS-08LCYJ-MS-37Li HXu MLi SHang CHZhao PLi WJCheng LWang JfalseFour Distinct Dynamic Intracranial Pressure Trajectories and Their Prognostic Implications in Acute Brain Injury: A Multicenter Cohort Study.<h4>Background</h4>Acute brain injury (ABI) often elevates intracranial pressure (ICP), yet static measurements miss dynamic risk. We evaluated the prognostic value of early ICP trajectories.<h4>Methods</h4>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.<h4>Results</h4>Among 1700 patients with ABI, four trajectories emerged-Severe Progressive, Stabilized Ele2026-01-01T00:00:00Z2026 Jan2026-06-09T05:17:10.056Z2026-06-09T03:07:43.442ZS-EPMC127593054148282010.1002/cns.70735