ArticleCNS neuroscience & therapeutics2026
Four Distinct Dynamic Intracranial Pressure Trajectories and Their Prognostic Implications in Acute Brain Injury: A Multicenter Cohort Study.
Article in CNS neuroscience & therapeutics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Response to Comment on "Evaluation of Intracranial Pressure in Patients with Severe Brain Injury Using Contrast-Enhanced Ultrasound: A Pilot Study with Preliminary Findings".Neurocritical care · 2026Article
- Four Distinct Dynamic Intracranial Pressure Trajectories and Their Prognostic Implications in Acute Brain Injury: A Multicenter Cohort Study.CNS neuroscience & therapeutics · 2026Article
- Dynamic TyG trajectories cumulative TyG burden are associated with in-hospital mortality in acute brain injury: a multicenter interpretable machine-learning analysis.Frontiers in nutrition · 2026Article
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8 authors.
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Abstract
backgroundAcute brain injury (ABI) often elevates intracranial pressure (ICP), yet static measurements miss dynamic risk. We evaluated the prognostic value of early ICP trajectories.
methodsWe 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.
resultsAmong 1700 patients with ABI, four trajectories emerged-Severe Progressive, Stabilized Elevated, Mildly Elevated Stable, and Normal. Versus Normal, mortality risk was highest for Severe Progressive (HR 13.54; 95% CI 9.35-19.59), followed by Stabilized Elevated (HR 2.53; 1.83-3.49) and Mildly Elevated Stable (HR 1.48; 1.16-1.91). In patients aged ≥ 55 years, risk with Stabilized Elevated was amplified (HR 2.87; 1.97-4.20). Adding trajectories improved risk stratification (IDI +0.065; NRI +0.201) with modest AUC gains.
conclusionsEarly ICP trajectories define reproducible phenotypes with distinct mortality risk. Incorporating trajectories-particularly the stabilized-elevated pattern in older adults-adds prognostic value beyond clinical variables and supports prospective validation.
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