Intracranial pressure (ICP) monitoring is widely used in traumatic brain injury (TBI) management, yet its prognostic value remains variable. This secondary analysis of a randomized clinical trial examined ICP during the first 48 hours post-injury as a predictor of 28-day mortality, adjusting for demographic and clinical factors. Multivariate logistic regression showed that average ICP over 48 hours was an independent predictor of mortality, with an 8% increased risk per mmHg increase. Shorter ICP intervals were not predictive. Glasgow Coma Scale, brain herniation, and age also influenced mortality. Findings apply to aggressively managed TBI patients.
