Identification of prognostic adverse outcomes after traumatic brain injury (TBI) could preclude immediate long distance military air evacuation and determine if a patient is Fit-to-fly to a neurosurgical-capable facility. This study aimed to test models of various data sources and biomarkers to predict adverse intracranial pressure (ICP) changes in severe TBI prior to occurrence. Patients with severe TBI were prospectively enrolled. Continuously measured VS and biomarker levels were obtained on admission and every 6 hours for 72 hours. Systemic vital signs, such as blood pressure and heart rate, and intracerebral monitoring, such as ICP and cerebral perfusion pressure, were recorded. Multimodal statistical analysis including biomarker variable importance ranking was utilized to predict the next 6 hour outcomes of ICP greater than 30mmHG for greater than 15 minutes. By studying multiple cytokines with ICP we were able to identify a combination of biomarkers, with statistical methods of variable ranking to determine a strong relation to neurological worsening.
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