Traumatic brain injury (TBI) is a significant global cause of mortality and morbidity with an increasing incidence, especially in low-and-middle income countries. The most severe TBIs are treated in intensive care units (ICU), but in spite of the proper and high-quality care, about one in three patients dies. Patients that suffer from severe TBI are unconscious, which makes it challenging to accurately monitor the condition of the patient during intensive care. In the ICU, many tens of variables are continuously monitored (e.g. However, only one variable, such as intracranial pressure, may yield hundreds of thousands of data points per day.

Our aim was to create simple and largely scalable machine learning-based algorithms that could predict mortality in a real-time fashion during intensive care after traumatic brain injury. We performed an observational multicenter study including adult TBI patients that were monitored for intracranial pressure (ICP) for at least 24 h in three ICUs. We used machine learning-based logistic regression modeling to create two algorithms (based on ICP, mean arterial pressure [MAP], cerebral perfusion pressure [CPP] and Glasgow Coma Scale [GCS]) to predict 30-day mortality. We used a stratified cross-validation technique for internal validation. Of 472 included patients, 92 patients (19%) died within 30 days.