Increased intracranial pressure (ICP) ≥15 mmHg is associated with adverse neurological outcomes, but needs invasive intracranial monitoring. Using the publicly available MIMIC-III Waveform Database (2000–2013) from Boston, we developed an artificial intelligence-derived biomarker for elevated ICP (aICP) for adult patients. aICP uses routinely collected extracranial waveform data as input, reducing the need for invasive monitoring. We externally validated aICP with an independent dataset from the Mount Sinai Hospital (2020–2022) in New York City. The AUROC, accuracy, sensitivity, and specificity on the external validation dataset were 0.80 (95% CI, 0.80–0.80), 73.8% (95% CI, 72.0–75.6%), 73.5% (95% CI 72.5–74.5%), and 73.0% (95% CI, 72.0–74.0%), respectively. We also present an exploratory analysis showing aICP predictions are associated with clinical phenotypes. A ten-percentile increment was associated with brain malignancy (OR = 1.68; 95% CI, 1.09-2.60), intracerebral hemorrhage (OR = 1.18; 95% CI, 1.07–1.32), and craniotomy (OR = 1.43; 95% CI, 1.12–1.84; P < 0.05 for all).

颅内压 (ICP) 升高≥15 mmHg 与不良神经系统结局相关，但需要侵入性颅内监测。利用波士顿公开的 MIMIC-III 波形数据库（2000-2013），我们开发了一种人工智能衍生的成人患者 ICP (aICP) 升高的生物标志物。 aICP 使用常规收集的颅外波形数据作为输入，减少了侵入性监测的需要。我们使用纽约市西奈山医院（2020-2022）的独立数据集对 aICP 进行了外部验证。外部验证数据集的 AUROC、准确性、敏感性和特异性分别为 0.80 (95% CI, 0.80–0.80)、73.8% (95% CI, 72.0–75.6%)、73.5% (95% CI 72.5–74.5%)和 73.0%（95% CI，72.0–74.0%）。我们还提出了一项探索性分析，显示 aICP 预测与临床表型相关。百分之十的增量与脑恶性肿瘤（OR = 1.68；95% CI，1.09-2.60）、脑出血（OR = 1.18；95% CI，1.07-1.32）和开颅手术（OR = 1.43；95% CI）相关。 ，1.12–1.84； P < 0.05）。