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MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials were searched through August 1, 2025, for studies comparing ICP-monitored and non-ICP-monitored patients with traumatic brain injury. Eligible study designs included randomized controlled trials, prospective observational cohort studies, retrospective observational cohort studies, registry-based cohort studies, and case-control studies. Study quality was assessed using the Strengthening the Reporting of Observational Studies in Epidemiology checklist, Risk of Bias 2.0 for randomized trials, and the Oxford Centre for Evidence-Based Medicine Levels of Evidence framework.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Thirty-one studies met inclusion criteria. The mortality meta-analysis included 121,799 patients. Pooled crude analysis showed lower mortality in ICP-monitored patients than in non-monitored patients (OR 0.79, 95% CI 0.68\u20130.91, p\u2009=\u20090.002), with high heterogeneity (I\u00b2=92%). Across studies with extractable group-level mortality percentages, median mortality was 28.6% in ICP-monitored patients and 33.2% in non-monitored patients. Functional neurological outcomes were inconsistently reported and did not show a consistent benefit with ICPm. ICU and hospital LOS were generally longer in ICP-monitored patients. Ten studies reported complication data, most commonly infection, hemorrhagic events, and mechanical or device-related complications; reporting was heterogeneous and precluded pooled analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>ICPm was associated with lower crude mortality in sTBI; however, substantial heterogeneity and residual confounding limit causal interpretation. Functional outcomes did not show consistent benefit. Complication reporting was inconsistent, but reported events included infection, hemorrhage, and device-related complications. Future studies should standardize functional outcome reporting and adjust for key confounders.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of evidence<\/jats:title>\n                    <jats:p>Systematic review and meta-analysis; Level III.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00068-026-03302-5","type":"journal-article","created":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T12:26:16Z","timestamp":1786537576000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Impacts of intracranial pressure monitoring on mortality and length of stay in severe traumatic brain injury: a systematic review and meta-analysis"],"prefix":"10.1007","volume":"52","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7199-0967","authenticated-orcid":false,"given":"Michael","family":"Merakis","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"NakHyun","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gina","family":"Velli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0277-4822","authenticated-orcid":false,"given":"Zsolt J.","family":"Balogh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,8,12]]},"reference":[{"key":"3302_CR1","doi-asserted-by":"publisher","first-page":"111","DOI":"10.1097\/01.ccx.0000155358.31983.37","volume":"11","author":"CH Salmond","year":"2005","unstructured":"Salmond CH, Sahakian BJ. 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