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Article History

Received: 19 February 2026

Accepted: 10 April 2026

First Online: 17 May 2026

Declarations

:

: The authors declare no conflicts of interest.

: The MIMIC IV database has received ethical approval from the institutional review boards (IRB) at BIDMC and MIT, and, because the database does not contain protected health information, a waiver of the requirement for informed consent was included in the IRB approval. Use of routinely collected intensive-care data from Imperial College Healthcare NHS Trust (ICHT) was approved by the UK Health Research Authority and the London-Brighton & Sussex Research Ethics Committee (REC reference 25/HRA/0032; IRAS project ID 348389; protocol 6438939). All ICHT records were fully de-identified, and the REC likewise waived the requirement for individual informed consent. AmsterdamUMCdb (Amsterdam University Medical Centers ICU database) was created using a risk-based de-identification strategy and underwent external privacy and ethics audits. Access is governed by an end-user license and mandatory research-integrity training; therefore, individual informed consent is not required for use of this anonymized dataset. Preliminary findings for this study were presented at the American Thoracic Society Congress 2026.

: During manuscript preparation, the authors employed ChatGPT (OpenAI, accessed October 2025) exclusively for proofreading (spelling, grammar, and consistency of terminology). The AI system was not used to generate scientific content, interpret data, or draft any original sections.