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Article History

Received: 11 June 2025

Accepted: 12 November 2025

First Online: 5 December 2025

Declaration

:

: This study was conducted using two retrospective datasets. The internal validation cohort was derived from the MIMIC-IV database. The Institutional Review Board at the Beth Israel Deaconess Medical Center approved the collection and use of patient data in MIMIC-IV and granted a waiver of informed consent. The external validation cohort consisted of de-identified patient data from the Second Affiliated Hospital of Wenzhou Medical University. The use of these data was approved by the Ethics Committee of the Second Affiliated Hospital of Wenzhou Medical University (approval number: [MR-33–25-018841]), and the requirement for informed consent was waived due to the retrospective nature of the study. All methods were performed in accordance with the relevant ethical guidelines and regulations, including the Declaration of Helsinki and its later amendments, the International Ethical Guidelines for Health-related Research Involving Humans (CIOMS), the Measures for the Ethical Review of Biomedical Research Involving Humans (National Health Commission of China), and other applicable ethical standards.

: Not applicable.

: The authors declare no competing interests.