Document is current

Article History

Received: 21 January 2026

Accepted: 15 May 2026

First Online: 7 July 2026

Declarations

Human ethics and consent to participate declarations: This study was a retrospective analysis of de-identified data obtained from publicly available databases (MIMIC and eICU) and an institutional ICU database in which all patient identifiers were removed prior to analysis. The use of the MIMIC and eICU databases for research is authorized under their respective data use agreements, which include ethical oversight from the originating institutions. The external validation using the local ICU database from Yantai Yuhuangding Hospital was specifically reviewed and approved by the Institutional Review Board (IRB) of Yantai Yuhuangding Hospital (Approval No.: 2025-682), which confirmed that the use of fully de-identified retrospective data did not constitute human subjects research requiring additional ethical approval.

Declaration of Helsinki: All study procedures were conducted in accordance with the ethical standards of the Declaration of Helsinki.

Consent to participate declaration: Not applicable. Informed consent was waived for the analysis of the local institutional database by the Institutional Review Board (IRB) of Yantai Yuhuangding Hospital, as this study involved secondary analysis of de-identified retrospective data, and no direct patient contact or intervention was performed. For the MIMIC and eICU databases, patient consent was obtained during the original data collection processes as per the policies of the data source institutions.

Consent for publication: Not applicable. The data used in this study were obtained from the MIMIC and eICU databases, which are publicly available and de-identified. The local institutional data were fully anonymized. Therefore, individual patient consent for publication is not applicable.

Competing interests: The authors declare no competing interests.