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Accurately predicting patient outcomes is essential for optimizing therapeutic interventions and improving clinical decision-making. This study evaluates the predictive performance of the Cox proportional hazards model and advanced machine learning techniques, such as extreme gradient boosting (XGBoost), gradient boosting machine (GBM), and random survival forests (RSF), in forecasting survival outcomes for sepsis patients. Feature selection methods, including adaptive elastic net (AEN), smoothly clipped absolute deviation (SCAD), minimax concave penalty (MCP), and information gain (IG), were employed to refine model performance by identifying the most relevant clinical features. The results demonstrate that XGBoost consistently outperforms the Cox model, achieving a higher concordance index and demonstrating superior accuracy in handling complex, non-linear clinical interactions. 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