{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T18:53:19Z","timestamp":1791226399214,"version":"4.1.0"},"reference-count":35,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T00:00:00Z","timestamp":1789689600000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Skin graft failure is a significant complication in burn care that prolongs recovery, compromises surgical outcomes, and necessitates repeat operations. Accurate risk assessment is challenging due to a complex interplay of patient and injury factors, underscoring the need for objective, data-driven predictive tools. We developed and validated an interpretable machine learning (ML)-driven tool to provide individualized, data-driven risk assessment for skin graft loss in patients with burn injuries.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A cohort study of patients who had autologous skin grafting from the American Burn Association Burn Care Quality Platform was conducted from 2013 to 2022. A Random Forest ML model was developed and validated on independent training (70%), validation (15%), and testing (15%) sets. Model performance was assessed using the area under the receiver operating characteristic curve (AUC-ROC).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 286\u2009479 patients during the study period, 24\u2009046 underwent autologous skin grafting. Machine learning demonstrated discriminatory predictive performance with AUC-ROC of 0.794. Burns \u2265 40% total body burn surface area (odds ratio [OR] 8.16; P\u2009&amp;lt;\u2009.001), history of alcohol abuse (OR 1.86; P\u2009&amp;lt;\u2009.001), active tobacco use (OR 1.45; P\u2009=\u2009.004), age\u2009&amp;gt;\u200960\u00a0years (OR 1.70; P\u2009=\u2009.013), hypertension (OR 1.52; P\u2009=\u2009.003), male sex (OR 0.74; P\u2009=\u2009.009), diabetes mellitus (OR 1.45; P\u2009=\u2009.030), and contact burns (OR 1.70; P\u2009=\u2009.006) emerged as independent predictors of graft loss. The model was translated into an interactive, interpretable web-based clinical tool.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The Skin Graft Loss Risk Estimator provides a transparent, interpretable and personalized risk assessment of skin graft loss to enhance clinical judgment, facilitate effective patient counseling and surgical planning in burn care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jbcr\/irag166","type":"journal-article","created":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T19:25:42Z","timestamp":1789673142000},"source":"Crossref","is-referenced-by-count":0,"title":["Development and Validation of the Skin Graft Loss Risk Estimator: An Interpretable Machine Learning-Driven Tool for Individualized Assessment in Burn Patients"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1070-0524","authenticated-orcid":false,"given":"Abbas M","family":"Hassan","sequence":"first","affiliation":[{"name":"Division of Plastic Surgery, Department of Surgery, Indiana University , Indianapolis, IN 46202 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4146-6179","authenticated-orcid":false,"given":"Hilary Y","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery, University of Pittsburgh Medical Center , Pittsburgh, PA 15213 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7531-0132","authenticated-orcid":false,"given":"Leigh J","family":"Spera","sequence":"additional","affiliation":[{"name":"Division of Plastic Surgery, Department of Surgery, Indiana University , Indianapolis, IN 46202 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco M","family":"Egro","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery, University of Pittsburgh Medical Center , Pittsburgh, PA 15213 ,","place":["United States"]},{"name":"Department of Surgery, University of Pittsburgh Medical Center , Pittsburgh, PA 15213 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,9,18]]},"reference":[{"key":"2026100514072718300_ref1","doi-asserted-by":"publisher","first-page":"944","DOI":"10.1097\/sla.0000000000003447","article-title":"Trends of burn injury in the United States: 1990 to 2016","volume":"270","author":"Crowe","year":"2019","journal-title":"Ann Surg"},{"key":"2026100514072718300_ref2","doi-asserted-by":"publisher","first-page":"1095","DOI":"10.1093\/jbcr\/irae053","article-title":"The burden of burns: an analysis of public health measures","volume":"45","author":"Ivanko","year":"2024","journal-title":"J Burn Care Res"},{"key":"2026100514072718300_ref3","doi-asserted-by":"publisher","first-page":"e5100","DOI":"10.1097\/gox.0000000000005100","article-title":"Autologous skin grafts, versus tissue-engineered skin constructs: a systematic review and meta-analysis","volume":"11","author":"Kianian","year":"2023","journal-title":"Plast Reconstr Surg Glob Open"},{"key":"2026100514072718300_ref4","doi-asserted-by":"publisher","first-page":"e218","DOI":"10.1097\/gox.0000000000000176","article-title":"Epidermal healing in burns: autologous keratinocyte transplantation as a standard procedure: update and perspective","volume":"2","author":"McHeik","year":"2014","journal-title":"Plast Reconstr Surg Glob Open"},{"key":"2026100514072718300_ref5","doi-asserted-by":"publisher","first-page":"1245","DOI":"10.1016\/j.bjps.2019.04.013","article-title":"Is allograft skin, the gold-standard for burn skin substitute? 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