{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T10:49:32Z","timestamp":1789728572635,"version":"4.0.1"},"reference-count":26,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2025,12,26]],"date-time":"2025-12-26T00:00:00Z","timestamp":1766707200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100012166","name":"National Key Research and Development Program of China","doi-asserted-by":"publisher","award":["2021YFC2500500"],"award-info":[{"award-number":["2021YFC2500500"]}],"id":[{"id":"10.13039\/501100012166","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background\/Objectives: Post-thrombotic syndrome (PTS) following unprovoked deep vein thrombosis (DVT) lacks readily available, calibrated risk estimates at defined follow-up horizons. Building on signals that thrombus burden, care processes, and a form of metabolic\u2013inflammatory tone influence outcomes, we prospectively evaluated survival machine-learning models, explicitly including hyperuricemia while excluding what we consider major inflammatory confounders. Methods: Adults with first-episode unprovoked lower-extremity DVT were enrolled at two centers (July 2024\u2013September 2025). PTS (Villalta) was assessed at 3, 6, 9, and 12 months. The cohort was split 70\/30 into training and test sets. Eight learners (RSF, GBM, LASSO + Cox, CoxBoost, survivalsvm, XGBoost-Cox, superpc, and plsRcox) were tuned using 10-fold cross-validation in training and once evaluated in the independent test set. Performance metrics included all time-dependent AUCs, fixed-time ROC AUCs with bootstrap 95% CIs, C-index, various forms of calibration, decision-curve analysis, and simple Kaplan\u2013Meier risk group separation. Results: 193 patients were analyzed (PTS in 64%). High 9-month AUCs were seen in training: GBM (0.992) and RSF (0.982) being the strongest; by 12 months, both remained near constant. Test set performance followed a similar pattern, with RSF again favored (AUC 0.948) and XGBoost\/GBM close behind. Calibration was satisfactory, net benefit from decision curves positive, and to a large extent, risk groups were separated as expected. Conclusions: Survival machine-learning models, at least in this dual-center prospective cohort, produced a clinically useful risk of PTS. Hyperuricemia, or any metabolically based signal, is a valuable addition to the \u201canatomy and care\u201d of DVT. External validation is still required.<\/jats:p>","DOI":"10.3390\/diagnostics16010088","type":"journal-article","created":{"date-parts":[[2025,12,29]],"date-time":"2025-12-29T08:47:27Z","timestamp":1766998047000},"page":"88","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Hyperuricemia-Informed Survival Machine-Learning Prediction of Post-Thrombotic Syndrome After Unprovoked DVT: A Dual-Center Prospective Study"],"prefix":"10.3390","volume":"16","author":[{"given":"Yajing","family":"Li","sequence":"first","affiliation":[{"name":"Department of Vascular Surgery, Xuanwu Hospital, Capital Medical University, Beijing 100053, China"},{"name":"Department of Vascular Surgery, Fu Xing Hospital, Capital Medical University (FXH-CMU), Beijing 100038, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongru","family":"Deng","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, Fu Xing Hospital, Capital Medical University (FXH-CMU), Beijing 100038, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-4454-5717","authenticated-orcid":false,"given":"Yongquan","family":"Gu","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, Xuanwu Hospital, Capital Medical University, Beijing 100053, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,12,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"874","DOI":"10.1177\/17085381231158833","article-title":"Do treatment methods for deep vein thrombosis have different effects on post-thrombotic syndrome and the quality of life?","volume":"32","year":"2024","journal-title":"Vascular"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1016\/j.avsg.2022.03.002","article-title":"Determinants of Quality of Life in Patients with Post-Thrombotic Syndrome","volume":"85","author":"Silva","year":"2022","journal-title":"Ann. 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