{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T09:09:16Z","timestamp":1788858556871,"version":"build-2803163510"},"reference-count":21,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T00:00:00Z","timestamp":1788566400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004921","name":"Fundamental Research Funds for the Central Universities","doi-asserted-by":"publisher","award":["YG2024LC10"],"award-info":[{"award-number":["YG2024LC10"]}],"id":[{"id":"10.13039\/501100004921","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003399","name":"Shanghai 2024 Action Plan for Science, Technology and Innovation, Innovative Medical Products Application Demonstration Project","doi-asserted-by":"publisher","award":["24SF1906100"],"award-info":[{"award-number":["24SF1906100"]}],"id":[{"id":"10.13039\/501100003399","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Clin. Med.","JCM"],"abstract":"<jats:p>Background\/Objectives: It is uncertain whether intraoperative blood pressure (BP) summaries improve transportable prediction of prolonged postoperative length of stay (PLOS) after lung resection. We developed and temporally validated baseline and BP-enhanced models and evaluated their unchanged performance in the Korean VitalDB cohort. Methods: This retrospective prediction-model study used 536 local patients (249 PLOS events) for development and 184 later patients (74 events) for temporal validation. External validation included 626 procedure-restricted VitalDB patients; paired model comparisons used 624 patients with all four BP features. PLOS was a prespecified operational outcome defined as postoperative stay &gt; 4 days. L2-penalized logistic models were assessed using nested cross-validation, discrimination, calibration, Brier score, and decision-curve analysis. Results: Baseline-model AUROCs were 0.714 (95% confidence interval [CI], 0.667\u20130.756) internally, 0.719 (0.640\u20130.788) temporally, and 0.623 (0.579\u20130.666) externally. Corresponding BP-enhanced AUROCs were 0.721, 0.725, and 0.615. BP features changed temporal AUROC by +0.006 (95% CI, \u22120.009 to +0.021) and external AUROC by \u22120.007 (\u22120.022 to +0.008). Temporal calibration slopes were 1.113 and 1.112, whereas external slopes were 0.570 and 0.534. Sensitivity analyses showed no consistent BP increment. Conclusions: The baseline model retained similar discrimination locally but had limited unchanged external transportability. Four intraoperative BP summaries provided no reproducible incremental predictive value. Neither model is ready for direct cross-center implementation without harmonization, updating, and further validation.<\/jats:p>","DOI":"10.3390\/jcm15176887","type":"journal-article","created":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T12:12:25Z","timestamp":1788783145000},"page":"6887","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Prolonged Length of Stay After Lung Resection: A Prediction Model That Loses Accuracy Across Hospitals, with No Added Benefit from Blood Pressure Data"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-6570-5375","authenticated-orcid":false,"given":"Yuyao","family":"Zhu","sequence":"first","affiliation":[{"name":"Department of Anesthesiology, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, 241 West Huaihai Road, Xuhui District, Shanghai 200030, China"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"software","vocabulary":"credit"},{"role":"validation","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"visualization","vocabulary":"credit"},{"role":"project-administration","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-2897-1252","authenticated-orcid":false,"given":"Sunmian","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, 241 West Huaihai Road, Xuhui District, Shanghai 200030, China"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"validation","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"given":"Cheng","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, 241 West Huaihai Road, Xuhui District, Shanghai 200030, China"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"given":"Hai","family":"Chen","sequence":"additional","affiliation":[{"name":"School of Medicine, Tongji University, Shanghai 200331, China"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"methodology","vocabulary":"credit"},{"role":"validation","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2858-9668","authenticated-orcid":false,"given":"Jingxiang","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, 241 West Huaihai Road, Xuhui District, Shanghai 200030, China"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"funding-acquisition","vocabulary":"credit"},{"role":"conceptualization","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"resources","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"},{"role":"project-administration","vocabulary":"credit"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,5]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1093\/ejcts\/ezy301","article-title":"Guidelines for enhanced recovery after lung surgery: Recommendations of the Enhanced Recovery After Surgery (ERAS) Society and the European Society of Thoracic Surgeons (ESTS)","volume":"55","author":"Batchelor","year":"2019","journal-title":"Eur. 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