Machine Learning-based Diagnostic Model Combined with Chinese Natural Language Processing for Surgical Site Infections: Development and Validation.

BACKGROUND: Surgical site infections (SSI) is a major healthcare-associated complication, yet early detection remains challenging. OBJECTIVE: To develop and validate a machine learning-based predictive model for the detection of SSI in Chinese surgical patients. METHODS: A multicenter cohort study was conducted at two tertiary hospitals in China. Data from 118,314 patients who underwent surgery between June 2023 and December 2024 were used for model development and validation. Clinical, microbiological, and demographic variables were considered as predictors. Multiple machine learning algorithms were applied, with hyperparameter tuning and cross-validation. Model performance was evaluated using area under the curve (AUC), sensitivity, specificity, and accuracy. RESULTS: The decision tree model demonstrated robust predictive performance, achieving an AUC of 0.92 in the development cohort and 0.90 in the validation cohort. Sensitivity and specificity values confirmed its effectiveness in identifying patients at elevated risk of SSIs. Performance remained stable across subgroups. CONCLUSIONS: This study established and externally validated a machine learning-based model for SSI prediction in surgical patients. The model showed strong and consistent performance and may support clinical decision-making by enabling real-time, automated risk assessment.