The previously developed prediction model for ICU-AW showed poor performance in a new independent multicenter validation cohort. Model updating methods improved calibration but not discrimination.

The newly derived prediction model showed fair discrimination. This indicates that early prediction of ICU-AW is still challenging and needs further attention.

Of 349 analyzed patients in the validation cohort, 190 (54%) developed ICU-AW.

Both model calibration and discrimination of the original model were poor in the validation cohort.

The area under the receiver operating characteristics curve (AUC-ROC) was 0.60 (95% confidence interval [CI]: 0.54-0.66).

Model updating methods improved calibration but not discrimination.

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