In this era of expanding availability of ML models, external validation and retraining are key steps to consider before applying machine learning (ML) models to new settings.

Clinicians and decision-makers should take this into account when considering applying new ML models to their local settings.

We assessed discrimination by area under the receiver operating characteristic curve (AUC) and calibration (slope and intercept).

We retrained and recalibrated the original model and assessed performance via a temporal validation design.

The final retrained model was cross-validated on all data from the new site.

Readmission or death within 7 days after ICU discharge occurred in 577 of 10,052 ICU admissions (5.7%) at the new site.

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