feat: derive subject status from visits

backend/app/api/v1/subjects.py

@@ -176,9 +176,10 @@ async def update_subject(
     # 基线/治疗日期是访视计划的唯一推算基准，不能用入组日期替代。
     if updated.baseline_date:
         await subject_crud.sync_visits_from_baseline(db, updated)
+        updated = await subject_crud.sync_subject_status(db, updated)
     detail = None
-    if subject_in.status and subject_in.status != old_status:
-        detail = f"参与者 {updated.subject_no} 状态 {old_status} -> {subject_in.status}"
+    if updated.status != old_status:
+        detail = f"参与者 {updated.subject_no} 状态 {old_status} -> {updated.status}"
     await audit_crud.log_action(
         db,
         study_id=study_id,

backend/app/api/v1/visits.py

@@ -98,6 +98,7 @@ async def create_visit(
                 base_date=visit_in.planned_date,
                 visit_schedule=study.visit_schedule,
             )
+    subject = await subject_crud.sync_subject_status(db, subject)
     await audit_crud.log_action(
         db,
         study_id=study_id,
@@ -147,7 +148,6 @@ async def create_early_termination(
         db,
         subject,
         SubjectUpdate(
-            status="DROPPED",
             completion_date=termination_in.termination_date,
             drop_reason=reason,
         ),
@@ -192,6 +192,7 @@ async def update_visit(
     if visit_in.actual_date and visit.window_end and visit_in.actual_date > visit.window_end:
         raise HTTPException(status_code=status.HTTP_400_BAD_REQUEST, detail="实际访视日期不能晚于访视窗口结束日期")
     updated = await visit_crud.update_visit(db, visit, visit_in)
+    await subject_crud.sync_subject_status(db, subject)
     detail = None
     if visit_in.status:
         detail = f"访视 {visit.visit_code} {visit.status} -> {visit_in.status}"
@@ -226,6 +227,7 @@ async def delete_visit(
     if not visit or visit.subject_id != subject_id or visit.study_id != study_id:
         raise HTTPException(status_code=status.HTTP_404_NOT_FOUND, detail="访视不存在")
     await visit_crud.delete_visit(db, visit)
+    await subject_crud.sync_subject_status(db, subject)
     await audit_crud.log_action(
         db,
         study_id=study_id,

backend/app/crud/subject.py

@@ -16,6 +16,55 @@ from app.models.subject import Subject
 from app.schemas.subject import SubjectCreate, SubjectUpdate
 
 
+def _visit_code(visit) -> str:
+    return str(getattr(visit, "visit_code", "") or "").strip()
+
+
+def _is_cancelled_visit(visit) -> bool:
+    return str(getattr(visit, "status", "") or "").strip().upper() == "CANCELLED"
+
+
+def _standard_visit_codes(visit_schedule: list[dict] | None) -> set[str]:
+    return {
+        str(item.get("visit_code") or "").strip()
+        for item in visit_schedule or []
+        if str(item.get("visit_code") or "").strip()
+        and str(item.get("visit_code") or "").strip() not in visit_crud.NON_TREATMENT_VISIT_CODES
+    }
+
+
+def derive_subject_status(subject, visits: Sequence[Visit], visit_schedule: list[dict] | None = None) -> str:
+    if any(_visit_code(visit) == "提前终止" and getattr(visit, "actual_date", None) for visit in visits):
+        return "DROPPED"
+
+    standard_codes = _standard_visit_codes(visit_schedule)
+    completion_visits = [
+        visit
+        for visit in visits
+        if _visit_code(visit) not in visit_crud.NON_TREATMENT_VISIT_CODES
+        and not _is_cancelled_visit(visit)
+        and getattr(visit, "planned_date", None) is not None
+    ]
+    if standard_codes:
+        standard_visits = [visit for visit in completion_visits if _visit_code(visit) in standard_codes]
+        if standard_visits:
+            latest_planned_date = max(getattr(visit, "planned_date") for visit in completion_visits)
+            latest_visits = [
+                visit for visit in completion_visits if getattr(visit, "planned_date", None) == latest_planned_date
+            ]
+            if latest_visits and all(getattr(visit, "actual_date", None) for visit in latest_visits):
+                return "COMPLETED"
+    elif completion_visits:
+        latest_planned_date = max(getattr(visit, "planned_date") for visit in completion_visits)
+        latest_visits = [visit for visit in completion_visits if getattr(visit, "planned_date", None) == latest_planned_date]
+        if latest_visits and all(getattr(visit, "actual_date", None) for visit in latest_visits):
+            return "COMPLETED"
+
+    if getattr(subject, "enrollment_date", None):
+        return "ENROLLED"
+    return "SCREENING"
+
+
 def _validate_subject_date_chain(
     *,
     screening_date: date | None,
@@ -80,6 +129,7 @@ async def create_subject(db: AsyncSession, study_id: uuid.UUID, subject_in: Subj
     await db.refresh(subject)
 
     await sync_visits_from_baseline(db, subject)
+    await sync_subject_status(db, subject)
     return subject
 
 
@@ -121,12 +171,30 @@ async def sync_visits_from_baseline(db: AsyncSession, subject: Subject) -> None:
     )
 
 
+async def sync_subject_status(db: AsyncSession, subject: Subject) -> Subject:
+    visits_result = await db.execute(select(Visit).where(Visit.subject_id == subject.id))
+    visits = list(visits_result.scalars().all())
+    study_result = await db.execute(select(Study.visit_schedule).where(Study.id == subject.study_id))
+    visit_schedule = study_result.scalar_one_or_none() or []
+    next_status = derive_subject_status(subject, visits, visit_schedule)
+    if subject.status != next_status:
+        await db.execute(
+            sa_update(Subject)
+            .where(Subject.id == subject.id)
+            .values(status=next_status)
+        )
+        await db.commit()
+        await db.refresh(subject)
+    return subject
+
+
 async def generate_default_visits(db: AsyncSession, subject: Subject) -> None:
     await sync_visits_from_baseline(db, subject)
 
 
 async def update_subject(db: AsyncSession, subject: Subject, subject_in: SubjectUpdate) -> Subject:
     update_data = subject_in.model_dump(exclude_unset=True)
+    update_data.pop("status", None)
     next_screening_date = subject.screening_date
     next_consent_date = update_data.get("consent_date", subject.consent_date)
     next_enrollment_date = update_data.get("enrollment_date", subject.enrollment_date)
@@ -146,7 +214,7 @@ async def update_subject(db: AsyncSession, subject: Subject, subject_in: Subject
         )
         await db.commit()
     await db.refresh(subject)
-    return subject
+    return await sync_subject_status(db, subject)
 
 
 def should_generate_visits_after_subject_update(

backend/tests/test_visit_schedule.py

@@ -1,7 +1,7 @@
 from datetime import date
 from types import SimpleNamespace
 
-from app.crud.subject import should_generate_visits_after_subject_update
+from app.crud.subject import derive_subject_status, should_generate_visits_after_subject_update
 from app.crud.visit import (
     build_early_termination_visit_changes,
     build_visit_schedule_dates,
@@ -227,3 +227,51 @@ def test_validate_early_termination_date_requires_date_before_last_visit_window_
         assert "提前终止日期必须早于方案最后一个计划访视窗口开始日" in str(exc)
     else:
         raise AssertionError("same-day final visit window start should not be accepted as early termination")
+
+
+def test_derive_subject_status_marks_dropped_when_early_termination_has_actual_date():
+    subject = SimpleNamespace(screening_date=date(2026, 5, 1), enrollment_date=date(2026, 5, 3))
+    visits = [
+        SimpleNamespace(visit_code="V1", planned_date=date(2026, 5, 10), actual_date=date(2026, 5, 10), status="DONE", created_at=None),
+        SimpleNamespace(visit_code="提前终止", planned_date=None, actual_date=date(2026, 5, 12), status="DONE", created_at=None),
+    ]
+
+    assert derive_subject_status(subject, visits, [{"visit_code": "V1"}]) == "DROPPED"
+
+
+def test_derive_subject_status_marks_completed_when_last_standard_visit_has_actual_date():
+    subject = SimpleNamespace(screening_date=date(2026, 5, 1), enrollment_date=date(2026, 5, 3))
+    visits = [
+        SimpleNamespace(visit_code="V1", planned_date=date(2026, 5, 10), actual_date=date(2026, 5, 10), status="DONE", created_at=None),
+        SimpleNamespace(visit_code="V2", planned_date=date(2026, 5, 17), actual_date=date(2026, 5, 17), status="DONE", created_at=None),
+    ]
+
+    assert derive_subject_status(subject, visits, [{"visit_code": "V1"}, {"visit_code": "V2"}]) == "COMPLETED"
+
+
+def test_derive_subject_status_rolls_back_to_enrolled_when_followup_after_standard_end_is_unfinished():
+    subject = SimpleNamespace(screening_date=date(2026, 5, 1), enrollment_date=date(2026, 5, 3))
+    visits = [
+        SimpleNamespace(visit_code="V1", planned_date=date(2026, 5, 10), actual_date=date(2026, 5, 10), status="DONE", created_at=None),
+        SimpleNamespace(visit_code="V2", planned_date=date(2026, 5, 17), actual_date=date(2026, 5, 17), status="DONE", created_at=None),
+        SimpleNamespace(visit_code="安全性随访", planned_date=date(2026, 5, 24), actual_date=None, status="PLANNED", created_at=None),
+    ]
+
+    assert derive_subject_status(subject, visits, [{"visit_code": "V1"}, {"visit_code": "V2"}]) == "ENROLLED"
+
+
+def test_derive_subject_status_uses_completed_standard_visit_when_extra_visit_is_before_standard_end():
+    subject = SimpleNamespace(screening_date=date(2026, 5, 1), enrollment_date=date(2026, 5, 3))
+    visits = [
+        SimpleNamespace(visit_code="V1", planned_date=date(2026, 5, 10), actual_date=date(2026, 5, 10), status="DONE", created_at=None),
+        SimpleNamespace(visit_code="安全性随访", planned_date=date(2026, 5, 12), actual_date=None, status="PLANNED", created_at=None),
+        SimpleNamespace(visit_code="V2", planned_date=date(2026, 5, 17), actual_date=date(2026, 5, 17), status="DONE", created_at=None),
+    ]
+
+    assert derive_subject_status(subject, visits, [{"visit_code": "V1"}, {"visit_code": "V2"}]) == "COMPLETED"
+
+
+def test_derive_subject_status_marks_screening_until_enrollment_date_is_filled():
+    subject = SimpleNamespace(screening_date=date(2026, 5, 1), enrollment_date=None)
+
+    assert derive_subject_status(subject, [], []) == "SCREENING"