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Article History

Received: 30 August 2025

Accepted: 30 December 2025

First Online: 15 January 2026

Declarations

:

: This study was deemed exempt from Institutional Review Board (IRB) approval, as it involved only secondary analysis of de-identified data. The research was conducted in accordance with the principles outlined in the Declaration of Helsinki and adheres to all HCUP data use agreements.

: Not applicable. This study used the Nationwide Inpatient Sample (NIS), a publicly available, de-identified administrative database provided by the Healthcare Cost and Utilization Project (HCUP) and the Agency for Healthcare Research and Quality (AHRQ). As such, no individual-level identifying information was accessed, and patient consent was not required.

: Not applicable.

: The authors declare no competing interests.

: The study was conducted under exempt status granted by the institutional review board, and the requirement for informed consent was waived due to the de-identified nature of the NIS dataset.

: Not applicable. Ethical approval was not required due to the de-identified nature of the data.

: Not applicable. All data were anonymized prior to analysis, and no human participants were directly involved.