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Article History

Received: 3 July 2025

Accepted: 9 September 2025

First Online: 6 October 2025

Competing interests

: The authors declare no competing interests.

: The study protocol was reviewed by the Medical Research Ethics Committee (MEC-U) on September 20, 2022 under reference number W22.184, declaring that the study was beyond the scope of the Dutch Medical Research in Humans Act (WMO). Subsequently our local review board reviewed the study protocol and approved the study on September 29, 2022 under reference number Z22.069.

: In this study, written informed consent was waived by the MEC-U because the research was retrospective in nature and involved the use of routinely collected data. No additional procedures, interventions, ore behavioural measures were introduced, and no active participation from subjects was required. Furthermore, the data used are pseudonymized and not directly traceable to individual patients, ensuring compliance with data protection and privacy regulations. Also in our hospital, patients are informed regarding the secondary use of healthcare data for quality improvement and scientific research according to hospital guidelines and are given the option to ‘opt-out’. Patients who have opted out are not included in this study.