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Article History

Accepted: 31 July 2025

First Online: 21 August 2025

Declarations

:

: This study was supported by the National Natural Science Foundation of China (72304205, 82270349, 72274133 and 82000338), Tianjin Key Medical Discipline (Specialty) Construction Project (TJYXZDXK-069C).

: Xuefang Yu, Liang Zhao, Hangkuan Liu, Xin Zhou, Guoyan Zhao, Zhiqiang Zhang, Xilong Qian, Bin Sun, Shiyang Fang, Qing Yang, Pengfei Sun have no relevant financial or non-financial interests to disclose.

: This study received approval from the Tianjin Municipal Health Commission and conforms to ethical guidelines from the Tianjin Medical University General Hospital Ethical Committee (IRB2024-YX-338-01).

: Considering the retrospective nature of the research and the lack of direct patient interaction or privacy breaches, informed consent was deemed unnecessary.

: Not applicable.

: Data may be obtained from a third party and are not publicly available. The data that support the findings of this study are available from Tianjin Municipal Health Commission, but restrictions apply to the availability of these data, which were used under license for the current study and so are not publicly available. However, data are available from the authors upon reasonable request and with permission of the Tianjin Municipal Health Commission.

: All statistical analyses were conducted using R software (version 4.1.3, ).

: Xuefang Yu, Pengfei Sun, and Qing Yang designed the study. Guoyan Zhao, Zhiqiang Zhang, Bin Sun, and Xilong Qian extracted the dataset and performed statistical analysis. Xuefang Yu wrote the first draft. Liang Zhao, Hangkuan Liu, and Xin Zhou prepared the figures and tables, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.