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Article History

Received: 20 June 2025

Revised: 3 July 2025

Accepted: 4 August 2025

First Online: 8 August 2025

Competing interests

: The authors declare no competing interests.

: German law allows the use of anonymous electronic medical records for research purposes under certain conditions. According to this legislation, it is not necessary to obtain informed consent from patients or approval from a medical ethics committee for this type of observational study that contains no directly identifiable data. Therefore, no waiver of ethical approval was obtained from an Institutional Review Board (IRB) or ethics committee. The authors had no access to any identifying information at any moment during the analysis of the data.