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Article History

Received: 8 January 2026

Accepted: 26 February 2026

First Online: 10 March 2026

Declarations

:

: This study was approved by the Ethics Committee of the University of Yamanashi (approval no. 2086) and was conducted in accordance with the Declaration of Helsinki and relevant national guidelines for medical and health research involving human subjects. Given the retrospective design and the use of data obtained from routine clinical care, the requirement for written informed consent was waived by the Ethics Committee. An opt-out approach was used; study information was posted in the ED waiting area, and patients were given an opportunity to refuse participation. All data were de-identified prior to analysis, and no directly identifiable personal information was included in the analytic dataset.

: Not applicable.

: The authors declare no competing interests.