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Article History

Received: 29 June 2025

Accepted: 20 November 2025

First Online: 22 December 2025

Declarations

:

: The study was approved by the Ethics Council in Biomedical Research at Phu San Hanoi Hospital (2091 CN/PS), which specifically authorized the use of an opt-out consent procedure, and was conducted in accordance with the Declaration of Helsinki and CIOMS Ethical Guidelines [ , ]. Approval for data management was also granted by the Swedish Ethical Review Authority (2023-04610-01).Because the study was non-interventional, involved no deviation from routine clinical care, posed no additional risk, and relied solely on secondary data obtained from medical records, written informed consent from all caregivers was deemed impracticable given the large patient volume. In accordance with the ethics committee approval, parents or legal guardians of participants who were minors received verbal and written information in Vietnamese and were informed that health-related data would be used unless they actively declined participation through the informed opt-out consent procedure. Caregivers were clearly informed that participation was voluntary and that they could decline or withdraw their child’s data at any time without any consequences. Data were included only for patients whose parents or legal guardians did not opt out [ ].

: Not applicable.

: The authors declare no competing interests.