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Article History

Received: 1 November 2024

Accepted: 12 March 2025

First Online: 1 May 2025

Declarations

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: The views expressed in this publication represent those of the authors and do not necessarily represent the official views of Hospital Corporation of America (HCA) Healthcare or any of its affiliated entities. Research was conducted with respect to principles of the Belmont Report and Declaration of Helsinki. This research was supported in whole or in part by HCA Healthcare and/or an HCA Healthcare affiliated entity. The views expressed in this publication represent those of the authors and do not necessarily represent the official views of HCA Healthcare or any of its affiliated entities.This study protocol was reviewed and approved by HCA Healthcare PUBCLEAR (Project #24–1742) and determined to be non-human subject research. Ethics approval was waived, and Institutional Review Board (IRB) oversight was not required, as determined by the Centralized Algorithms for Research Rules on IRB Exemption (Submission ID #: 2024–519), in accordance with 45 CFR 46.102(e), which defines what constitutes human subjects research, which clarifies that this study does not involve "human subjects" as defined by U.S. federal regulations. Anonymized data were extracted from HCA Healthcare electronic health records for all initial encounters meeting the inclusion criteria. All patients had accepted the possibility of their results being de-identified prior to record creation.

: Not applicable.

: The authors declare no competing interests.