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Article History

Received: 16 September 2025

Accepted: 3 March 2026

First Online: 7 March 2026

Declarations

:

: The study protocol was reviewed and approved by the Research Ethics Committee of the Armed Forces Hospitals Southern Region (AFHSR), Khamis Mushait, Saudi Arabia (Registration No. H-06-KM-001; Approval Code: AFHSRMREC/2025/ACADEMIC AFFAIRS/811) on 20 July 2025. The approval covered the retrospective secondary analysis of routinely collected electronic health records generated at AFHSR between January 2017 and April 2025 and remains valid for five years. No data were prospectively collected for research purposes prior to ethics approval. The Research Ethics Committee waived the requirement for individual informed consent because the study involved retrospective analysis of anonymized clinical data, posed minimal risk to participants, and did not involve any direct patient contact. All data were extracted from the hospital electronic health record system and fully anonymized prior to analysis, with no access to personal identifiers. The study was conducted in accordance with the principles of the Declaration of Helsinki and complied with applicable institutional policies and national regulations governing the secondary use of health data in Saudi Arabia, including relevant guidance from the Saudi Ministry of Health on informed consent and data protection.

: Not applicable.

: The authors declare no competing interests.