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Article History

Received: 12 July 2025

Accepted: 21 September 2025

First Online: 16 October 2025

Declarations

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: After approval from the Ethics Committee of the Japanese Association for the Surgery of Trauma, each participating institution, and the Ethical Guidelines for Medical and Health Research Involving Human Subjects published by the Ministry of Health, Labor, and Welfare of Japan, informed consent was waived for registration in the Japan Trauma Data Bank (JTDB). The approval document from the Japanese Association for the Surgery of Trauma and the Representative Institution (National Defense Medical College Research Institute) is available on the JTDB website () (Approval ID No. 2548). Use of the JTDB data was also approved by our institution (Approval No. S2019-12).

: GF received a research grant from the Japan Society for the Promotion of Science, KI received research grants from the Japan Society for the Promotion of Science, the Japan Agency for Medical Research and Development, and the Japan Science and Technology. KI has received consulting fees from Cancerscan, Cykinso, Kagome, and Mizkan outside of this work. NH serves as the chair of a department supported by a donation from Nxera Pharma Co., Ltd. YO received a research grant from the ZOLL Foundation and overseas scholarships from the Japan Society for the Promotion of Science, FUKUDA Foundation for Medical Technology, and the International Medical Research Foundation.