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Article History

Received: 29 April 2025

Accepted: 2 August 2025

First Online: 20 August 2025

Declarations

:

: Not applicable as it is not a study but an observation of patients treated in the regular setting. This observation is based on a retrospective analysis of routine clinical data collected within our own department. In accordance with § 6 of the Health Data Protection Act of North Rhine-Westphalia (GDSG NRW) and § 15 (1) of the Professional Code of Conduct of the Medical Association of Westphalia-Lippe, no patient consent or formal ethics approval is required in this case, as the data were extracted exclusively from internal patient records by individuals directly involved in the patients’ clinical care. The data were handled in compliance with data protection regulations and used solely in anonymized form for scientific analysis. According to these regulations, consultation of an ethics committee is not mandatory for such departmental, retrospective, and anonymized evaluations in publicly governed institutions.

: Not applicable as data is pseudonymized and no personal information are included in the manuscript.

: The authors declare no competing interests.