SBU conceived and designed the study, coordinated the data analysis, drafted the manuscript, and served as the corresponding author. BÖ contributed to data interpretation, manuscript writing, and critical revision of the manuscript. KÖ performed the statistical analyses, contributed to data visualization, and critically reviewed the manuscript for important intellectual content. MHU participated in data collection and patient follow-up and critically reviewed the manuscript. GG contributed to the literature review, clinical interpretation of the findings, and critical revision of the manuscript. DBG assisted in data verification, ethical documentation, and critical revision of the manuscript. MG contributed to the study design, supervised the overall project, and critically reviewed the manuscript for important intellectual content. All authors read and approved the final manuscript. All authors agree to be accountable for all aspects of the work.

The study was conducted in accordance with the principles of the Declaration of Helsinki. Ethical approval was obtained from the Ethics Committee of the University of Health Sciences, Bursa Yüksek İhtisas Training and Research Hospital (approval date: February 22, 2023; protocol no: 2011-KAEK-25 2023/02-15). Written informed consent was obtained from all participants prior to inclusion in the study.

The authors sincerely thank all patients who generously agreed to participate in this study.

This research received no external funding.

The authors declare no conflict of interest.

During the preparation of this manuscript, the authors used ChatGPT-5 (OpenAI) to assist in improving the clarity and fluency of the English language and to check grammar consistency. The authors subsequently reviewed, revised, and approved all contents of the manuscript, and take full responsibility for the integrity and accuracy of the published work.