{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T09:47:34Z","timestamp":1791625654259,"version":"4.3.4"},"reference-count":42,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,4,30]],"date-time":"2025-04-30T00:00:00Z","timestamp":1745971200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,4,30]],"date-time":"2025-04-30T00:00:00Z","timestamp":1745971200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World J Emerg Surg"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Frailty and sarcopenia have been independently shown to predict mortality in emergency laparotomy (EmLap), and both can be indicative of poor physical status. We aim to assess the prevalence of frailty, sarcopenia, and physical status in EmLap and explore the relationship between these factors and 30-day, 90-day and 1-year mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Retrospective analysis was performed on prospectively maintained Emergency Laparotomy and Laparoscopic Scottish Audit (ELLSA) database (2017\u20132019) which included patients\u2009\u2265\u200918 years who underwent EmLap. Clinical frailty scale (CFS) was used to classify frailty (score\u2009\u2265\u20094 as frail). Sarcopenia was assessed using total psoas index (TPI). Poor physical status (PPS) was defined by American Society of Anaesthesiologists physical status classification (ASA)\u2009\u2265\u20094. Binary logistic regression and fisher\u2019s exact tests were used for statistical analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      215 patients were included in the study, with 57.2% female and median age of 64 years. Frailty was present in 17.2%, sarcopenia in 25.1% and 14.4% had PPS; 3.3% had all three factors. Frail patients had significantly higher risk for 30-day (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.003), 90-day (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.006) and 1-year mortality (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.032). Patients with poor physical status also showed significantly higher mortality at 30-day (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), 90-day (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and 1-year (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001). Sarcopenic patients did not show significant differences in mortality risks up to 1 year. Patients with all three factors had significantly higher 30-day (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.003), 90-day (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.046) and 1-year mortality (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.108) compared to patients who had none of the factors.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Frailty, sarcopenia, and PPS are prevalent in EmLap. Frailty and PPS were independently associated with short and long-term mortality, but not sarcopenia. While overlap exists between three factors, more research is required to understand the complex interplay.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s13017-025-00588-5","type":"journal-article","created":{"date-parts":[[2025,4,30]],"date-time":"2025-04-30T01:20:53Z","timestamp":1745976053000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["The influence between frailty, sarcopenia and physical status on mortality in patients undergoing emergency laparotomy"],"prefix":"10.1186","volume":"20","author":[{"given":"May Myat","family":"Thu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hwei Jene","family":"Ng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"Moug","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,4,30]]},"reference":[{"issue":"3","key":"588_CR1","doi-asserted-by":"publisher","first-page":"218","DOI":"10.1002\/bjs.11392","volume":"107","author":"B Carter","year":"2020","unstructured":"Carter B, Law J, Hewitt J, Parmar KL, Boyle JM, Casey P, et al. Association between preadmission frailty and care level at discharge in older adults undergoing emergency laparotomy. Br J Surg. 2020;107(3):218\u201326.","journal-title":"Br J Surg"},{"issue":"4","key":"588_CR2","doi-asserted-by":"publisher","first-page":"709","DOI":"10.1097\/SLA.0000000000003402","volume":"273","author":"KL Parmar","year":"2021","unstructured":"Parmar KL, Law J, Carter B, Hewitt J, Boyle JM, Casey P, et al. Frailty in older patients undergoing emergency laparotomy: results from the UK Observational Emergency Laparotomy and Frailty (ELF) Study. Ann Surg. 2021;273(4):709\u201318.","journal-title":"Ann Surg"},{"issue":"4","key":"588_CR3","first-page":"219","volume":"6","author":"R Smart","year":"2017","unstructured":"Smart R, Carter B, McGovern J, Luckman S, Connelly A, Hewitt J, et al. Frailty exists in younger adults admitted as Surgical Emergency leading to adverse outcomes. J Frailty Aging. 2017;6(4):219\u201323.","journal-title":"J Frailty Aging"},{"issue":"9868","key":"588_CR4","doi-asserted-by":"publisher","first-page":"752","DOI":"10.1016\/S0140-6736(12)62167-9","volume":"381","author":"A Clegg","year":"2013","unstructured":"Clegg A, Young J, Iliffe S, Rikkert MO, Rockwood K. Frailty in elderly people. Lancet. 2013;381(9868):752\u201362.","journal-title":"Lancet"},{"issue":"4","key":"588_CR5","doi-asserted-by":"publisher","first-page":"305","DOI":"10.14283\/jfa.2023.30","volume":"12","author":"N Humphry","year":"2023","unstructured":"Humphry N, Jones M, Goodison S, Carter B, Hewitt J. The Effect of Sarcopenia on postoperative outcomes following emergency laparotomy: a systematic review and Meta-analysis. J Frailty Aging. 2023;12(4):305\u201310.","journal-title":"J Frailty Aging"},{"issue":"9","key":"588_CR6","doi-asserted-by":"publisher","first-page":"1593","DOI":"10.1007\/s11605-015-2835-y","volume":"19","author":"N Amini","year":"2015","unstructured":"Amini N, Spolverato G, Gupta R, Margonis GA, Kim Y, Wagner D, et al. Impact total psoas volume on short- and long-term outcomes in patients undergoing curative resection for pancreatic adenocarcinoma: a New Tool to assess Sarcopenia. J Gastrointest Surg. 2015;19(9):1593\u2013602.","journal-title":"J Gastrointest Surg"},{"issue":"5","key":"588_CR7","first-page":"363","volume":"70","author":"K Takagi","year":"2016","unstructured":"Takagi K, Yagi T, Yoshida R, Shinoura S, Umeda Y, Nobuoka D, et al. Sarcopenia and American Society of Anesthesiologists Physical Status in the Assessment of Outcomes of Hepatocellular Carcinoma patients undergoing Hepatectomy. Acta Med Okayama. 2016;70(5):363\u201370.","journal-title":"Acta Med Okayama"},{"issue":"11","key":"588_CR8","doi-asserted-by":"publisher","first-page":"O256","DOI":"10.1111\/codi.13067","volume":"17","author":"DD Huang","year":"2015","unstructured":"Huang DD, Wang SL, Zhuang CL, Zheng BS, Lu JX, Chen FF, et al. Sarcopenia, as defined by low muscle mass, strength and physical performance, predicts complications after surgery for colorectal cancer. Colorectal Dis. 2015;17(11):O256\u201364.","journal-title":"Colorectal Dis"},{"issue":"13","key":"588_CR9","doi-asserted-by":"publisher","first-page":"e3164","DOI":"10.1097\/MD.0000000000003164","volume":"95","author":"CL Zhuang","year":"2016","unstructured":"Zhuang CL, Huang DD, Pang WY, Zhou CJ, Wang SL, Lou N, et al. Sarcopenia is an independent predictor of severe postoperative complications and long-term Survival after Radical Gastrectomy for gastric Cancer: analysis from a large-scale cohort. Med (Baltim). 2016;95(13):e3164.","journal-title":"Med (Baltim)"},{"issue":"9","key":"588_CR10","doi-asserted-by":"publisher","first-page":"877","DOI":"10.1007\/s10151-019-02072-0","volume":"23","author":"DR Dolan","year":"2019","unstructured":"Dolan DR, Knight KA, Maguire S, Moug SJ. The relationship between Sarcopenia and survival at 1 year in patients having elective colorectal cancer surgery. Tech Coloproctol. 2019;23(9):877\u201385.","journal-title":"Tech Coloproctol"},{"key":"588_CR11","unstructured":"Anesthesiologists ASo. ASA Physical Status Classification System Internet2022 [cited 2023 8 February]. Available from: https:\/\/www.asahq.org\/standards-and-guidelines\/asa-physical-status-classification-system"},{"key":"588_CR12","doi-asserted-by":"crossref","unstructured":"Aggarwal G, Broughton KJ, Williams LJ, Peden CJ, Quiney N. Early postoperative death in patients undergoing emergency high-risk surgery: towards a better understanding of patients for whom surgery may not be beneficial. J Clin Med. 2020;9(5).","DOI":"10.3390\/jcm9051288"},{"issue":"4","key":"588_CR13","doi-asserted-by":"publisher","first-page":"20","DOI":"10.7603\/s40681-015-0020-y","volume":"5","author":"DS Nag","year":"2015","unstructured":"Nag DS. Assessing the risk: Scoring systems for outcome prediction in emergency laparotomies. Biomed (Taipei). 2015;5(4):20.","journal-title":"Biomed (Taipei)"},{"key":"588_CR14","doi-asserted-by":"publisher","first-page":"743","DOI":"10.1016\/j.amsu.2020.11.089","volume":"60","author":"M Akhtar","year":"2020","unstructured":"Akhtar M, Donnachie DJ, Siddiqui Z, Ali N, Uppara M. Hierarchical regression of ASA prediction model in predicting mortality prior to performing emergency laparotomy a systematic review. Ann Med Surg (Lond). 2020;60:743\u20139.","journal-title":"Ann Med Surg (Lond)"},{"issue":"3","key":"588_CR15","doi-asserted-by":"publisher","first-page":"202","DOI":"10.1308\/rcsann.2021.0156","volume":"104","author":"K Nicoll","year":"2022","unstructured":"Nicoll K, Lucocq J, Khalil T, Khalil M, Watson H, Patil P. Follow-up after emergency laparotomy suggests high one- and five-year mortality with risk stratified by ASA. Ann R Coll Surg Engl. 2022;104(3):202\u20139.","journal-title":"Ann R Coll Surg Engl"},{"key":"588_CR16","unstructured":"Resources SGHaSC. Emergency laparotomy and laparoscopic Scottish audit (ELLSA) Internet [cited 2023 8 February]. Available from: https:\/\/learn.nes.nhs.scot\/13211\/scottish-government-health-and-social-care-resources\/modernising-patient-pathways-programme\/enhanced-recovery-after-surgery-eras-in-scotland\/emergency-laparotomy-and-laparoscopic-scottish-audit-ellsa"},{"key":"588_CR17","unstructured":"Audit Inclusion & Exclusion Criteria: National Emergency Laparotomy Audit (NELA). 2017 [cited 2023 8 February]. Available from: https:\/\/www.nela.org.uk\/Criteria"},{"issue":"6","key":"588_CR18","doi-asserted-by":"publisher","first-page":"771","DOI":"10.1002\/jso.23862","volume":"111","author":"S Joglekar","year":"2015","unstructured":"Joglekar S, Asghar A, Mott SL, Johnson BE, Button AM, Clark E, et al. Sarcopenia is an independent predictor of complications following pancreatectomy for adenocarcinoma. J Surg Oncol. 2015;111(6):771\u20135.","journal-title":"J Surg Oncol"},{"issue":"2","key":"588_CR19","doi-asserted-by":"publisher","first-page":"271","DOI":"10.1016\/j.jamcollsurg.2010.03.039","volume":"211","author":"MJ Englesbe","year":"2010","unstructured":"Englesbe MJ, Patel SP, He K, Lynch RJ, Schaubel DE, Harbaugh C, et al. Sarcopenia and mortality after liver transplantation. J Am Coll Surg. 2010;211(2):271\u20138.","journal-title":"J Am Coll Surg"},{"issue":"8","key":"588_CR20","doi-asserted-by":"publisher","first-page":"1478","DOI":"10.1007\/s11605-012-1923-5","volume":"16","author":"P Peng","year":"2012","unstructured":"Peng P, Hyder O, Firoozmand A, Kneuertz P, Schulick RD, Huang D, et al. Impact of Sarcopenia on outcomes following resection of pancreatic adenocarcinoma. J Gastrointest Surg. 2012;16(8):1478\u201386.","journal-title":"J Gastrointest Surg"},{"issue":"6","key":"588_CR21","doi-asserted-by":"publisher","first-page":"1179","DOI":"10.1097\/TA.0000000000001657","volume":"83","author":"EL Rangel","year":"2017","unstructured":"Rangel EL, Rios-Diaz AJ, Uyeda JW, Castillo-Angeles M, Cooper Z, Olufajo OA, et al. Sarcopenia increases risk of long-term mortality in elderly patients undergoing emergency abdominal surgery. J Trauma Acute Care Surg. 2017;83(6):1179\u201386.","journal-title":"J Trauma Acute Care Surg"},{"issue":"5","key":"588_CR22","doi-asserted-by":"publisher","first-page":"489","DOI":"10.1503\/cmaj.050051","volume":"173","author":"K Rockwood","year":"2005","unstructured":"Rockwood K, Song X, MacKnight C, Bergman H, Hogan DB, McDowell I, et al. A global clinical measure of fitness and frailty in elderly people. CMAJ. 2005;173(5):489\u201395.","journal-title":"CMAJ"},{"issue":"3","key":"588_CR23","doi-asserted-by":"publisher","first-page":"210","DOI":"10.5770\/cgj.23.463","volume":"23","author":"K Rockwood","year":"2020","unstructured":"Rockwood K, Theou O. Using the clinical Frailty Scale in allocating Scarce Health Care resources. Can Geriatr J. 2020;23(3):210\u20135.","journal-title":"Can Geriatr J"},{"issue":"6","key":"588_CR24","doi-asserted-by":"publisher","first-page":"e307","DOI":"10.1016\/j.surge.2021.11.009","volume":"20","author":"CA Kennedy","year":"2022","unstructured":"Kennedy CA, Shipway D, Barry K. Frailty and emergency abdominal surgery: a systematic review and meta-analysis. Surgeon. 2022;20(6):e307\u201314.","journal-title":"Surgeon"},{"issue":"6","key":"588_CR25","doi-asserted-by":"publisher","first-page":"1095","DOI":"10.1007\/s00384-020-03570-6","volume":"35","author":"G Simpson","year":"2020","unstructured":"Simpson G, Manu N, Magee C, Wilson J, Moug S, Vimalachandran D. Measuring Sarcopenia on pre-operative CT in older adults undergoing emergency laparotomy: a comparison of three different calculations. Int J Colorectal Dis. 2020;35(6):1095\u2013102.","journal-title":"Int J Colorectal Dis"},{"issue":"1","key":"588_CR26","doi-asserted-by":"publisher","first-page":"e000500","DOI":"10.1136\/tsaco-2020-000500","volume":"5","author":"JM Wohlgemut","year":"2020","unstructured":"Wohlgemut JM, Ramsay G, Griffin RL, Jansen JO. Impact of deprivation and comorbidity on outcomes in emergency general surgery: an epidemiological study. Trauma Surg Acute Care Open. 2020;5(1):e000500.","journal-title":"Trauma Surg Acute Care Open"},{"issue":"9","key":"588_CR27","doi-asserted-by":"publisher","first-page":"1942","DOI":"10.1007\/s11605-022-05372-3","volume":"26","author":"AT Ylimartimo","year":"2022","unstructured":"Ylimartimo AT, Lahtinen S, Nurkkala J, Koskela M, Kaakinen T, Vakkala M, et al. Long-term outcomes after Emergency Laparotomy: a retrospective study. J Gastrointest Surg. 2022;26(9):1942\u201350.","journal-title":"J Gastrointest Surg"},{"issue":"11","key":"588_CR28","doi-asserted-by":"publisher","first-page":"1347","DOI":"10.1111\/acem.14493","volume":"29","author":"JH Lee","year":"2022","unstructured":"Lee JH, Park YS, Kim MJ, Shin HJ, Roh YH, Kim JH, et al. Clinical Frailty Scale as a predictor of short-term mortality: a systematic review and meta-analysis of studies on diagnostic test accuracy. Acad Emerg Med. 2022;29(11):1347\u201356.","journal-title":"Acad Emerg Med"},{"key":"588_CR29","doi-asserted-by":"crossref","unstructured":"Park B, Alani Z, Sulistio E, Barazanchi AWH, Koea J, Vandal A et al. Frailty using the clinical Frailty Scale to predict short- and long-term adverse outcomes following emergency laparotomy: meta-analysis. BJS Open. 2024;8(4).","DOI":"10.1093\/bjsopen\/zrae078"},{"issue":"3","key":"588_CR30","doi-asserted-by":"publisher","first-page":"231","DOI":"10.1308\/rcsann.2021.0331","volume":"105","author":"M Thomas","year":"2023","unstructured":"Thomas M, Baltatzis M, Price A, Fox J, Pearce L, Vilches-Moraga A. The influence of frailty on outcomes for older adults admitted to hospital with benign biliary disease: a single-centre, observational cohort study. Ann R Coll Surg Engl. 2023;105(3):231\u201340.","journal-title":"Ann R Coll Surg Engl"},{"issue":"11","key":"588_CR31","doi-asserted-by":"publisher","first-page":"2367","DOI":"10.1007\/s40520-020-01578-0","volume":"32","author":"A Vilches-Moraga","year":"2020","unstructured":"Vilches-Moraga A, Rowley M, Fox J, Khan H, Paracha A, Price A, et al. Emergency laparotomy in the older patient: factors predictive of 12-month mortality-Salford-POPS-GS. An observational study. Aging Clin Exp Res. 2020;32(11):2367\u201373.","journal-title":"Aging Clin Exp Res"},{"key":"588_CR32","unstructured":"NELA Fifth Patient Report: National Emergency Laparotomy Audit (NELA). 2019 [cited 2023 8 February]. Available from: https:\/\/www.nela.org.uk\/Fifth-Patient-NELA-Report"},{"issue":"1","key":"588_CR33","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1186\/s12877-021-02679-9","volume":"22","author":"T Knight","year":"2022","unstructured":"Knight T, Atkin C, Martin FC, Subbe C, Holland M, Cooksley T, et al. Frailty assessment and acute frailty service provision in the UK: results of a national \u2018day of care\u2019 survey. BMC Geriatr. 2022;22(1):19.","journal-title":"BMC Geriatr"},{"key":"588_CR34","unstructured":"NELA Eighth Patient Report: National Emergency Laparotomy Audit (NELA). 2023 [cited 2023 13 February]. Available from: https:\/\/www.nela.org.uk\/Eighth-Patient-Report#pt"},{"issue":"1","key":"588_CR35","doi-asserted-by":"publisher","first-page":"190","DOI":"10.1186\/s12893-023-02093-5","volume":"23","author":"HJ Ng","year":"2023","unstructured":"Ng HJ, Quasim T, Rattray NJW, Moug S. Investigation of frailty markers including a novel biomarker panel in emergency laparotomy: protocol of a prospective cohort study. BMC Surg. 2023;23(1):190.","journal-title":"BMC Surg"},{"issue":"3","key":"588_CR36","doi-asserted-by":"publisher","first-page":"399","DOI":"10.1097\/TA.0000000000000764","volume":"79","author":"CE Cauley","year":"2015","unstructured":"Cauley CE, Panizales MT, Reznor G, Haynes AB, Havens JM, Kelley E, et al. Outcomes after emergency abdominal surgery in patients with advanced cancer: opportunities to reduce complications and improve palliative care. J Trauma Acute Care Surg. 2015;79(3):399\u2013406.","journal-title":"J Trauma Acute Care Surg"},{"issue":"1","key":"588_CR37","doi-asserted-by":"publisher","first-page":"59","DOI":"10.1007\/s00423-024-03252-9","volume":"409","author":"S Hajibandeh","year":"2024","unstructured":"Hajibandeh S, Brown C, Harper ER, Saji AP, Hughes I, Mitra K, et al. Sarcopenia versus clinical frailty scale in predicting the risk of postoperative mortality after emergency laparotomy: a retrospective cohort study. Langenbecks Arch Surg. 2024;409(1):59.","journal-title":"Langenbecks Arch Surg"},{"key":"588_CR38","doi-asserted-by":"crossref","unstructured":"Saji AP, Ioan H, Hajibandeh S, Alessandri G, Duncan T. Development and Validation of HAS (Hajibandeh Index, ASA Status, Sarcopenia) - a Novel Model for Predicting Mortality after Emergency Laparotomy. British Journal of Surgery; 2024.","DOI":"10.1093\/bjs\/znae046.090"},{"issue":"1","key":"588_CR39","doi-asserted-by":"publisher","first-page":"436","DOI":"10.1016\/j.surg.2022.02.014","volume":"172","author":"B Park","year":"2022","unstructured":"Park B, Bhat S, Wells CI, Barazanchi AWH, Hill AG, MacCormick AD. Short- and long-term impact of Sarcopenia on outcomes after emergency laparotomy: a systematic review and meta-analysis. Surgery. 2022;172(1):436\u201345.","journal-title":"Surgery"},{"key":"588_CR40","doi-asserted-by":"crossref","unstructured":"Yang T-r, Luo K, Deng X, Xu L, Wang R-r, Ji P. Effect of Sarcopenia in predicting postoperative mortality in emergency laparotomy: a systematic review and meta-analysis. World Journal of Emergency Surgery; 2022.","DOI":"10.1186\/s13017-022-00440-0"},{"issue":"7","key":"588_CR41","doi-asserted-by":"publisher","first-page":"e323","DOI":"10.1016\/S2468-2667(18)30091-4","volume":"3","author":"P Hanlon","year":"2018","unstructured":"Hanlon P, Nicholl BI, Jani BD, Lee D, McQueenie R, Mair FS. Frailty and pre-frailty in middle-aged and older adults and its association with multimorbidity and mortality: a prospective analysis of 493\u2008737 UK Biobank participants. Lancet Public Health. 2018;3(7):e323\u201332.","journal-title":"Lancet Public Health"},{"key":"588_CR42","doi-asserted-by":"publisher","first-page":"64","DOI":"10.1186\/1471-2318-13-64","volume":"13","author":"K Bouillon","year":"2013","unstructured":"Bouillon K, Kivimaki M, Hamer M, Sabia S, Fransson EI, Singh-Manoux A, et al. Measures of frailty in population-based studies: an overview. BMC Geriatr. 2013;13:64.","journal-title":"BMC Geriatr"}],"container-title":["World Journal of Emergency Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13017-025-00588-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s13017-025-00588-5\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13017-025-00588-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,30]],"date-time":"2025-04-30T01:20:58Z","timestamp":1745976058000},"score":1,"resource":{"primary":{"URL":"https:\/\/wjes.biomedcentral.com\/articles\/10.1186\/s13017-025-00588-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,30]]},"references-count":42,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["588"],"URL":"https:\/\/doi.org\/10.1186\/s13017-025-00588-5","relation":{},"ISSN":["1749-7922"],"issn-type":[{"value":"1749-7922","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4,30]]},"assertion":[{"value":"21 August 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"30 January 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"30 April 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable, as this is a retrospective study. Study approval was obtained from NHS National Services Caldicott on 23\/11\/2021.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"Not applicable.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Humans ethics and consent to participate"}},{"value":"The authors declare no competing interests.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"38"}}