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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Background</span><p id="par0005" class="elsevierStylePara elsevierViewall">Delirium is a clinical syndrome that typically affects hospitalized patients and institutionalized elderly individuals&#46; The condition is characterized by acute cognitive impairment and a fluctuating inability to maintain attention&#46; The prevalence of delirium varies depending on the study population&#44; context and diagnostic criteria employed&#44; with incidence rates ranging from 10&#37; to 80&#37;&#46;<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">1</span></a> The scarce studies that have prospectively analyzed delirium in Spain have reported a prevalence of approximately 20&#37;&#46;<a class="elsevierStyleCrossRefs" href="#bib0190"><span class="elsevierStyleSup">2&#44;3</span></a> Delirium is frequently underreported in discharge reports&#44; especially for polypathological patients with long diagnostic lists&#46; This situation could reflect a failure in the diagnosis&#44; coding errors or a truly low prevalence&#46; This relatively low figure for the phenotype in the large clinical-administrative databases could reduce the credibility of prevalence rates reported through this pathway to determine the actual situation of delirium&#46;<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">4</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Delirium in elderly hospitalized patients has been associated with severe adverse effects and an increase in hospitalization costs&#46;<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">5</span></a> A meta-analysis that investigated the mortality risk&#44; institutionalization and dementia of elderly patients with delirium showed that delirium was an independent risk factor for these 3 events&#46;<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">6</span></a> Numerous studies have shown the efficacy of delirium prevention strategies&#44; most of which are multidisciplinary and nonpharmacological&#46; The success of these strategies&#44; however&#44; is far from ideal&#46;<a class="elsevierStyleCrossRefs" href="#bib0215"><span class="elsevierStyleSup">7&#8211;11</span></a> The current recommendations on drug treatment reserve antipsychotics and other sedatives for risk situations for the patient or medical personnel or when other essential medical therapies can be interrupted&#46;<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">12</span></a> A recent meta-analysis supported multilevel interventions without clear evidence that melatonin or cholinesterase inhibitors were useful&#46;<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">1</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Given the high prevalence of delirium in hospitalized patients and its negative impact on hospitalization and on patients who are subsequently institutionalized&#44; we decided to employ the minimum basic data set &#40;MBDS&#41; to investigate the prevalence of delirium and its associated factors in Spain&#46; The MBDS is a database that hospitals of Spain&#39;s public health network must fill out and send to the Ministry of Health&#44; Consumer Affairs and Social Welfare&#46; The ultimate objective is to obtain a state standard&#44; a collection of indicators that define the activity of Spain&#39;s National Health System &#40;SNHS&#41; concerning the admissions classified using diagnosis-related groups &#40;DRGs&#41;&#46; The MBDS has been useful as a research tool in other studies conducted by the Clinical Management Workgroup of the Spanish Society of Internal Medicine&#46;<a class="elsevierStyleCrossRefs" href="#bib0240"><span class="elsevierStyleSup">12&#8211;17</span></a> In this case&#44; we employed data from more than 4&#46;5 million discharges and more than 100&#44;000 cases of delirium over a period of 8 years&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Methods</span><p id="par0020" class="elsevierStylePara elsevierViewall">We conducted a retrospective study that analyzed the information provided by the Ministry of Health&#44; Social Services and Equality from the MBDS of the discharges of patients admitted to the internal medicine departments of SNHS hospitals between January 1&#44; 2007 and December 31&#44; 2014&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">The diagnoses and procedures were coded using the 5th edition of the International Classification of Diseases-9th Revision-Clinical Modification &#40;ICD-9-CM&#41;&#46; The discharge processes were grouped using the patient classification system All Patients Diagnosis-Related Groups &#40;AP-DRG&#41; &#40;version 21&#41;&#46; The MBDS data include the classification by hospital size&#59; hospitalization conditions &#40;1&#44; emergency&#59; 2&#44; scheduled&#41;&#59; and circumstances of discharge &#40;1&#44; to home&#44; 2&#44; transfer to another hospital&#44; 3&#44; voluntary discharge&#44; 4&#44; death&#41;&#46; The main diagnosis according to the ICD-9 is the reason for admission after the examination of the patient &#40;even when there were significant complications or new independent diagnoses that are recorded as secondary diagnoses&#41;&#46; These secondary diagnoses &#40;up to 12&#41; can coexist with the main diagnosis&#46; Each patient in our series was classified into a DRG&#44; which are useful for classifying admissions by diagnosis and procedure under the assumption that patients with similar diagnoses consume similar resources and thereby incur similar expenses&#46; Each DRG has a relative weight that reflects the intensity of resources consumed&#46; To identify the patients with delirium&#44; we selected the following ICD-9 codes&#58; ICD-9-CM 298 or 293&#46;5 as the primary or secondary diagnosis in any of the diagnosis fields of the discharge report&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">We calculated the Ch arlson comorbidity index &#40;CCI&#41;<a class="elsevierStyleCrossRefs" href="#bib0270"><span class="elsevierStyleSup">18&#44;19</span></a> for each patient&#46; This index is based on the ICD categories and reflects the number and severity of the comorbidities&#46; The ICD has been adapted for use in clinical-administrative databases and assigns a weight &#40;on a scale from 1 to 16&#41;&#44; scoring up to 19 medical conditions&#46; The final score ranges from 0 to 37 &#40;a score &#8805;2 predicts a mortality &#62;50&#37; per year&#41;&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Based on the ICD-9-CM&#44; we identified the following risk factors in the primary and secondary diagnosis fields &#40;ICD-9-CM codes shown in parentheses&#41;&#58; pressure ulcer &#40;707&#42;&#41;&#44; urinary tract infection &#40;599&#46;00&#44; 590&#42;&#44; 646&#46;60&#8211;49&#44; 601&#41;&#44; sepsis &#40;038&#42;&#44; 995&#46;91&#44; 995&#46;92&#41;&#44; congestive heart failure &#40;398&#46;91&#44; 404&#42;&#44; 402&#46;11&#44; 402&#46;91&#44; 428&#8211;428&#46;9&#41;&#44; peripheral arterial disease &#40;440&#8211;448&#41;&#44; dementia &#40;290&#8211;290&#46;9&#41;&#44; cancer &#40;140&#46;0&#8211;172&#46;9&#44; 174&#46;0&#8211;195&#46;8&#44; 200&#8211;208&#46;9&#41;&#44; metastatic cancer &#40;196&#46;0&#8211;199&#46;99&#41;&#44; cerebrovascular disease &#40;430&#8211;438&#41;&#44; malnutrition &#40;260&#8211;263&#46;9&#41;&#44; colitis by <span class="elsevierStyleItalic">Clostridium difficile</span> &#40;008&#46;45&#41;&#44; upper gastrointestinal hemorrhage &#40;530&#46;2&#44; 530&#46;82&#44; 531&#44; 532&#42;&#44; 533&#42; 534&#42;&#44; 535&#46;10&#8211;60&#44; 537&#46;83&#41;&#44; liver disease &#40;571&#46;0&#8211;571&#46;99&#59; 572&#46;2&#8211;572&#46;8&#41;&#44; acquired immune deficiency syndrome &#40;042&#46;00&#44; V08&#41;&#44; septicemia by methicillin-sensitive <span class="elsevierStyleItalic">Staphylococcus aureus</span> &#40;038&#46;11&#41;&#44; septicemia by methicillin-resistant <span class="elsevierStyleItalic">Staphylococcus aureus</span> &#40;038&#46;12&#41;&#44; bladder catheter &#40;57&#46;94&#41;&#44; nasogastric tube &#40;96&#46;35&#41;&#44; enteral nutrition &#40;96&#46;6&#41;&#44; parenteral nutrition &#40;99&#46;15&#41;&#44; gastrostomy &#40;44&#46;11&#44; 44&#46;19&#44; 44&#46;32&#41; and palliative care consultation &#40;V66&#46;7&#41;&#46;</p><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Statistical analysis</span><p id="par0040" class="elsevierStylePara elsevierViewall">We performed a descriptive analysis of the patients included with the demographic and clinical variables&#44; comparing the hospitalized patients with and without delirium&#46; For the dichotomous variables&#44; we employed the chi-squared test with Yates correction and Fisher&#39;s exact test when the expected value in a cell was &#60;5&#46; For the quantitative variables&#44; we employed Student&#39;s <span class="elsevierStyleItalic">t</span>-test for independent samples&#46; We analyzed the rate at which delirium was coded during the study period&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">Given that this was a government database&#44; controlling the confounding variables was essential&#46; For this reason&#44; we performed a logistic regression analysis to determine the risk of mortality and readmission attributable to the presence of delirium after correcting for potential confounding factors such as age&#44; Charlson index&#44; sex and the presence of dementia&#46; The OR and confidence intervals &#40;CI&#41; were calculated based on the coefficients of the regression indices&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">We also performed an estimate of the expenditure attributable to the presence of delirium during the hospitalization&#46; To this end&#44; we calculated the figure for the extra stay attributable to delirium&#44; multiplying it by the cost for 1 day of hospitalization and then by the total number of episodes of delirium identified over the course of the study period&#46; This operation enabled us to obtain a total expenditure figure&#44; as well as the extra expenditure per patient&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">Using our data&#44; we constructed a model for predicting the risk of developing delirium during the hospitalization using the presence or absence of the following variables during the hospitalization&#44; as well as age and sex&#58; diabetes&#44; dementia&#44; dysphagia&#44; depression&#44; malnutrition&#44; hyponatremia&#44; pneumonia&#44; urinary tract infection&#44; sepsis and admission from a nursing home&#46; For our model&#44; we calculated the calibration using the Hosmer&#8211;Lemeshow test and calculated the discriminatory capacity using a receiver operating characteristic curve&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">The threshold for statistical significance was set at <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;05&#46; We employed the commercial software SPSS version 16 &#40;SPSS Inc&#46;&#44; Chicago&#44; IL&#41;&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">The study was not evaluated by an ethics committee given that this was a completely anonymous computerized database with no possibility of linking the information to individuals&#46;</p></span></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Results</span><p id="par0070" class="elsevierStylePara elsevierViewall">We analyzed a total of 4&#44;628&#44;397 discharges by internal medicine departments during the study period &#40;2007&#8211;2014&#41; from all hospitals of the SNHS&#46; We identified a diagnosis of delirium in 114&#44;343 discharge reports &#40;prevalence of 2&#46;5&#37;&#41;&#46; Of these&#44; 14&#44;925 cases had delirium as the primary diagnosis&#44; and 99&#44;418 had it as the secondary diagnosis&#46; The patients with delirium were generally elderly &#40;mean age&#44; 79&#46;0<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>12&#46;8 vs&#46; 71&#46;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>16&#46;9 years&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;0001&#41;&#46; With most cases of delirium in the 81&#8211;90-year age group &#40;48&#37; of all cases&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46; The patients&#8217; mean age increased over the course of the study period &#40;76&#46;6 years in 2007 vs&#46; 80&#46;3 years in 2014&#41; as the number of cases coded per year increased&#46; We found no significant differences by sex &#40;47&#46;4&#37; vs&#46; 47&#46;8&#37; in women&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;053&#41;&#46; Delirium was significantly more common in patients admitted from nursing homes &#40;4&#46;5&#37; vs&#46; 2&#46;9&#37;&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;0001&#41;&#44; and these patients were significantly more often discharged to an institution than were the general population &#40;4&#46;3&#37; vs&#46; 1&#46;2&#37;&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0075" class="elsevierStylePara elsevierViewall">The diagnoses most commonly associated with delirium during the hospitalization were dementia &#40;14&#37; vs&#46; 7&#37;&#41;&#44; depression &#40;11&#46;2&#37; vs&#46; 7&#46;1&#37;&#41;&#44; cerebrovascular disease &#40;17&#37; vs&#46; 11&#37;&#41;&#44; malnutrition &#40;4&#37; vs&#46; 2&#37;&#41;&#44; pressure ulcers &#40;4&#37; vs&#46; 2&#37;&#41;&#44; dysphagia &#40;2&#37; vs&#46; 0&#46;2&#37;&#41; and hyponatremia &#40;5&#37; vs&#46; 2&#37;&#41; &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001 in all cases&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41;&#46; The number of comorbidities &#40;evaluated using the CCI&#41; in the population with delirium increased over the study period&#46; <a class="elsevierStyleCrossRefs" href="#fig0005">Figs&#46; 1 and 2</a> show the temporal progression of the annual cases of delirium over the study period&#46; <a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a> shows the comorbidity of the study population expressed according to the Charlson index for each year&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0080" class="elsevierStylePara elsevierViewall">The patients with delirium coded in their discharge report also had a higher rate of sepsis &#40;5&#37; vs&#46; 3&#37;&#41;&#44; urinary tract infection &#40;12&#37; vs&#46; 7&#37;&#41; and pneumonia &#40;14&#37; vs&#46; 10&#46;7&#37;&#41; &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;0001&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41;&#46; The patients with obesity had a lower likelihood of delirium that those without obesity &#40;5&#37; vs&#46; 8&#37;&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;0001&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41;&#46; Most of the risk factors we selected were associated in our series with the presence of delirium in the discharge report&#44; with the exception of peripheral arterial disease and cancer&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">In terms of the analyzed procedures&#44; we found significant differences between the population with and without delirium&#46; Magnetic resonance imaging and the placement of urinary catheters&#44; nasogastric tubes and central venous pathways were performed more often on the population with delirium&#46; We found no significant differences in the transfusion of blood products&#44; and computed tomography was performed less often in the population with delirium encoded in the discharge report&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">Finally&#44; the patients with delirium had a significantly longer mean stay &#40;11&#46;85<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>13&#46;15 days vs&#46; 9&#46;49<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>11&#46;17&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;0001&#41; and a higher hospital mortality &#40;12&#37; vs&#46; 10&#37;&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;0001&#41;&#46; Daily hospitalization and internal medicine costs have been estimated at &#8364;400 in Spain&#46; Our study has shown a mean increase of 2&#46;36 days in the length of stay attributable to delirium&#59; each patient with delirium therefore incurred an increase in costs of &#8364;944 per hospitalization&#46; With 114&#44;343 episodes of delirium during the 8-year study period&#44; the excess expenditures attributable to delirium increased to &#8364;107&#44;939&#44;792 for the SNHS&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">The multivariate analysis showed that the development of delirium during hospitalization in our series was independently associated with age&#44; the male sex and hyponatremia &#40;OR&#44; 2&#46;05&#59; 95&#37; CI 1&#46;94&#8211;2&#46;06&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;0001&#41;&#44; dysphagia &#40;OR&#44; 1&#46;65&#59; 95&#37; CI 1&#46;57&#8211;1&#46;73&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;0001&#41;&#44; malnutrition &#40;OR&#44; 1&#46;75&#59; 95&#37; CI 1&#46;7&#8211;1&#46;81&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;0001&#41; and urinary tract infection &#40;OR&#44; 1&#46;54&#59; 95&#37; CI 1&#46;51&#8211;1&#46;57&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;0001&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#41;&#46; Originating from an institution &#40;nursing home&#41; also increased the risk of delirium &#40;OR&#44; 1&#46;09&#59; 95&#37; CI 1&#46;05&#8211;1&#46;12&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;0001&#41;&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0100" class="elsevierStylePara elsevierViewall">Delirium was also independently associated with the in-hospital mortality risk &#40;OR&#44; 1&#46;41&#59; 95&#37; CI 1&#46;39&#8211;1&#46;43&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;0001&#41; after correcting for age and sex in the multiple logistic regression model &#40;<a class="elsevierStyleCrossRef" href="#tbl0020">Table 4</a>&#41;&#46; In the analysis of the encoded procedures&#44; bladder catheterization and nasogastric intubation were more common for the patients with delirium &#40;<a class="elsevierStyleCrossRefs" href="#tbl0025">Tables 5 and 6</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia><elsevierMultimedia ident="tbl0025"></elsevierMultimedia><elsevierMultimedia ident="tbl0030"></elsevierMultimedia><p id="par0105" class="elsevierStylePara elsevierViewall">By taking advantage of the considerable sample size&#44; we constructed a model to predict the risk of developing delirium during hospitalization&#46; This model reached a sensitivity of only 39&#46;8&#37; &#40;false negatives&#44; 60&#37;&#41; but had a much better specificity &#40;80&#37;&#41;&#46; The AUC&#44; however&#44; was just acceptable &#40;0&#46;656&#41;&#46; This result meant that our model was able to identify patients with a low risk of developing delirium but could not predict those with a high risk&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Discussion</span><p id="par0110" class="elsevierStylePara elsevierViewall">We have shown that 2&#46;5&#37; of patients hospitalized in Spanish internal medicine departments over an 8-year period had a delirium diagnosis coded in their discharge report and that this situation is associated with a significantly longer hospital stay and significantly greater mortality&#46; We confirmed that numerous comorbidities and procedures&#44; as well as living in an institution&#44; are associated with the presence of delirium during the hospitalization&#46;</p><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Prevalence</span><p id="par0115" class="elsevierStylePara elsevierViewall">The prevalence of 2&#46;5&#37; in our study is lower than the recently reported 16&#46;5&#37; in a patient group with neurological conditions hospitalized in Spain<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">4</span></a> and the 19&#46;1&#37; reported in an acute care medical ward of a general hospital&#46;<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">2</span></a> In the literature&#44; the figures reach 50&#37; of hospitalized patients at risk of delirium&#44; with rates that vary according to the study population &#40;mean age&#44; comorbidities&#41; and the scenario &#40;hospital department&#44; unit&#44; residence&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">20</span></a> In our study&#44; we obtained the information exclusively from the discharge report&#44; and delirium was not detected systematically&#46; These 2 facts are surely responsible&#44; at least in part&#44; for the low prevalence detected in our series&#46; Delirium is probably underreported in discharge reports&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Factors associated with delirium</span><p id="par0120" class="elsevierStylePara elsevierViewall">Unlike other studies&#44; we observed that delirium was not associated with an increased degree of comorbidity as evaluated by the adapted version of the CCI&#44;<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">1</span></a> although none of the other studies employed this index as a measure of comorbidity&#46; A systematic literature review showed how the number of comorbidities was associated with the persistence of delirium at the time of and beyond the discharge&#46;<a class="elsevierStyleCrossRef" href="#bib0285"><span class="elsevierStyleSup">21</span></a></p><p id="par0125" class="elsevierStylePara elsevierViewall">The independent factors associated with an increase in the presence of delirium in our series were related to age&#44; residence &#40;institutionalization&#41;&#44; neuropsychiatric comorbidities &#40;dementia and depression&#41;&#44; metabolic comorbidities &#40;diabetes&#44; nutritional malnutrition and dysphagia&#41;&#44; hydroelectrolytic disorders &#40;hyponatremia&#41; and infectious disorders &#40;sepsis&#44; urinary tract infections and pneumonia&#41;&#46; These factors have been previously reported in hospitalized patients with delirium and can be considered as precipitating factors&#46; A meta-analysis of 11 studies with a total of 2388 patients &#40;411 participants and 1927 controls&#41; identified the following factors&#58; dementia&#44; age&#44; comorbidity&#44; severity of the acute disease&#44; infection&#44; reduced activities of daily life&#44; immobility&#44; sensory impairment&#44; bladder catheterization&#44; urea and electrolyte disorders and malnutrition&#46; In another prospective study&#44; both previous dementia and the severity of the acute disease appeared as clear risk factors for developing delirium in patients older than 80 years hospitalized in internal medicine wards&#46; The multivariate analysis identified infection and uremia as additional risk factors&#46; The presence of more than 4 risk factors&#44; hyponatremia&#44; depression and previous functional deficit were only identified as risk factors in the univariate analysis&#46;<a class="elsevierStyleCrossRefs" href="#bib0290"><span class="elsevierStyleSup">22&#44;23</span></a> The analysis of the procedures performed by internal medicine departments show that patients with delirium are catheterized more often than the general population&#44; a maneuver linked to delirium in other studies&#46;<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">24</span></a> Among the other procedures&#44; only computed tomography is performed more often in the general population&#44; which could suggest that delirium develops in a patient group especially susceptible to iatrogenesis&#46; Among the other procedures&#44; only computed tomography is performed more often in the general population&#44; which could suggest that delirium develops in a patient group especially susceptible to iatrogenesis&#46; It is worth asking&#44; however&#44; whether instrumentalization and the excess of procedures undergone by these patients are the cause or consequence of the delirium they develop&#46; Of course&#44; our study was not designed to answer this question&#46; However&#44; a number of the measures taken with these patients can lead to excessive instrumentalization and should be avoided &#40;e&#46;g&#46;&#44; clamping measures that lead to a loss of pathways&#44; phlebitis &#91;sometimes septic&#93; and the need for placing central venous pathways&#41;&#46; The progression of confusional syndromes to frank delirium can prevent sufficient feeding and precipitate bronchoaspiration or the need for an artificial feeding tube&#46; There is only one solution for this&#58; early identification and prevention of at-risk patients&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">For elderly hospitalized patients&#44; depressive symptoms&#44; cognitive impairment and dementia are known risk factors for developing delirium&#46; Malnutrition frequently occurs in patients with cognitive impairment&#44; even those with mild impairment&#44; and is associated with an increased risk of developing delirium during the hospitalization&#46;<a class="elsevierStyleCrossRefs" href="#bib0305"><span class="elsevierStyleSup">25&#8211;28</span></a> Hyponatremia and infections are the most common acute conditions associated with the development of intrahospital delirium in elderly patients&#46; This information could be useful for identifying patients at risk and implementing more rigorous measures aimed at prevention&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">Delirium is a marker of cognitive frailty and of a poor outcome of hospitalization&#46; According to previous studies&#44;<a class="elsevierStyleCrossRefs" href="#bib0200"><span class="elsevierStyleSup">4&#44;29</span></a> the presence of delirium lengthens the stay and thereby increases the hospitalization costs&#46; The importance of delirium might continue to be underestimated while its social and economic implications continue to be undocumented&#46;<a class="elsevierStyleCrossRef" href="#bib0330"><span class="elsevierStyleSup">30</span></a> Current estimates suggest that this disease complicates the hospitalizations of more than 2&#46;3 million elderly individuals annually in the United States&#44; representing 17&#46;5 million days of hospitalization for a total amount exceeding 4 billion dollars&#46;<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">7</span></a> In our study&#44; the excess costs attributable to delirium in 8 years exceeded &#8364;100 million&#44; with a mean of almost &#8364;1000 per hospitalization&#47;patient&#46;</p><p id="par0140" class="elsevierStylePara elsevierViewall">A study on patients older than 65 years hospitalized for acute disease showed that delirium present at admission behaved as an independent risk factor for hospital mortality and mortality at 3 months of discharge&#46;<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">7</span></a> A systematic review and meta-analysis of 42 studies on critically ill patients with delirium showed that delirium was associated with increased mortality risk&#44; institutionalization and dementia&#46;<a class="elsevierStyleCrossRef" href="#bib0335"><span class="elsevierStyleSup">31</span></a> In our study&#44; the mean age of the patients with delirium increased over the study period&#46; The comorbidities evaluated with the CCI also increased&#46; Delirium in many cases can be interpreted as the consequence of hospitalization for patients with internal &#40;comorbidities&#41; and external risk factors &#40;hospitalization-related&#41;&#46;</p><p id="par0145" class="elsevierStylePara elsevierViewall">Numerous strategies aimed at mitigating the severe repercussions of delirium have been attempted&#59; however&#44; the initial experiences were not favorable&#46;<a class="elsevierStyleCrossRefs" href="#bib0220"><span class="elsevierStyleSup">8&#44;9&#44;5</span></a> More recent studies have achieved somewhat better efficacy&#44; although the evidence is still limited&#46;<a class="elsevierStyleCrossRef" href="#bib0340"><span class="elsevierStyleSup">32</span></a> It is also important to note that errors in treating these patients can also lead to the development of this condition&#46;<a class="elsevierStyleCrossRef" href="#bib0345"><span class="elsevierStyleSup">33</span></a></p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Predictive model</span><p id="par0150" class="elsevierStylePara elsevierViewall">Our predictive model did not achieve the desired objective&#46; However&#44; the model showed a good capacity for identifying patients at low risk of developing delirium during the hospitalization&#46; A significant number of predictive scales and models have been published for identifying patients at risk&#46; In postsurgical patients&#44; the preoperative situation is the best predictor&#44; and age behaves as an independent factor&#46; Postsurgical delirium is 4 times more common in emergency surgery than in elective surgery&#46;<a class="elsevierStyleCrossRef" href="#bib0350"><span class="elsevierStyleSup">34</span></a> In elderly patients in general&#44; incidental delirium is independently associated with a poorer functional state &#40;Barthel index&#41; and dehydration &#40;creatinine-urea ratio&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0355"><span class="elsevierStyleSup">35</span></a> However&#44; we still lack a good model to identify medical patients with a high risk of delirium&#46;</p><p id="par0155" class="elsevierStylePara elsevierViewall">Prevention measures and improving the early diagnosis are the first steps in treating delirium in Spanish internal medicine departments&#44; where the mean age has exceeded 74 years and the CCI approaches 5&#46;<a class="elsevierStyleCrossRef" href="#bib0360"><span class="elsevierStyleSup">36</span></a> Multilevel interventions &#40;pharmacological&#44; environmental and rehabilitative&#41; have been shown to be the most effective when resolving this condition&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Limitations</span><p id="par0160" class="elsevierStylePara elsevierViewall">Our study does not lack limitations&#46; As with any retrospective study based on clinical-government data&#44; it is safe to say that not all diagnoses of delirium were correctly included&#46; Considering the low prevalence observed in our study&#44; it is more than likely that a considerable number of cases were not registered&#44; A problem that has already been reported in other studies with large databases&#46;<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">4</span></a> Having numerous comorbidities is not uncommon in patients hospitalized in internal medicine &#40;22&#37; of our series had a CCI<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>2&#41;&#44; Which would explain why the diagnosis of intrahospital delirium can go unreported or be considered a minor diagnosis in hospitalized patients with severe acute processes and a considerable number of complications&#46; In any case&#44; one of the strengths of our study is the considerable sample size and statistical power it confers&#46; We had access to more than 4&#46;5 million discharge reports and more than 100&#44;000 episodes of delirium over the course of 8 years&#44; a number rarely accessible among publications on this topic&#46;</p></span></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Conclusions</span><p id="par0165" class="elsevierStylePara elsevierViewall">Our analysis of an extensive clinical-government database of more than 4&#46;5 million discharges and 100&#44;000 episodes of delirium in patients hospitalized in internal medicine departments in Spain over 8 years shows that these patients are older than other hospitalized patients&#44; have a longer mean stay and have greater mortality&#46;</p><p id="par0170" class="elsevierStylePara elsevierViewall">Institutionalization was associated with a greater prevalence of delirium and a greater possibility of being discharged to an institution than the rest of the hospitalized population&#46; Unlike other studies&#44; we found that the patients with a higher level of comorbidities &#40;measured by the CCI&#41; did not have a greater risk of developing delirium&#46; Delirium is infracoded and likely underreported in the discharge reports prepared by internists&#46; This issue needs improvement in the management of this disease&#44; which currently lacks prevention and whose negative repercussions represent patient suffering and death and healthcare system expenditures&#46;</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Funding</span><p id="par0175" class="elsevierStylePara elsevierViewall">This research study received no grant or financial assistance from funding agencies of the public&#44; private or commercial sector&#46;</p></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0130">Conflicts of interest</span><p id="par0180" class="elsevierStylePara elsevierViewall">None of the authors are subject to conflicts of interest concerning this article&#46;</p></span></span>"
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        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objectives</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">To investigate the prevalence of reported delirium and its associated factors and costs&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Design</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Retrospective and descriptive analysis of a national clinical-administrative database that includes all patients hospitalized in Spain in internal medicine departments from January 2007 to December 2014&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Material and method</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">The study included the patients&#8217; sociodemographic and clinical data &#40;sex&#44; age&#44; diagnosis and procedures&#41;&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Results</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">The prevalence of reported delirium was 2&#46;5&#37; &#40;114&#44;343 of 4&#44;628&#44;397 discharge reports&#41;&#46; Delirium was most common in the 81&#8211;90-year age group &#40;48&#37;&#41; and in institutionalized patients &#40;4&#46;5&#37; vs&#46; 2&#46;9&#37;&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001&#41;&#46; The diagnoses most associated with delirium were dementia &#40;14&#37; vs&#46; 7&#37; for patients without delirium&#41;&#44; cerebrovascular disease &#40;17&#37; vs&#46; 11&#37;&#41;&#44; malnutrition &#40;4&#37; vs&#46; 2&#37;&#41;&#44; pressure ulcers &#40;4&#37; vs&#46; 2&#37;&#41;&#44; dysphagia &#40;2&#37; vs&#46; 0&#46;2&#37;&#41; and hyponatraemia &#40;5&#37; vs&#46; 2&#37;&#41; &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001 in all cases&#41;&#46; Patients with delirium also had longer mean stays &#40;11&#46;85<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>13&#46;15<span class="elsevierStyleHsp" style=""></span>days vs&#46; 9&#46;49<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>11&#46;17&#41; and higher hospital mortality &#40;OR&#58; 1&#46;41&#59; 95&#37;<span class="elsevierStyleHsp" style=""></span>CI&#58; 1&#46;39&#8211;1&#46;43&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;0001&#41;&#46;</p><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">The costs attributable to delirium in 8 years exceeded &#8364;100 million &#40;almost &#8364;1000 per hospitalization&#47;patient&#41;&#46; We developed a predictive model for the risk of developing delirium&#44; which has insufficient sensitivity but is useful for identifying low-risk patients&#46;</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Conclusions</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Patients who develop delirium during their hospitalization in internal medicine have a longer stay&#44; greater mortality and an increased risk of being institutionalized at discharge&#46; Delirium is probably poorly reported in the discharge reports prepared by internists&#46;</p></span>"
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        "resumen" => "<span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Objetivos</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Investigar la prevalencia del delirio reportado&#44; los factores asociados y los costes&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Dise&#241;o</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">An&#225;lisis retrospectivo y descriptivo de una base de datos cl&#237;nico-administrativa nacional que incluye todos los pacientes ingresados en Espa&#241;a en los servicios de medicina interna desde enero de 2007 a diciembre de 2014&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Material y m&#233;todo</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Se incluyen datos sociodemogr&#225;ficos y cl&#237;nicos &#40;sexo&#44; edad&#44; diagn&#243;stico y procedimientos&#41;&#44; entre otros&#46;</p></span> <span id="abst0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Resultados</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">La prevalencia del delirio reportado fue del 2&#44;5&#37; &#40;114&#46;343 de 4&#46;628&#46;397 informes de alta&#41;&#46; El delirio fue m&#225;s frecuente en el grupo de 81 a 90 a&#241;os &#40;48&#37;&#41; y en pacientes institucionalizados &#40;4&#44;5&#37; vs 2&#44;9&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#46; Los diagn&#243;sticos m&#225;s asociados al delirio fueron demencia &#40;14&#37; vs 7&#37; en los sujetos sin delirio&#41;&#44; enfermedad cerebrovascular &#40;17&#37; vs 11&#37;&#41;&#44; desnutrici&#243;n &#40;4&#37; vs 2&#37;&#41;&#44; &#250;lceras por presi&#243;n &#40;4&#37; vs 2&#37;&#41;&#44; disfagia &#40;2&#37; vs 0&#44;2&#37;&#41; e hiponatremia &#40;5&#37; vs 2&#37;&#41;&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001 en todos los casos&#46; Tambi&#233;n tuvieron una estancia media m&#225;s larga&#58; 11&#44;85 &#40;DE&#58; 13&#44;15&#41; d&#237;as vs 9&#44;49 &#40;DE&#58; 11&#44;17&#41; d&#237;as&#44; y mortalidad intrahospitalaria m&#225;s elevada &#40;OR&#58; 1&#44;41&#59; IC<span class="elsevierStyleHsp" style=""></span>95&#37;&#58; 1&#44;39-1&#44;43&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;0001&#41;&#46;</p><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">El coste atribuible al delirio en 8<span class="elsevierStyleHsp" style=""></span>a&#241;os supera los 100 millones de euros &#40;casi 1&#46;000<span class="elsevierStyleHsp" style=""></span>&#8364; por ingreso&#47;paciente&#41;&#46; Elaboramos un modelo predictivo del riesgo de desarrollar delirio sin sensibilidad suficiente pero &#250;til para identificar pacientes de bajo riesgo&#46;</p></span> <span id="abst0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Conclusiones</span><p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Los pacientes que desarrollan delirio durante su ingreso en medicina interna tienen una estancia m&#225;s prolongada&#44; mayor mortalidad y mayor riesgo de ser institucionalizados al alta&#46; El delirio est&#225; probablemente poco reportado en los informes de alta que elaboran los internistas&#46;</p></span>"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Marco J&#44; M&#233;ndez M&#44; Cruz-Jentoft AJ&#44; Garc&#237;a Klepzig JL&#44; Calvo E&#44; Canora J&#44; et al&#46; Caracter&#237;sticas cl&#237;nicas del delirio y sus implicaciones pron&#243;sticas en los servicios de medicina interna espa&#241;oles&#58; an&#225;lisis de una gran base de datos cl&#237;nico-administrativa&#46; Rev Clin Esp&#46; 2019&#59;219&#58;415&#8211;423&#46;</p>"
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">91&#8211;100&#44; <span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">12&#44;990 &#40;11&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">292&#44;504 &#40;6&#46;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;100&#44; <span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">266 &#40;0&#46;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5012 &#40;0&#46;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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          "leyenda" => "<p id="spar0090" class="elsevierStyleSimplePara elsevierViewall">The comorbidities are shown in order of delirium frequency&#46;</p><p id="spar0095" class="elsevierStyleSimplePara elsevierViewall">Data based on discharge reports of the minimum basic data set&#46;</p>"
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Delirium &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>99&#44;418&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">No delirium &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>4&#44;527&#44;938&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Mean age&#44; years &#40;SD&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">79&#46;1 &#40;12&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">71&#46;9 &#40;16&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;0001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Female&#44; <span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">46&#44;824 &#40;47&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;147&#44;066 &#40;47&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;053&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Mean stay&#44; days &#40;SD&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11&#46;85 &#40;13&#46;15&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&#46;49 &#40;11&#46;17&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;0001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Institutionalized&#44; <span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4460 &#40;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">130&#44;891 &#40;2&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;0001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Charlson Comorbidity Index &#62;2&#44; <span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">21&#44;818 &#40;22&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">958&#44;885 &#40;21&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;0001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Mean Charlson Comorbidity Index&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;69&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;56&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">COPD&#44; <span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">35&#44;059 &#40;35&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">165&#44;037 &#40;36&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;0001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Diabetes&#44; <span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">29&#44;602 &#40;30&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;273&#44;451 &#40;28&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;0001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Heart failure&#44; <span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">22&#44;350 &#40;28&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;070&#44;044 &#40;24&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;0001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Anemia&#44; <span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">18&#44;208 &#40;18&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">754&#44;272 &#40;17&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;0001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Cerebrovascular disease&#44; <span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">17&#44;167 &#40;17&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">502&#44;048 &#40;11&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;0001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Pneumonia&#44; <span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13&#44;794 &#40;14&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">486&#44;834 &#40;11&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;0001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Dementia&#44; <span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13&#44;466 &#40;14&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">334&#44;478 &#40;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;0001&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">Chronic renal failure&#44; <span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13&#44;164 &#40;13&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">497&#44;157 &#40;11&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">Urinary tract infection&#44; <span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11&#44;819 &#40;12&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">299&#44;332 &#40;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">&#46;0001&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">Neoplasia&#44; <span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11&#44;044 &#40;11&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">502&#44;839 &#40;11&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Depression&#44; <span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7591 &#40;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">286&#44;239 &#40;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;0001&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Ischemic heart disease&#44; <span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">6275 &#40;6&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">Obesity&#44; <span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">Sepsis&#44; <span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">5129 &#40;5&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1838 &#40;2&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">0&#46;79&#8211;0&#46;81&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;0001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Institutionalized&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;09&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;05&#8211;1&#46;12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;0001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Diabetes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;02&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1008&#8211;1036&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;0001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Dementia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;39&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;38&#8211;1&#46;36&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;0001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Dysphagia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;65&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;57&#8211;1&#46;73&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;0001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Depression&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;31&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;28&#8211;1&#46;35&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;0001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Malnutrition&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;75&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;70&#8211;1&#46;81&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;0001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hyponatremia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;05&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;94&#8211;2&#46;06&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;0001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Pneumonia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;21&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;19&#8211;1&#46;24&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;0001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Urinary tract infection&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;54&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;54&#8211;1&#46;51&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;0001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Sepsis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;31&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;28&#8211;1&#46;35&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;0001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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          "en" => "<p id="spar0100" class="elsevierStyleSimplePara elsevierViewall">Logistic regression analysis of the comorbidities associated with delirium in Spanish internal medicine departments &#40;2007&#8211;2014&#41;&#46;</p>"
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Variable&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Odds ratio&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">95&#37; CI&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">Age&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;104&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;104&#8211;1&#46;105&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;0001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Male sex&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;02&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;019&#8211;1&#46;026&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;0001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Delirium&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;54&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;52&#8211;1&#46;57&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;0001&nbsp;\t\t\t\t\t\t\n
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                0 => """
                  <table border="0" frame="\n
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                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Delirium &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>99&#44;418&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">No delirium &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>4&#44;527&#44;938&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
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                      "titulo" => "Delirium&#58; screening prevention&#44; and diagnosis &#8212; a systematic review of the evidence&#46; VA evidence-based synthesis program reports"
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                      "titulo" => "Incidence and predictive factors of delirium in hospitalised neurological patients"
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                            0 => "B&#46; Ruiz Bajo"
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                            3 => "J&#46; Mart&#237;n Mart&#237;nez"
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                        ]
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                    0 => array:2 [
                      "doi" => "10.1016/j.nrl.2012.07.001"
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                0 => array:2 [
                  "contribucion" => array:1 [
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                      "titulo" => "Delirium prevention and treatment in elderly hip fracture"
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                            0 => "M&#46;J&#46; Robles"
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                      "titulo" => "Delirium in elderly patients and the risk of postdischarge mortality&#44; institutionalization&#44; and dementia&#58; a meta-analysis"
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            6 => array:3 [
              "identificador" => "bib0215"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Multicomponent targeted intervention to prevent delirium in hospitalized older patients&#58; what is the economic value&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "J&#46;A&#46; Rizzo"
                            1 => "S&#46;T&#46; Bogardus Jr&#46;"
                            2 => "L&#46; Leo-Summers"
                            3 => "C&#46;S&#46; Williams"
                            4 => "D&#46; Acampora"
                            5 => "S&#46;K&#46; Inouye"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/00005650-200107000-00010"
                      "Revista" => array:6 [
                        "tituloSerie" => "Med Care"
                        "fecha" => "2001"
                        "volumen" => "39"
                        "paginaInicial" => "740"
                        "paginaFinal" => "752"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11458138"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0220"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Multicomponent intervention strategies for managing delirium in hospitalized older people&#58; systematic review"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "K&#46; Milisen"
                            1 => "J&#46; Lemiengre"
                            2 => "T&#46; Braes"
                            3 => "M&#46;D&#46; Foreman"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1365-2648.2005.03557.x"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Adv Nurs"
                        "fecha" => "2005"
                        "volumen" => "52"
                        "paginaInicial" => "79"
                        "paginaFinal" => "90"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16149984"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0225"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The effects of a targeted multicomponent delirium intervention on postdischarge outcomes for hospitalized older adults"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "S&#46;T&#46; Bogardus Jr&#46;"
                            1 => "M&#46;M&#46; Desai"
                            2 => "C&#46;S&#46; Williams"
                            3 => "L&#46; Leo-Summers"
                            4 => "D&#46; Acampora"
                            5 => "S&#46;K&#46; Inouye"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/s0002-9343(02)01569-3"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Med"
                        "fecha" => "2003"
                        "volumen" => "114"
                        "paginaInicial" => "383"
                        "paginaFinal" => "390"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12714128"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0230"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "An intervention integrated into daily clinical practice reduces the incidence of delirium during hospitalization in elderly patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "M&#46;T&#46; Vid&#225;n"
                            1 => "E&#46; S&#225;nchez"
                            2 => "M&#46; Alonso"
                            3 => "B&#46; Montero"
                            4 => "J&#46; Ortiz"
                            5 => "J&#46;A&#46; Serra"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1532-5415.2009.02485.x"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Am Geriatr Soc"
                        "fecha" => "2009"
                        "volumen" => "57"
                        "paginaInicial" => "2029"
                        "paginaFinal" => "2036"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19754498"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "identificador" => "bib0235"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Efficacy of non-pharmacological interventions to prevent and treat delirium in older patients&#58; a systematic overview&#46; The SENATOR project ONTOP Series"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "I&#46; Abraha"
                            1 => "F&#46; Trotta"
                            2 => "J&#46;M&#46; Rimland"
                            3 => "A&#46; Cruz-Jentoft"
                            4 => "I&#46; Lozano-Montoya"
                            5 => "R&#46;L&#46; Soiza"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1371/journal.pone.0123090"
                      "Revista" => array:5 [
                        "tituloSerie" => "PLoS One"
                        "fecha" => "2015"
                        "volumen" => "10"
                        "paginaInicial" => "e0123090"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26062023"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "identificador" => "bib0240"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Delirium in older persons&#58; advances in diagnosis and treatment"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "E&#46;S&#46; Oh"
                            1 => "T&#46;G&#46; Fong"
                            2 => "T&#46;T&#46; Hshieh"
                            3 => "S&#46;K&#46; Inouye"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1001/jama.2017.12067"
                      "Revista" => array:6 [
                        "tituloSerie" => "JAMA"
                        "fecha" => "2017"
                        "volumen" => "318"
                        "paginaInicial" => "1161"
                        "paginaFinal" => "1174"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28973626"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "identificador" => "bib0245"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The obesity paradox in stroke&#58; impact on mortality and short-term readmission"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "R&#46; Barba"
                            1 => "J&#46; Marco"
                            2 => "J&#46; Ruiz"
                            3 => "J&#46; Canora"
                            4 => "J&#46; Hinojosa"
                            5 => "S&#46; Plaza"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Stroke Cerebrovasc Dis"
                        "fecha" => "2015"
                        "volumen" => "4"
                        "paginaInicial" => "766"
                        "paginaFinal" => "770"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib0250"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Malnutrition and obesity&#58; influence in mortality and readmissions in chronic obstructive pulmonary disease patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46; Zapatero"
                            1 => "R&#46; Barba"
                            2 => "J&#46; Ruiz"
                            3 => "J&#46;E&#46; Losa"
                            4 => "S&#46; Plaza"
                            5 => "J&#46; Canora"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/jhn.12088"
                      "Revista" => array:7 [
                        "tituloSerie" => "J Hum Nutr Diet"
                        "fecha" => "2013"
                        "volumen" => "26"
                        "numero" => "Suppl&#46; 1"
                        "paginaInicial" => "16"
                        "paginaFinal" => "22"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23656492"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib0255"
              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Anaemia in chronic obstructive pulmonary disease&#58; a readmission prognosis factor"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "R&#46; Barba"
                            1 => "G&#46; Garc&#237;a de Casasola"
                            2 => "J&#46; Marco"
                            3 => "J&#46; Losa"
                            4 => "S&#46; Plaza"
                            5 => "J&#46; Canora"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1185/03007995.2012.675318"
                      "Revista" => array:6 [
                        "tituloSerie" => "Curr Med Res Opin"
                        "fecha" => "2012"
                        "volumen" => "28"
                        "paginaInicial" => "617"
                        "paginaFinal" => "622"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22409165"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib0260"
              "etiqueta" => "16"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Frequency of hypoglycemia and its impact on length of stay mortality and short-term readmission in patients with diabetes hospitalized in internal medicine wards"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "Zapatero&#160;A"
                            1 => "R&#46; G&#243;mez-Huelgas"
                            2 => "N&#46; Gonz&#225;lez"
                            3 => "J&#46; Canora"
                            4 => "A&#46; Asenjo"
                            5 => "J&#46; Hinojosa"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Endocr Pract"
                        "fecha" => "2014"
                        "volumen" => "18"
                        "paginaInicial" => "1"
                        "paginaFinal" => "15"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22522068"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib0265"
              "etiqueta" => "17"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Low prevalence of hyponatremia codification in departments of internal medicine and its prognostic implications"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46; Marco"
                            1 => "R&#46; Barba"
                            2 => "P&#46; Mat&#237;a"
                            3 => "S&#46; Plaza"
                            4 => "M&#46; M&#233;ndez"
                            5 => "J&#46; Canora"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1185/03007995.2013.836079"
                      "Revista" => array:6 [
                        "tituloSerie" => "Curr Med Res Opin"
                        "fecha" => "2013"
                        "volumen" => "29"
                        "paginaInicial" => "1757"
                        "paginaFinal" => "1762"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23992405"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib0270"
              "etiqueta" => "18"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A new method of classifying prognostic comorbidity in longitudinal studies&#58; development and validation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "M&#46;E&#46; Charlson"
                            1 => "P&#46; Pompei"
                            2 => "K&#46;L&#46; Ales"
                            3 => "C&#46;R&#46; MacKenzie"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/0021-9681(87)90171-8"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Chronic Dis"
                        "fecha" => "1987"
                        "volumen" => "40"
                        "paginaInicial" => "373"
                        "paginaFinal" => "383"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3558716"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "identificador" => "bib0275"
              "etiqueta" => "19"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Adapting a clinical comorbidity index for use with ICD-9-CM administrative databases"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "R&#46;A&#46; Deyo"
                            1 => "D&#46;C&#46; Cherkin"
                            2 => "M&#46;A&#46; Ciol"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/0895-4356(92)90133-8"
                      "Revista" => array:7 [
                        "tituloSerie" => "J Clin Epidemiol"
                        "fecha" => "1992"
                        "volumen" => "45"
                        "paginaInicial" => "613"
                        "paginaFinal" => "619"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1607900"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S0190962212002472"
                          "estado" => "S300"
                          "issn" => "01909622"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib0280"
              "etiqueta" => "20"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Clinical characteristics and risk factors of delirium in demented and not demented elderly medical inpatients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "A&#46; Margiotta"
                            1 => "A&#46; Bianchetti"
                            2 => "P&#46; Ranieri"
                            3 => "M&#46; Trabucchi"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Nutr Health Aging"
                        "fecha" => "2006"
                        "volumen" => "10"
                        "paginaInicial" => "535"
                        "paginaFinal" => "539"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17183425"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "identificador" => "bib0285"
              "etiqueta" => "21"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Delirium in the hospitalized elder and recommendations for practice"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "T&#46;S&#46; Rigney"
                          ]
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                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.gerinurse.2006.03.014"
                      "Revista" => array:6 [
                        "tituloSerie" => "Geriatr Nurs"
                        "fecha" => "2006"
                        "volumen" => "27"
                        "paginaInicial" => "151"
                        "paginaFinal" => "157"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16757386"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib0290"
              "etiqueta" => "22"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Risk factors for developing delirium in older patients admitted to general medical wards"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "V&#46; Srinonprasert"
                            1 => "S&#46; Pakdeewongse"
                            2 => "J&#46; Assanasen"
                            3 => "W&#46; Eiamjinnasuwat"
                            4 => "A&#46; Sirisuwat"
                            5 => "D&#46; Limmathuroskul"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:7 [
                        "tituloSerie" => "J Med Assoc Thai"
                        "fecha" => "2011"
                        "volumen" => "94"
                        "numero" => "Suppl&#46; 1"
                        "paginaInicial" => "S99"
                        "paginaFinal" => "S104"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21721434"
                            "web" => "Medline"
                          ]
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                      ]
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                  ]
                ]
              ]
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Risk factors for incident delirium among older people in acute hospital medical units&#58; a systematic review and meta-analysis"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "S&#46; Ahmed"
                            1 => "B&#46; Leurent"
                            2 => "E&#46; Sampson"
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                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
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                      "Revista" => array:5 [
                        "tituloSerie" => "Age Age"
                        "fecha" => "2014"
                        "volumen" => "43"
                        "paginaInicial" => "326"
                        "paginaFinal" => "333"
                      ]
                    ]
                  ]
                ]
              ]
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Demented versus non-demented very old inpatients&#58; the same comorbidities but poorer functional and nutritional status"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "D&#46; Zekry"
                            1 => "F&#46;R&#46; Herrmann"
                            2 => "R&#46; Grandjean"
                            3 => "M&#46;P&#46; Meynet"
                            4 => "J&#46;P&#46; Michel"
                            5 => "G&#46; Gold"
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                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Age Age"
                        "fecha" => "2008"
                        "volumen" => "37"
                        "paginaInicial" => "83"
                        "paginaFinal" => "89"
                      ]
                    ]
                  ]
                ]
              ]
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                      "titulo" => "Risk factors and clinical aspects of delirium in elderly hospitalized patients in Iran"
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                            2 => "S&#46;E&#46; Said"
                            3 => "A&#46;A&#46; Akbari Kamrani"
                            4 => "V&#46; Rashedi"
                            5 => "T&#46; Zandi"
                          ]
                        ]
                      ]
                    ]
                  ]
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                    0 => array:2 [
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                        "volumen" => "28"
                        "paginaInicial" => "313"
                        "paginaFinal" => "319"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26194422"
                            "web" => "Medline"
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                ]
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                            5 => "A&#46; Ciampi"
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                        "fecha" => "2009"
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                        "paginaFinal" => "102"
                        "link" => array:1 [
                          0 => array:2 [
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              "etiqueta" => "29"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Systematic detection and multidisciplinary care of delirium in older medical inpatients&#58; a randomized trial"
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                          "etal" => true
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                            5 => "M&#46;J&#46; Bonnycastle"
                          ]
                        ]
                      ]
                    ]
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                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12389836"
                            "web" => "Medline"
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                ]
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              "referencia" => array:1 [
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                      "titulo" => "The importance of delirium&#58; economic and societal costs"
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                          "autores" => array:2 [
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                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
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                        "fecha" => "2011"
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                        "numero" => "Suppl&#46; 2"
                        "paginaInicial" => "S241"
                        "paginaFinal" => "S243"
                        "link" => array:1 [
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                            "web" => "Medline"
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                      ]
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                  ]
                ]
              ]
            ]
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              "referencia" => array:1 [
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                    0 => array:2 [
                      "titulo" => "Outcome of delirium in critically ill patients&#58; systematic review and meta-analysis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "J&#46;I&#46; Salluh"
                            1 => "H&#46; Wang"
                            2 => "E&#46;B&#46; Schneider"
                            3 => "N&#46; Nagaraja"
                            4 => "G&#46; Yenokyan"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1136/bmj.h2538"
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                        "volumen" => "350"
                        "paginaInicial" => "h2538"
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                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26041151"
                            "web" => "Medline"
                          ]
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                      ]
                    ]
                  ]
                ]
              ]
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              "etiqueta" => "32"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Interventions for preventing delirium in older people in institutional long-term care"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "A&#46; Clegg"
                            1 => "N&#46; Siddiqi"
                            2 => "A&#46; Heaven"
                            3 => "J&#46; Young"
                            4 => "R&#46; Holt"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/14651858.CD005619.pub3"
                      "Revista" => array:4 [
                        "tituloSerie" => "Cochrane Database Syst Rev"
                        "fecha" => "2014"
                        "volumen" => "1"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30707445"
                            "web" => "Medline"
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                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "etiqueta" => "33"
              "referencia" => array:1 [
                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Gaps in patient care practices to prevent hospital-acquired delirium"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "K&#46; Alagiakrishnan"
                            1 => "T&#46; Marrie"
                            2 => "D&#46; Rolfson"
                            3 => "W&#46; Coke"
                            4 => "R&#46; Camicioli"
                            5 => "D&#46; Duggan"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Can Fam Phys"
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                        "volumen" => "55"
                        "paginaInicial" => "e41"
                        "paginaFinal" => "e46"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            33 => array:3 [
              "identificador" => "bib0350"
              "etiqueta" => "34"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Risk factors and prediction of postoperative delirium in elderly hip-surgery patients&#58; implementation and validation of a medical risk factor model"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "K&#46;J&#46; Kalisvaart"
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                            2 => "J&#46;F&#46; de Jonghe"
                            3 => "T&#46; van der Ploeg"
                            4 => "W&#46;A&#46; van Gool"
                            5 => "P&#46; Eikelenboom"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Am Geriatr Soc"
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                        "volumen" => "54"
                        "paginaInicial" => "817"
                        "paginaFinal" => "822"
                      ]
                    ]
                  ]
                ]
              ]
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                    0 => array:2 [
                      "titulo" => "Development and validation of a delirium predictive score in older people"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "M&#46;P&#46; Carrasco"
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                            3 => "J&#46; Calder&#243;n"
                            4 => "M&#46; Gonz&#225;lez"
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                      ]
                    ]
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                  "host" => array:1 [
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                ]
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Original article
Clinical characteristics and prognosis for delirium in Spanish internal medicine departments: An analysis from a large clinical-administrative database
Características clínicas del delirio y sus implicaciones pronósticas en los servicios de medicina interna españoles: análisis de una gran base de datos clínico-administrativa
J. Marcoa,
Corresponding author
javiermarco.z@gmail.com

Corresponding author.
, M. Méndeza, A.J. Cruz-Jentoftb, J.L. García Klepziga, E. Calvoa, J. Canorac, A. Zapateroc, R. Barbad
a Departmento de Medicina Interna, Hospital Clínico San Carlos, Madrid, Spain
b Servicio de Geriatría, Hospital Universitario Ramón y Cajal (IRYCIS), Madrid, Spain
c Departamento de Medicina Interna, Hospital de Fuenlabrada, Fuenlabrada, Madrid, Spain
d Departamento de Medicina Interna, Hospital Rey Juan Carlos, Móstoles, Madrid, Spain
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Background</span><p id="par0005" class="elsevierStylePara elsevierViewall">Delirium is a clinical syndrome that typically affects hospitalized patients and institutionalized elderly individuals&#46; The condition is characterized by acute cognitive impairment and a fluctuating inability to maintain attention&#46; The prevalence of delirium varies depending on the study population&#44; context and diagnostic criteria employed&#44; with incidence rates ranging from 10&#37; to 80&#37;&#46;<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">1</span></a> The scarce studies that have prospectively analyzed delirium in Spain have reported a prevalence of approximately 20&#37;&#46;<a class="elsevierStyleCrossRefs" href="#bib0190"><span class="elsevierStyleSup">2&#44;3</span></a> Delirium is frequently underreported in discharge reports&#44; especially for polypathological patients with long diagnostic lists&#46; This situation could reflect a failure in the diagnosis&#44; coding errors or a truly low prevalence&#46; This relatively low figure for the phenotype in the large clinical-administrative databases could reduce the credibility of prevalence rates reported through this pathway to determine the actual situation of delirium&#46;<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">4</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Delirium in elderly hospitalized patients has been associated with severe adverse effects and an increase in hospitalization costs&#46;<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">5</span></a> A meta-analysis that investigated the mortality risk&#44; institutionalization and dementia of elderly patients with delirium showed that delirium was an independent risk factor for these 3 events&#46;<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">6</span></a> Numerous studies have shown the efficacy of delirium prevention strategies&#44; most of which are multidisciplinary and nonpharmacological&#46; The success of these strategies&#44; however&#44; is far from ideal&#46;<a class="elsevierStyleCrossRefs" href="#bib0215"><span class="elsevierStyleSup">7&#8211;11</span></a> The current recommendations on drug treatment reserve antipsychotics and other sedatives for risk situations for the patient or medical personnel or when other essential medical therapies can be interrupted&#46;<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">12</span></a> A recent meta-analysis supported multilevel interventions without clear evidence that melatonin or cholinesterase inhibitors were useful&#46;<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">1</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Given the high prevalence of delirium in hospitalized patients and its negative impact on hospitalization and on patients who are subsequently institutionalized&#44; we decided to employ the minimum basic data set &#40;MBDS&#41; to investigate the prevalence of delirium and its associated factors in Spain&#46; The MBDS is a database that hospitals of Spain&#39;s public health network must fill out and send to the Ministry of Health&#44; Consumer Affairs and Social Welfare&#46; The ultimate objective is to obtain a state standard&#44; a collection of indicators that define the activity of Spain&#39;s National Health System &#40;SNHS&#41; concerning the admissions classified using diagnosis-related groups &#40;DRGs&#41;&#46; The MBDS has been useful as a research tool in other studies conducted by the Clinical Management Workgroup of the Spanish Society of Internal Medicine&#46;<a class="elsevierStyleCrossRefs" href="#bib0240"><span class="elsevierStyleSup">12&#8211;17</span></a> In this case&#44; we employed data from more than 4&#46;5 million discharges and more than 100&#44;000 cases of delirium over a period of 8 years&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Methods</span><p id="par0020" class="elsevierStylePara elsevierViewall">We conducted a retrospective study that analyzed the information provided by the Ministry of Health&#44; Social Services and Equality from the MBDS of the discharges of patients admitted to the internal medicine departments of SNHS hospitals between January 1&#44; 2007 and December 31&#44; 2014&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">The diagnoses and procedures were coded using the 5th edition of the International Classification of Diseases-9th Revision-Clinical Modification &#40;ICD-9-CM&#41;&#46; The discharge processes were grouped using the patient classification system All Patients Diagnosis-Related Groups &#40;AP-DRG&#41; &#40;version 21&#41;&#46; The MBDS data include the classification by hospital size&#59; hospitalization conditions &#40;1&#44; emergency&#59; 2&#44; scheduled&#41;&#59; and circumstances of discharge &#40;1&#44; to home&#44; 2&#44; transfer to another hospital&#44; 3&#44; voluntary discharge&#44; 4&#44; death&#41;&#46; The main diagnosis according to the ICD-9 is the reason for admission after the examination of the patient &#40;even when there were significant complications or new independent diagnoses that are recorded as secondary diagnoses&#41;&#46; These secondary diagnoses &#40;up to 12&#41; can coexist with the main diagnosis&#46; Each patient in our series was classified into a DRG&#44; which are useful for classifying admissions by diagnosis and procedure under the assumption that patients with similar diagnoses consume similar resources and thereby incur similar expenses&#46; Each DRG has a relative weight that reflects the intensity of resources consumed&#46; To identify the patients with delirium&#44; we selected the following ICD-9 codes&#58; ICD-9-CM 298 or 293&#46;5 as the primary or secondary diagnosis in any of the diagnosis fields of the discharge report&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">We calculated the Ch arlson comorbidity index &#40;CCI&#41;<a class="elsevierStyleCrossRefs" href="#bib0270"><span class="elsevierStyleSup">18&#44;19</span></a> for each patient&#46; This index is based on the ICD categories and reflects the number and severity of the comorbidities&#46; The ICD has been adapted for use in clinical-administrative databases and assigns a weight &#40;on a scale from 1 to 16&#41;&#44; scoring up to 19 medical conditions&#46; The final score ranges from 0 to 37 &#40;a score &#8805;2 predicts a mortality &#62;50&#37; per year&#41;&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Based on the ICD-9-CM&#44; we identified the following risk factors in the primary and secondary diagnosis fields &#40;ICD-9-CM codes shown in parentheses&#41;&#58; pressure ulcer &#40;707&#42;&#41;&#44; urinary tract infection &#40;599&#46;00&#44; 590&#42;&#44; 646&#46;60&#8211;49&#44; 601&#41;&#44; sepsis &#40;038&#42;&#44; 995&#46;91&#44; 995&#46;92&#41;&#44; congestive heart failure &#40;398&#46;91&#44; 404&#42;&#44; 402&#46;11&#44; 402&#46;91&#44; 428&#8211;428&#46;9&#41;&#44; peripheral arterial disease &#40;440&#8211;448&#41;&#44; dementia &#40;290&#8211;290&#46;9&#41;&#44; cancer &#40;140&#46;0&#8211;172&#46;9&#44; 174&#46;0&#8211;195&#46;8&#44; 200&#8211;208&#46;9&#41;&#44; metastatic cancer &#40;196&#46;0&#8211;199&#46;99&#41;&#44; cerebrovascular disease &#40;430&#8211;438&#41;&#44; malnutrition &#40;260&#8211;263&#46;9&#41;&#44; colitis by <span class="elsevierStyleItalic">Clostridium difficile</span> &#40;008&#46;45&#41;&#44; upper gastrointestinal hemorrhage &#40;530&#46;2&#44; 530&#46;82&#44; 531&#44; 532&#42;&#44; 533&#42; 534&#42;&#44; 535&#46;10&#8211;60&#44; 537&#46;83&#41;&#44; liver disease &#40;571&#46;0&#8211;571&#46;99&#59; 572&#46;2&#8211;572&#46;8&#41;&#44; acquired immune deficiency syndrome &#40;042&#46;00&#44; V08&#41;&#44; septicemia by methicillin-sensitive <span class="elsevierStyleItalic">Staphylococcus aureus</span> &#40;038&#46;11&#41;&#44; septicemia by methicillin-resistant <span class="elsevierStyleItalic">Staphylococcus aureus</span> &#40;038&#46;12&#41;&#44; bladder catheter &#40;57&#46;94&#41;&#44; nasogastric tube &#40;96&#46;35&#41;&#44; enteral nutrition &#40;96&#46;6&#41;&#44; parenteral nutrition &#40;99&#46;15&#41;&#44; gastrostomy &#40;44&#46;11&#44; 44&#46;19&#44; 44&#46;32&#41; and palliative care consultation &#40;V66&#46;7&#41;&#46;</p><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Statistical analysis</span><p id="par0040" class="elsevierStylePara elsevierViewall">We performed a descriptive analysis of the patients included with the demographic and clinical variables&#44; comparing the hospitalized patients with and without delirium&#46; For the dichotomous variables&#44; we employed the chi-squared test with Yates correction and Fisher&#39;s exact test when the expected value in a cell was &#60;5&#46; For the quantitative variables&#44; we employed Student&#39;s <span class="elsevierStyleItalic">t</span>-test for independent samples&#46; We analyzed the rate at which delirium was coded during the study period&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">Given that this was a government database&#44; controlling the confounding variables was essential&#46; For this reason&#44; we performed a logistic regression analysis to determine the risk of mortality and readmission attributable to the presence of delirium after correcting for potential confounding factors such as age&#44; Charlson index&#44; sex and the presence of dementia&#46; The OR and confidence intervals &#40;CI&#41; were calculated based on the coefficients of the regression indices&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">We also performed an estimate of the expenditure attributable to the presence of delirium during the hospitalization&#46; To this end&#44; we calculated the figure for the extra stay attributable to delirium&#44; multiplying it by the cost for 1 day of hospitalization and then by the total number of episodes of delirium identified over the course of the study period&#46; This operation enabled us to obtain a total expenditure figure&#44; as well as the extra expenditure per patient&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">Using our data&#44; we constructed a model for predicting the risk of developing delirium during the hospitalization using the presence or absence of the following variables during the hospitalization&#44; as well as age and sex&#58; diabetes&#44; dementia&#44; dysphagia&#44; depression&#44; malnutrition&#44; hyponatremia&#44; pneumonia&#44; urinary tract infection&#44; sepsis and admission from a nursing home&#46; For our model&#44; we calculated the calibration using the Hosmer&#8211;Lemeshow test and calculated the discriminatory capacity using a receiver operating characteristic curve&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">The threshold for statistical significance was set at <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;05&#46; We employed the commercial software SPSS version 16 &#40;SPSS Inc&#46;&#44; Chicago&#44; IL&#41;&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">The study was not evaluated by an ethics committee given that this was a completely anonymous computerized database with no possibility of linking the information to individuals&#46;</p></span></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Results</span><p id="par0070" class="elsevierStylePara elsevierViewall">We analyzed a total of 4&#44;628&#44;397 discharges by internal medicine departments during the study period &#40;2007&#8211;2014&#41; from all hospitals of the SNHS&#46; We identified a diagnosis of delirium in 114&#44;343 discharge reports &#40;prevalence of 2&#46;5&#37;&#41;&#46; Of these&#44; 14&#44;925 cases had delirium as the primary diagnosis&#44; and 99&#44;418 had it as the secondary diagnosis&#46; The patients with delirium were generally elderly &#40;mean age&#44; 79&#46;0<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>12&#46;8 vs&#46; 71&#46;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>16&#46;9 years&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;0001&#41;&#46; With most cases of delirium in the 81&#8211;90-year age group &#40;48&#37; of all cases&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46; The patients&#8217; mean age increased over the course of the study period &#40;76&#46;6 years in 2007 vs&#46; 80&#46;3 years in 2014&#41; as the number of cases coded per year increased&#46; We found no significant differences by sex &#40;47&#46;4&#37; vs&#46; 47&#46;8&#37; in women&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;053&#41;&#46; Delirium was significantly more common in patients admitted from nursing homes &#40;4&#46;5&#37; vs&#46; 2&#46;9&#37;&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;0001&#41;&#44; and these patients were significantly more often discharged to an institution than were the general population &#40;4&#46;3&#37; vs&#46; 1&#46;2&#37;&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0075" class="elsevierStylePara elsevierViewall">The diagnoses most commonly associated with delirium during the hospitalization were dementia &#40;14&#37; vs&#46; 7&#37;&#41;&#44; depression &#40;11&#46;2&#37; vs&#46; 7&#46;1&#37;&#41;&#44; cerebrovascular disease &#40;17&#37; vs&#46; 11&#37;&#41;&#44; malnutrition &#40;4&#37; vs&#46; 2&#37;&#41;&#44; pressure ulcers &#40;4&#37; vs&#46; 2&#37;&#41;&#44; dysphagia &#40;2&#37; vs&#46; 0&#46;2&#37;&#41; and hyponatremia &#40;5&#37; vs&#46; 2&#37;&#41; &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001 in all cases&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41;&#46; The number of comorbidities &#40;evaluated using the CCI&#41; in the population with delirium increased over the study period&#46; <a class="elsevierStyleCrossRefs" href="#fig0005">Figs&#46; 1 and 2</a> show the temporal progression of the annual cases of delirium over the study period&#46; <a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a> shows the comorbidity of the study population expressed according to the Charlson index for each year&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0080" class="elsevierStylePara elsevierViewall">The patients with delirium coded in their discharge report also had a higher rate of sepsis &#40;5&#37; vs&#46; 3&#37;&#41;&#44; urinary tract infection &#40;12&#37; vs&#46; 7&#37;&#41; and pneumonia &#40;14&#37; vs&#46; 10&#46;7&#37;&#41; &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;0001&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41;&#46; The patients with obesity had a lower likelihood of delirium that those without obesity &#40;5&#37; vs&#46; 8&#37;&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;0001&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41;&#46; Most of the risk factors we selected were associated in our series with the presence of delirium in the discharge report&#44; with the exception of peripheral arterial disease and cancer&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">In terms of the analyzed procedures&#44; we found significant differences between the population with and without delirium&#46; Magnetic resonance imaging and the placement of urinary catheters&#44; nasogastric tubes and central venous pathways were performed more often on the population with delirium&#46; We found no significant differences in the transfusion of blood products&#44; and computed tomography was performed less often in the population with delirium encoded in the discharge report&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">Finally&#44; the patients with delirium had a significantly longer mean stay &#40;11&#46;85<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>13&#46;15 days vs&#46; 9&#46;49<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>11&#46;17&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;0001&#41; and a higher hospital mortality &#40;12&#37; vs&#46; 10&#37;&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;0001&#41;&#46; Daily hospitalization and internal medicine costs have been estimated at &#8364;400 in Spain&#46; Our study has shown a mean increase of 2&#46;36 days in the length of stay attributable to delirium&#59; each patient with delirium therefore incurred an increase in costs of &#8364;944 per hospitalization&#46; With 114&#44;343 episodes of delirium during the 8-year study period&#44; the excess expenditures attributable to delirium increased to &#8364;107&#44;939&#44;792 for the SNHS&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">The multivariate analysis showed that the development of delirium during hospitalization in our series was independently associated with age&#44; the male sex and hyponatremia &#40;OR&#44; 2&#46;05&#59; 95&#37; CI 1&#46;94&#8211;2&#46;06&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;0001&#41;&#44; dysphagia &#40;OR&#44; 1&#46;65&#59; 95&#37; CI 1&#46;57&#8211;1&#46;73&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;0001&#41;&#44; malnutrition &#40;OR&#44; 1&#46;75&#59; 95&#37; CI 1&#46;7&#8211;1&#46;81&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;0001&#41; and urinary tract infection &#40;OR&#44; 1&#46;54&#59; 95&#37; CI 1&#46;51&#8211;1&#46;57&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;0001&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#41;&#46; Originating from an institution &#40;nursing home&#41; also increased the risk of delirium &#40;OR&#44; 1&#46;09&#59; 95&#37; CI 1&#46;05&#8211;1&#46;12&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;0001&#41;&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0100" class="elsevierStylePara elsevierViewall">Delirium was also independently associated with the in-hospital mortality risk &#40;OR&#44; 1&#46;41&#59; 95&#37; CI 1&#46;39&#8211;1&#46;43&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;0001&#41; after correcting for age and sex in the multiple logistic regression model &#40;<a class="elsevierStyleCrossRef" href="#tbl0020">Table 4</a>&#41;&#46; In the analysis of the encoded procedures&#44; bladder catheterization and nasogastric intubation were more common for the patients with delirium &#40;<a class="elsevierStyleCrossRefs" href="#tbl0025">Tables 5 and 6</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia><elsevierMultimedia ident="tbl0025"></elsevierMultimedia><elsevierMultimedia ident="tbl0030"></elsevierMultimedia><p id="par0105" class="elsevierStylePara elsevierViewall">By taking advantage of the considerable sample size&#44; we constructed a model to predict the risk of developing delirium during hospitalization&#46; This model reached a sensitivity of only 39&#46;8&#37; &#40;false negatives&#44; 60&#37;&#41; but had a much better specificity &#40;80&#37;&#41;&#46; The AUC&#44; however&#44; was just acceptable &#40;0&#46;656&#41;&#46; This result meant that our model was able to identify patients with a low risk of developing delirium but could not predict those with a high risk&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Discussion</span><p id="par0110" class="elsevierStylePara elsevierViewall">We have shown that 2&#46;5&#37; of patients hospitalized in Spanish internal medicine departments over an 8-year period had a delirium diagnosis coded in their discharge report and that this situation is associated with a significantly longer hospital stay and significantly greater mortality&#46; We confirmed that numerous comorbidities and procedures&#44; as well as living in an institution&#44; are associated with the presence of delirium during the hospitalization&#46;</p><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Prevalence</span><p id="par0115" class="elsevierStylePara elsevierViewall">The prevalence of 2&#46;5&#37; in our study is lower than the recently reported 16&#46;5&#37; in a patient group with neurological conditions hospitalized in Spain<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">4</span></a> and the 19&#46;1&#37; reported in an acute care medical ward of a general hospital&#46;<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">2</span></a> In the literature&#44; the figures reach 50&#37; of hospitalized patients at risk of delirium&#44; with rates that vary according to the study population &#40;mean age&#44; comorbidities&#41; and the scenario &#40;hospital department&#44; unit&#44; residence&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">20</span></a> In our study&#44; we obtained the information exclusively from the discharge report&#44; and delirium was not detected systematically&#46; These 2 facts are surely responsible&#44; at least in part&#44; for the low prevalence detected in our series&#46; Delirium is probably underreported in discharge reports&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Factors associated with delirium</span><p id="par0120" class="elsevierStylePara elsevierViewall">Unlike other studies&#44; we observed that delirium was not associated with an increased degree of comorbidity as evaluated by the adapted version of the CCI&#44;<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">1</span></a> although none of the other studies employed this index as a measure of comorbidity&#46; A systematic literature review showed how the number of comorbidities was associated with the persistence of delirium at the time of and beyond the discharge&#46;<a class="elsevierStyleCrossRef" href="#bib0285"><span class="elsevierStyleSup">21</span></a></p><p id="par0125" class="elsevierStylePara elsevierViewall">The independent factors associated with an increase in the presence of delirium in our series were related to age&#44; residence &#40;institutionalization&#41;&#44; neuropsychiatric comorbidities &#40;dementia and depression&#41;&#44; metabolic comorbidities &#40;diabetes&#44; nutritional malnutrition and dysphagia&#41;&#44; hydroelectrolytic disorders &#40;hyponatremia&#41; and infectious disorders &#40;sepsis&#44; urinary tract infections and pneumonia&#41;&#46; These factors have been previously reported in hospitalized patients with delirium and can be considered as precipitating factors&#46; A meta-analysis of 11 studies with a total of 2388 patients &#40;411 participants and 1927 controls&#41; identified the following factors&#58; dementia&#44; age&#44; comorbidity&#44; severity of the acute disease&#44; infection&#44; reduced activities of daily life&#44; immobility&#44; sensory impairment&#44; bladder catheterization&#44; urea and electrolyte disorders and malnutrition&#46; In another prospective study&#44; both previous dementia and the severity of the acute disease appeared as clear risk factors for developing delirium in patients older than 80 years hospitalized in internal medicine wards&#46; The multivariate analysis identified infection and uremia as additional risk factors&#46; The presence of more than 4 risk factors&#44; hyponatremia&#44; depression and previous functional deficit were only identified as risk factors in the univariate analysis&#46;<a class="elsevierStyleCrossRefs" href="#bib0290"><span class="elsevierStyleSup">22&#44;23</span></a> The analysis of the procedures performed by internal medicine departments show that patients with delirium are catheterized more often than the general population&#44; a maneuver linked to delirium in other studies&#46;<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">24</span></a> Among the other procedures&#44; only computed tomography is performed more often in the general population&#44; which could suggest that delirium develops in a patient group especially susceptible to iatrogenesis&#46; Among the other procedures&#44; only computed tomography is performed more often in the general population&#44; which could suggest that delirium develops in a patient group especially susceptible to iatrogenesis&#46; It is worth asking&#44; however&#44; whether instrumentalization and the excess of procedures undergone by these patients are the cause or consequence of the delirium they develop&#46; Of course&#44; our study was not designed to answer this question&#46; However&#44; a number of the measures taken with these patients can lead to excessive instrumentalization and should be avoided &#40;e&#46;g&#46;&#44; clamping measures that lead to a loss of pathways&#44; phlebitis &#91;sometimes septic&#93; and the need for placing central venous pathways&#41;&#46; The progression of confusional syndromes to frank delirium can prevent sufficient feeding and precipitate bronchoaspiration or the need for an artificial feeding tube&#46; There is only one solution for this&#58; early identification and prevention of at-risk patients&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">For elderly hospitalized patients&#44; depressive symptoms&#44; cognitive impairment and dementia are known risk factors for developing delirium&#46; Malnutrition frequently occurs in patients with cognitive impairment&#44; even those with mild impairment&#44; and is associated with an increased risk of developing delirium during the hospitalization&#46;<a class="elsevierStyleCrossRefs" href="#bib0305"><span class="elsevierStyleSup">25&#8211;28</span></a> Hyponatremia and infections are the most common acute conditions associated with the development of intrahospital delirium in elderly patients&#46; This information could be useful for identifying patients at risk and implementing more rigorous measures aimed at prevention&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">Delirium is a marker of cognitive frailty and of a poor outcome of hospitalization&#46; According to previous studies&#44;<a class="elsevierStyleCrossRefs" href="#bib0200"><span class="elsevierStyleSup">4&#44;29</span></a> the presence of delirium lengthens the stay and thereby increases the hospitalization costs&#46; The importance of delirium might continue to be underestimated while its social and economic implications continue to be undocumented&#46;<a class="elsevierStyleCrossRef" href="#bib0330"><span class="elsevierStyleSup">30</span></a> Current estimates suggest that this disease complicates the hospitalizations of more than 2&#46;3 million elderly individuals annually in the United States&#44; representing 17&#46;5 million days of hospitalization for a total amount exceeding 4 billion dollars&#46;<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">7</span></a> In our study&#44; the excess costs attributable to delirium in 8 years exceeded &#8364;100 million&#44; with a mean of almost &#8364;1000 per hospitalization&#47;patient&#46;</p><p id="par0140" class="elsevierStylePara elsevierViewall">A study on patients older than 65 years hospitalized for acute disease showed that delirium present at admission behaved as an independent risk factor for hospital mortality and mortality at 3 months of discharge&#46;<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">7</span></a> A systematic review and meta-analysis of 42 studies on critically ill patients with delirium showed that delirium was associated with increased mortality risk&#44; institutionalization and dementia&#46;<a class="elsevierStyleCrossRef" href="#bib0335"><span class="elsevierStyleSup">31</span></a> In our study&#44; the mean age of the patients with delirium increased over the study period&#46; The comorbidities evaluated with the CCI also increased&#46; Delirium in many cases can be interpreted as the consequence of hospitalization for patients with internal &#40;comorbidities&#41; and external risk factors &#40;hospitalization-related&#41;&#46;</p><p id="par0145" class="elsevierStylePara elsevierViewall">Numerous strategies aimed at mitigating the severe repercussions of delirium have been attempted&#59; however&#44; the initial experiences were not favorable&#46;<a class="elsevierStyleCrossRefs" href="#bib0220"><span class="elsevierStyleSup">8&#44;9&#44;5</span></a> More recent studies have achieved somewhat better efficacy&#44; although the evidence is still limited&#46;<a class="elsevierStyleCrossRef" href="#bib0340"><span class="elsevierStyleSup">32</span></a> It is also important to note that errors in treating these patients can also lead to the development of this condition&#46;<a class="elsevierStyleCrossRef" href="#bib0345"><span class="elsevierStyleSup">33</span></a></p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Predictive model</span><p id="par0150" class="elsevierStylePara elsevierViewall">Our predictive model did not achieve the desired objective&#46; However&#44; the model showed a good capacity for identifying patients at low risk of developing delirium during the hospitalization&#46; A significant number of predictive scales and models have been published for identifying patients at risk&#46; In postsurgical patients&#44; the preoperative situation is the best predictor&#44; and age behaves as an independent factor&#46; Postsurgical delirium is 4 times more common in emergency surgery than in elective surgery&#46;<a class="elsevierStyleCrossRef" href="#bib0350"><span class="elsevierStyleSup">34</span></a> In elderly patients in general&#44; incidental delirium is independently associated with a poorer functional state &#40;Barthel index&#41; and dehydration &#40;creatinine-urea ratio&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0355"><span class="elsevierStyleSup">35</span></a> However&#44; we still lack a good model to identify medical patients with a high risk of delirium&#46;</p><p id="par0155" class="elsevierStylePara elsevierViewall">Prevention measures and improving the early diagnosis are the first steps in treating delirium in Spanish internal medicine departments&#44; where the mean age has exceeded 74 years and the CCI approaches 5&#46;<a class="elsevierStyleCrossRef" href="#bib0360"><span class="elsevierStyleSup">36</span></a> Multilevel interventions &#40;pharmacological&#44; environmental and rehabilitative&#41; have been shown to be the most effective when resolving this condition&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Limitations</span><p id="par0160" class="elsevierStylePara elsevierViewall">Our study does not lack limitations&#46; As with any retrospective study based on clinical-government data&#44; it is safe to say that not all diagnoses of delirium were correctly included&#46; Considering the low prevalence observed in our study&#44; it is more than likely that a considerable number of cases were not registered&#44; A problem that has already been reported in other studies with large databases&#46;<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">4</span></a> Having numerous comorbidities is not uncommon in patients hospitalized in internal medicine &#40;22&#37; of our series had a CCI<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>2&#41;&#44; Which would explain why the diagnosis of intrahospital delirium can go unreported or be considered a minor diagnosis in hospitalized patients with severe acute processes and a considerable number of complications&#46; In any case&#44; one of the strengths of our study is the considerable sample size and statistical power it confers&#46; We had access to more than 4&#46;5 million discharge reports and more than 100&#44;000 episodes of delirium over the course of 8 years&#44; a number rarely accessible among publications on this topic&#46;</p></span></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Conclusions</span><p id="par0165" class="elsevierStylePara elsevierViewall">Our analysis of an extensive clinical-government database of more than 4&#46;5 million discharges and 100&#44;000 episodes of delirium in patients hospitalized in internal medicine departments in Spain over 8 years shows that these patients are older than other hospitalized patients&#44; have a longer mean stay and have greater mortality&#46;</p><p id="par0170" class="elsevierStylePara elsevierViewall">Institutionalization was associated with a greater prevalence of delirium and a greater possibility of being discharged to an institution than the rest of the hospitalized population&#46; Unlike other studies&#44; we found that the patients with a higher level of comorbidities &#40;measured by the CCI&#41; did not have a greater risk of developing delirium&#46; Delirium is infracoded and likely underreported in the discharge reports prepared by internists&#46; This issue needs improvement in the management of this disease&#44; which currently lacks prevention and whose negative repercussions represent patient suffering and death and healthcare system expenditures&#46;</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Funding</span><p id="par0175" class="elsevierStylePara elsevierViewall">This research study received no grant or financial assistance from funding agencies of the public&#44; private or commercial sector&#46;</p></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0130">Conflicts of interest</span><p id="par0180" class="elsevierStylePara elsevierViewall">None of the authors are subject to conflicts of interest concerning this article&#46;</p></span></span>"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objectives</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">To investigate the prevalence of reported delirium and its associated factors and costs&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Design</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Retrospective and descriptive analysis of a national clinical-administrative database that includes all patients hospitalized in Spain in internal medicine departments from January 2007 to December 2014&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Material and method</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">The study included the patients&#8217; sociodemographic and clinical data &#40;sex&#44; age&#44; diagnosis and procedures&#41;&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Results</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">The prevalence of reported delirium was 2&#46;5&#37; &#40;114&#44;343 of 4&#44;628&#44;397 discharge reports&#41;&#46; Delirium was most common in the 81&#8211;90-year age group &#40;48&#37;&#41; and in institutionalized patients &#40;4&#46;5&#37; vs&#46; 2&#46;9&#37;&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001&#41;&#46; The diagnoses most associated with delirium were dementia &#40;14&#37; vs&#46; 7&#37; for patients without delirium&#41;&#44; cerebrovascular disease &#40;17&#37; vs&#46; 11&#37;&#41;&#44; malnutrition &#40;4&#37; vs&#46; 2&#37;&#41;&#44; pressure ulcers &#40;4&#37; vs&#46; 2&#37;&#41;&#44; dysphagia &#40;2&#37; vs&#46; 0&#46;2&#37;&#41; and hyponatraemia &#40;5&#37; vs&#46; 2&#37;&#41; &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001 in all cases&#41;&#46; Patients with delirium also had longer mean stays &#40;11&#46;85<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>13&#46;15<span class="elsevierStyleHsp" style=""></span>days vs&#46; 9&#46;49<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>11&#46;17&#41; and higher hospital mortality &#40;OR&#58; 1&#46;41&#59; 95&#37;<span class="elsevierStyleHsp" style=""></span>CI&#58; 1&#46;39&#8211;1&#46;43&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;0001&#41;&#46;</p><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">The costs attributable to delirium in 8 years exceeded &#8364;100 million &#40;almost &#8364;1000 per hospitalization&#47;patient&#41;&#46; We developed a predictive model for the risk of developing delirium&#44; which has insufficient sensitivity but is useful for identifying low-risk patients&#46;</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Conclusions</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Patients who develop delirium during their hospitalization in internal medicine have a longer stay&#44; greater mortality and an increased risk of being institutionalized at discharge&#46; Delirium is probably poorly reported in the discharge reports prepared by internists&#46;</p></span>"
        "secciones" => array:5 [
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            "identificador" => "abst0005"
            "titulo" => "Objectives"
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            "titulo" => "Design"
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        "resumen" => "<span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Objetivos</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Investigar la prevalencia del delirio reportado&#44; los factores asociados y los costes&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Dise&#241;o</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">An&#225;lisis retrospectivo y descriptivo de una base de datos cl&#237;nico-administrativa nacional que incluye todos los pacientes ingresados en Espa&#241;a en los servicios de medicina interna desde enero de 2007 a diciembre de 2014&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Material y m&#233;todo</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Se incluyen datos sociodemogr&#225;ficos y cl&#237;nicos &#40;sexo&#44; edad&#44; diagn&#243;stico y procedimientos&#41;&#44; entre otros&#46;</p></span> <span id="abst0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Resultados</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">La prevalencia del delirio reportado fue del 2&#44;5&#37; &#40;114&#46;343 de 4&#46;628&#46;397 informes de alta&#41;&#46; El delirio fue m&#225;s frecuente en el grupo de 81 a 90 a&#241;os &#40;48&#37;&#41; y en pacientes institucionalizados &#40;4&#44;5&#37; vs 2&#44;9&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#46; Los diagn&#243;sticos m&#225;s asociados al delirio fueron demencia &#40;14&#37; vs 7&#37; en los sujetos sin delirio&#41;&#44; enfermedad cerebrovascular &#40;17&#37; vs 11&#37;&#41;&#44; desnutrici&#243;n &#40;4&#37; vs 2&#37;&#41;&#44; &#250;lceras por presi&#243;n &#40;4&#37; vs 2&#37;&#41;&#44; disfagia &#40;2&#37; vs 0&#44;2&#37;&#41; e hiponatremia &#40;5&#37; vs 2&#37;&#41;&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001 en todos los casos&#46; Tambi&#233;n tuvieron una estancia media m&#225;s larga&#58; 11&#44;85 &#40;DE&#58; 13&#44;15&#41; d&#237;as vs 9&#44;49 &#40;DE&#58; 11&#44;17&#41; d&#237;as&#44; y mortalidad intrahospitalaria m&#225;s elevada &#40;OR&#58; 1&#44;41&#59; IC<span class="elsevierStyleHsp" style=""></span>95&#37;&#58; 1&#44;39-1&#44;43&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;0001&#41;&#46;</p><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">El coste atribuible al delirio en 8<span class="elsevierStyleHsp" style=""></span>a&#241;os supera los 100 millones de euros &#40;casi 1&#46;000<span class="elsevierStyleHsp" style=""></span>&#8364; por ingreso&#47;paciente&#41;&#46; Elaboramos un modelo predictivo del riesgo de desarrollar delirio sin sensibilidad suficiente pero &#250;til para identificar pacientes de bajo riesgo&#46;</p></span> <span id="abst0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Conclusiones</span><p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Los pacientes que desarrollan delirio durante su ingreso en medicina interna tienen una estancia m&#225;s prolongada&#44; mayor mortalidad y mayor riesgo de ser institucionalizados al alta&#46; El delirio est&#225; probablemente poco reportado en los informes de alta que elaboran los internistas&#46;</p></span>"
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            "titulo" => "Dise&#241;o"
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            "identificador" => "abst0040"
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      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Marco J&#44; M&#233;ndez M&#44; Cruz-Jentoft AJ&#44; Garc&#237;a Klepzig JL&#44; Calvo E&#44; Canora J&#44; et al&#46; Caracter&#237;sticas cl&#237;nicas del delirio y sus implicaciones pron&#243;sticas en los servicios de medicina interna espa&#241;oles&#58; an&#225;lisis de una gran base de datos cl&#237;nico-administrativa&#46; Rev Clin Esp&#46; 2019&#59;219&#58;415&#8211;423&#46;</p>"
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                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Mean age&#44; years &#40;SD&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">79&#46;1 &#40;12&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">71&#46;9 &#40;16&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;0001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Female&#44; <span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">46&#44;824 &#40;47&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;147&#44;066 &#40;47&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;053&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Mean stay&#44; days &#40;SD&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11&#46;85 &#40;13&#46;15&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&#46;49 &#40;11&#46;17&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;0001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Institutionalized&#44; <span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4460 &#40;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">130&#44;891 &#40;2&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;0001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Charlson Comorbidity Index &#62;2&#44; <span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">21&#44;818 &#40;22&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">958&#44;885 &#40;21&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;0001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Mean Charlson Comorbidity Index&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;69&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;56&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">COPD&#44; <span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">35&#44;059 &#40;35&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">165&#44;037 &#40;36&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;0001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Diabetes&#44; <span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">29&#44;602 &#40;30&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;273&#44;451 &#40;28&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;0001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Heart failure&#44; <span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">22&#44;350 &#40;28&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;070&#44;044 &#40;24&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;0001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Anemia&#44; <span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">18&#44;208 &#40;18&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">754&#44;272 &#40;17&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;0001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Cerebrovascular disease&#44; <span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">17&#44;167 &#40;17&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">502&#44;048 &#40;11&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;0001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Pneumonia&#44; <span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13&#44;794 &#40;14&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">486&#44;834 &#40;11&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;0001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Dementia&#44; <span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13&#44;466 &#40;14&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">334&#44;478 &#40;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;0001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Chronic renal failure&#44; <span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13&#44;164 &#40;13&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">497&#44;157 &#40;11&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;0001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Urinary tract infection&#44; <span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11&#44;819 &#40;12&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">299&#44;332 &#40;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;0001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Neoplasia&#44; <span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11&#44;044 &#40;11&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">502&#44;839 &#40;11&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;478&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Depression&#44; <span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7591 &#40;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">286&#44;239 &#40;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">&#46;0001&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">Ischemic heart disease&#44; <span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Sepsis&#44; <span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">Dysphagia&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">1&#46;65&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;57&#8211;1&#46;73&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;0001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Depression&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;31&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;28&#8211;1&#46;35&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;0001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Malnutrition&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;75&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;70&#8211;1&#46;81&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;0001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hyponatremia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;05&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;94&#8211;2&#46;06&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;0001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Pneumonia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;21&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;19&#8211;1&#46;24&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;0001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Urinary tract infection&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;54&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;54&#8211;1&#46;51&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;0001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Sepsis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;31&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;28&#8211;1&#46;35&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;0001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Variable&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Odds ratio&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">95&#37; CI&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;0001&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">Age&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;104&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;104&#8211;1&#46;105&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;0001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Male sex&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;02&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;019&#8211;1&#46;026&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;0001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Delirium&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;54&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;52&#8211;1&#46;57&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;0001&nbsp;\t\t\t\t\t\t\n
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                  <table border="0" frame="\n
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                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">No delirium &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>4&#44;527&#44;938&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Computed axial tomography&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11&#44;032 &#40;11&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">636&#44;933 &#40;14&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;&#46;0001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Magnetic resonance imaging&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4886 &#40;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">163&#44;101 &#40;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;&#46;0001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Transfusion of blood products&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5630 &#40;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">255&#44;406 &#40;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;476&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Urinary catheter&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5139 &#40;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
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              "identificador" => "bib0185"
              "etiqueta" => "1"
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Delirium&#58; screening prevention&#44; and diagnosis &#8212; a systematic review of the evidence&#46; VA evidence-based synthesis program reports"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "N&#46; Greer"
                            1 => "R&#46; Rossom"
                            2 => "P&#46; Anderson"
                            3 => "R&#46; MacDonald"
                            4 => "J&#46; Tacklind"
                            5 => "I&#46; Rutks"
                          ]
                        ]
                      ]
                    ]
                  ]
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                    0 => array:1 [
                      "Libro" => array:3 [
                        "fecha" => "2011"
                        "editorial" => "Department of Veterans Affairs &#40;US&#41;"
                        "editorialLocalizacion" => "Washington &#40;DC&#41;"
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "identificador" => "bib0190"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Incidence and predictive factors of delirium in hospitalised neurological patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "B&#46; Ruiz Bajo"
                            1 => "J&#46;C&#46; Roche Bueno"
                            2 => "M&#46; Seral Moral"
                            3 => "J&#46; Mart&#237;n Mart&#237;nez"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.nrl.2012.07.001"
                      "Revista" => array:6 [
                        "tituloSerie" => "Neurologia"
                        "fecha" => "2013"
                        "volumen" => "28"
                        "paginaInicial" => "356"
                        "paginaFinal" => "360"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23063732"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0195"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Delirium prevention and treatment in elderly hip fracture"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "M&#46;J&#46; Robles"
                            1 => "F&#46; Formiga"
                            2 => "M&#46;T&#46; Vid&#225;n"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Med Clin &#40;Barc&#41;"
                        "fecha" => "2014"
                        "volumen" => "142"
                        "paginaInicial" => "365"
                        "paginaFinal" => "369"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0200"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Underreporting of delirium in statewide claims data&#58; implications for clinical care and predictive modeling"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "T&#46;H&#46; McCoy Jr&#46;"
                            1 => "L&#46; Snapper"
                            2 => "T&#46;A&#46; Stern"
                            3 => "R&#46;H&#46; Perlis"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.psym.2016.06.001"
                      "Revista" => array:6 [
                        "tituloSerie" => "Psychosomatics"
                        "fecha" => "2016"
                        "volumen" => "57"
                        "paginaInicial" => "480"
                        "paginaFinal" => "488"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27480944"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0205"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A multicomponent intervention to prevent delirium in hospitalized older patients"
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                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "S&#46;K&#46; Inouye"
                            1 => "S&#46;T&#46; Bogardus Jr&#46;"
                            2 => "P&#46;A&#46; Charpentier"
                            3 => "L&#46; Leo-Summers"
                            4 => "D&#46; Acampora"
                            5 => "T&#46;R&#46; Holford"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1056/NEJM199903043400901"
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                        "tituloSerie" => "N Engl J Med"
                        "fecha" => "1999"
                        "volumen" => "340"
                        "paginaInicial" => "669"
                        "paginaFinal" => "676"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10053175"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "identificador" => "bib0210"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Delirium in elderly patients and the risk of postdischarge mortality&#44; institutionalization&#44; and dementia&#58; a meta-analysis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "J&#46; Witlox"
                            1 => "L&#46;S&#46; Eurelings"
                            2 => "J&#46;F&#46; de Jonghe"
                            3 => "K&#46;J&#46; Kalisvaart"
                            4 => "P&#46; Eikelenboom"
                            5 => "W&#46;A&#46; van Gool"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1001/jama.2010.1013"
                      "Revista" => array:6 [
                        "tituloSerie" => "JAMA"
                        "fecha" => "2010"
                        "volumen" => "304"
                        "paginaInicial" => "443"
                        "paginaFinal" => "451"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20664045"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "identificador" => "bib0215"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Multicomponent targeted intervention to prevent delirium in hospitalized older patients&#58; what is the economic value&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "J&#46;A&#46; Rizzo"
                            1 => "S&#46;T&#46; Bogardus Jr&#46;"
                            2 => "L&#46; Leo-Summers"
                            3 => "C&#46;S&#46; Williams"
                            4 => "D&#46; Acampora"
                            5 => "S&#46;K&#46; Inouye"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/00005650-200107000-00010"
                      "Revista" => array:6 [
                        "tituloSerie" => "Med Care"
                        "fecha" => "2001"
                        "volumen" => "39"
                        "paginaInicial" => "740"
                        "paginaFinal" => "752"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11458138"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0220"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Multicomponent intervention strategies for managing delirium in hospitalized older people&#58; systematic review"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "K&#46; Milisen"
                            1 => "J&#46; Lemiengre"
                            2 => "T&#46; Braes"
                            3 => "M&#46;D&#46; Foreman"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1365-2648.2005.03557.x"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Adv Nurs"
                        "fecha" => "2005"
                        "volumen" => "52"
                        "paginaInicial" => "79"
                        "paginaFinal" => "90"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16149984"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The effects of a targeted multicomponent delirium intervention on postdischarge outcomes for hospitalized older adults"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
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                            2 => "C&#46;S&#46; Williams"
                            3 => "L&#46; Leo-Summers"
                            4 => "D&#46; Acampora"
                            5 => "S&#46;K&#46; Inouye"
                          ]
                        ]
                      ]
                    ]
                  ]
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                      "doi" => "10.1016/s0002-9343(02)01569-3"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Med"
                        "fecha" => "2003"
                        "volumen" => "114"
                        "paginaInicial" => "383"
                        "paginaFinal" => "390"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12714128"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "identificador" => "bib0230"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "An intervention integrated into daily clinical practice reduces the incidence of delirium during hospitalization in elderly patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "M&#46;T&#46; Vid&#225;n"
                            1 => "E&#46; S&#225;nchez"
                            2 => "M&#46; Alonso"
                            3 => "B&#46; Montero"
                            4 => "J&#46; Ortiz"
                            5 => "J&#46;A&#46; Serra"
                          ]
                        ]
                      ]
                    ]
                  ]
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                    0 => array:2 [
                      "doi" => "10.1111/j.1532-5415.2009.02485.x"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Am Geriatr Soc"
                        "fecha" => "2009"
                        "volumen" => "57"
                        "paginaInicial" => "2029"
                        "paginaFinal" => "2036"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19754498"
                            "web" => "Medline"
                          ]
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                      ]
                    ]
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                ]
              ]
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Efficacy of non-pharmacological interventions to prevent and treat delirium in older patients&#58; a systematic overview&#46; The SENATOR project ONTOP Series"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "I&#46; Abraha"
                            1 => "F&#46; Trotta"
                            2 => "J&#46;M&#46; Rimland"
                            3 => "A&#46; Cruz-Jentoft"
                            4 => "I&#46; Lozano-Montoya"
                            5 => "R&#46;L&#46; Soiza"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1371/journal.pone.0123090"
                      "Revista" => array:5 [
                        "tituloSerie" => "PLoS One"
                        "fecha" => "2015"
                        "volumen" => "10"
                        "paginaInicial" => "e0123090"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26062023"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
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              "identificador" => "bib0240"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Delirium in older persons&#58; advances in diagnosis and treatment"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "E&#46;S&#46; Oh"
                            1 => "T&#46;G&#46; Fong"
                            2 => "T&#46;T&#46; Hshieh"
                            3 => "S&#46;K&#46; Inouye"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1001/jama.2017.12067"
                      "Revista" => array:6 [
                        "tituloSerie" => "JAMA"
                        "fecha" => "2017"
                        "volumen" => "318"
                        "paginaInicial" => "1161"
                        "paginaFinal" => "1174"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28973626"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "identificador" => "bib0245"
              "etiqueta" => "13"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The obesity paradox in stroke&#58; impact on mortality and short-term readmission"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "R&#46; Barba"
                            1 => "J&#46; Marco"
                            2 => "J&#46; Ruiz"
                            3 => "J&#46; Canora"
                            4 => "J&#46; Hinojosa"
                            5 => "S&#46; Plaza"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Stroke Cerebrovasc Dis"
                        "fecha" => "2015"
                        "volumen" => "4"
                        "paginaInicial" => "766"
                        "paginaFinal" => "770"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib0250"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Malnutrition and obesity&#58; influence in mortality and readmissions in chronic obstructive pulmonary disease patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46; Zapatero"
                            1 => "R&#46; Barba"
                            2 => "J&#46; Ruiz"
                            3 => "J&#46;E&#46; Losa"
                            4 => "S&#46; Plaza"
                            5 => "J&#46; Canora"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/jhn.12088"
                      "Revista" => array:7 [
                        "tituloSerie" => "J Hum Nutr Diet"
                        "fecha" => "2013"
                        "volumen" => "26"
                        "numero" => "Suppl&#46; 1"
                        "paginaInicial" => "16"
                        "paginaFinal" => "22"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23656492"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib0255"
              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Anaemia in chronic obstructive pulmonary disease&#58; a readmission prognosis factor"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "R&#46; Barba"
                            1 => "G&#46; Garc&#237;a de Casasola"
                            2 => "J&#46; Marco"
                            3 => "J&#46; Losa"
                            4 => "S&#46; Plaza"
                            5 => "J&#46; Canora"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1185/03007995.2012.675318"
                      "Revista" => array:6 [
                        "tituloSerie" => "Curr Med Res Opin"
                        "fecha" => "2012"
                        "volumen" => "28"
                        "paginaInicial" => "617"
                        "paginaFinal" => "622"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22409165"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib0260"
              "etiqueta" => "16"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Frequency of hypoglycemia and its impact on length of stay mortality and short-term readmission in patients with diabetes hospitalized in internal medicine wards"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "Zapatero&#160;A"
                            1 => "R&#46; G&#243;mez-Huelgas"
                            2 => "N&#46; Gonz&#225;lez"
                            3 => "J&#46; Canora"
                            4 => "A&#46; Asenjo"
                            5 => "J&#46; Hinojosa"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Endocr Pract"
                        "fecha" => "2014"
                        "volumen" => "18"
                        "paginaInicial" => "1"
                        "paginaFinal" => "15"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22522068"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib0265"
              "etiqueta" => "17"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Low prevalence of hyponatremia codification in departments of internal medicine and its prognostic implications"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46; Marco"
                            1 => "R&#46; Barba"
                            2 => "P&#46; Mat&#237;a"
                            3 => "S&#46; Plaza"
                            4 => "M&#46; M&#233;ndez"
                            5 => "J&#46; Canora"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1185/03007995.2013.836079"
                      "Revista" => array:6 [
                        "tituloSerie" => "Curr Med Res Opin"
                        "fecha" => "2013"
                        "volumen" => "29"
                        "paginaInicial" => "1757"
                        "paginaFinal" => "1762"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23992405"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib0270"
              "etiqueta" => "18"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A new method of classifying prognostic comorbidity in longitudinal studies&#58; development and validation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "M&#46;E&#46; Charlson"
                            1 => "P&#46; Pompei"
                            2 => "K&#46;L&#46; Ales"
                            3 => "C&#46;R&#46; MacKenzie"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/0021-9681(87)90171-8"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Chronic Dis"
                        "fecha" => "1987"
                        "volumen" => "40"
                        "paginaInicial" => "373"
                        "paginaFinal" => "383"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3558716"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib0275"
              "etiqueta" => "19"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Adapting a clinical comorbidity index for use with ICD-9-CM administrative databases"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "R&#46;A&#46; Deyo"
                            1 => "D&#46;C&#46; Cherkin"
                            2 => "M&#46;A&#46; Ciol"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/0895-4356(92)90133-8"
                      "Revista" => array:7 [
                        "tituloSerie" => "J Clin Epidemiol"
                        "fecha" => "1992"
                        "volumen" => "45"
                        "paginaInicial" => "613"
                        "paginaFinal" => "619"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1607900"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S0190962212002472"
                          "estado" => "S300"
                          "issn" => "01909622"
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                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib0280"
              "etiqueta" => "20"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Clinical characteristics and risk factors of delirium in demented and not demented elderly medical inpatients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "A&#46; Margiotta"
                            1 => "A&#46; Bianchetti"
                            2 => "P&#46; Ranieri"
                            3 => "M&#46; Trabucchi"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Nutr Health Aging"
                        "fecha" => "2006"
                        "volumen" => "10"
                        "paginaInicial" => "535"
                        "paginaFinal" => "539"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17183425"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "identificador" => "bib0285"
              "etiqueta" => "21"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Delirium in the hospitalized elder and recommendations for practice"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "T&#46;S&#46; Rigney"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.gerinurse.2006.03.014"
                      "Revista" => array:6 [
                        "tituloSerie" => "Geriatr Nurs"
                        "fecha" => "2006"
                        "volumen" => "27"
                        "paginaInicial" => "151"
                        "paginaFinal" => "157"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16757386"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "identificador" => "bib0290"
              "etiqueta" => "22"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Risk factors for developing delirium in older patients admitted to general medical wards"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "V&#46; Srinonprasert"
                            1 => "S&#46; Pakdeewongse"
                            2 => "J&#46; Assanasen"
                            3 => "W&#46; Eiamjinnasuwat"
                            4 => "A&#46; Sirisuwat"
                            5 => "D&#46; Limmathuroskul"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:7 [
                        "tituloSerie" => "J Med Assoc Thai"
                        "fecha" => "2011"
                        "volumen" => "94"
                        "numero" => "Suppl&#46; 1"
                        "paginaInicial" => "S99"
                        "paginaFinal" => "S104"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21721434"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Risk factors for incident delirium among older people in acute hospital medical units&#58; a systematic review and meta-analysis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "S&#46; Ahmed"
                            1 => "B&#46; Leurent"
                            2 => "E&#46; Sampson"
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                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Age Age"
                        "fecha" => "2014"
                        "volumen" => "43"
                        "paginaInicial" => "326"
                        "paginaFinal" => "333"
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "identificador" => "bib0300"
              "etiqueta" => "24"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Demented versus non-demented very old inpatients&#58; the same comorbidities but poorer functional and nutritional status"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "D&#46; Zekry"
                            1 => "F&#46;R&#46; Herrmann"
                            2 => "R&#46; Grandjean"
                            3 => "M&#46;P&#46; Meynet"
                            4 => "J&#46;P&#46; Michel"
                            5 => "G&#46; Gold"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Age Age"
                        "fecha" => "2008"
                        "volumen" => "37"
                        "paginaInicial" => "83"
                        "paginaFinal" => "89"
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "identificador" => "bib0305"
              "etiqueta" => "25"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Nutritional assessment of demented patients&#58; a descriptive study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "F&#46; Magri"
                            1 => "A&#46; Borza"
                            2 => "S&#46; del Vecchio"
                            3 => "S&#46; Chytiris"
                            4 => "G&#46; Cuzzoni"
                            5 => "L&#46; Busconi"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Aging Clin Exp Res"
                        "fecha" => "2003"
                        "volumen" => "15"
                        "paginaInicial" => "148"
                        "paginaFinal" => "153"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12889847"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            25 => array:3 [
              "identificador" => "bib0310"
              "etiqueta" => "26"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Risk factors and clinical aspects of delirium in elderly hospitalized patients in Iran"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "M&#46; Foroughan"
                            1 => "A&#46; Delbari"
                            2 => "S&#46;E&#46; Said"
                            3 => "A&#46;A&#46; Akbari Kamrani"
                            4 => "V&#46; Rashedi"
                            5 => "T&#46; Zandi"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s40520-015-0400-x"
                      "Revista" => array:6 [
                        "tituloSerie" => "Aging Clin Exp Res"
                        "fecha" => "2016"
                        "volumen" => "28"
                        "paginaInicial" => "313"
                        "paginaFinal" => "319"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26194422"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "identificador" => "bib0315"
              "etiqueta" => "27"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Partial and no recovery from delirium in older hospitalized adults&#58; frequency and baseline risk factors"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46;G&#46; Cole"
                            1 => "R&#46; Bailey"
                            2 => "M&#46; Bonnycastle"
                            3 => "J&#46; McCusker"
                            4 => "S&#46; Fung"
                            5 => "A&#46; Ciampi"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/jgs.13791"
                      "Revista" => array:7 [
                        "tituloSerie" => "J Am Geriatr Soc"
                        "fecha" => "2015"
                        "volumen" => "63"
                        "paginaInicial" => "2340"
                        "paginaFinal" => "2348"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26515438"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S0190962211006876"
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                          "issn" => "01909622"
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                  ]
                ]
              ]
            ]
            27 => array:3 [
              "identificador" => "bib0320"
              "etiqueta" => "28"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Nutritional status in hospitalized elderly patients with mild cognitive impairment"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "G&#46; Orsitto"
                            1 => "F&#46; Fulvio"
                            2 => "D&#46; Tria"
                            3 => "V&#46; Turi"
                            4 => "A&#46; Venezia"
                            5 => "C&#46; Manca"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.clnu.2008.12.001"
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Nutr"
                        "fecha" => "2009"
                        "volumen" => "28"
                        "paginaInicial" => "100"
                        "paginaFinal" => "102"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19110345"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            28 => array:3 [
              "identificador" => "bib0325"
              "etiqueta" => "29"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Systematic detection and multidisciplinary care of delirium in older medical inpatients&#58; a randomized trial"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46;G&#46; Cole"
                            1 => "J&#46; McCusker"
                            2 => "F&#46; Bellavance"
                            3 => "F&#46;J&#46; Primeau"
                            4 => "R&#46;F&#46; Bailey"
                            5 => "M&#46;J&#46; Bonnycastle"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "CMAJ"
                        "fecha" => "2002"
                        "volumen" => "167"
                        "paginaInicial" => "753"
                        "paginaFinal" => "759"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12389836"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            29 => array:3 [
              "identificador" => "bib0330"
              "etiqueta" => "30"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The importance of delirium&#58; economic and societal costs"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "D&#46;L&#46; Leslie"
                            1 => "S&#46;K&#46; Inouye"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1532-5415.2011.03671.x"
                      "Revista" => array:7 [
                        "tituloSerie" => "J Am Geriatr Soc"
                        "fecha" => "2011"
                        "volumen" => "59"
                        "numero" => "Suppl&#46; 2"
                        "paginaInicial" => "S241"
                        "paginaFinal" => "S243"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22091567"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            30 => array:3 [
              "identificador" => "bib0335"
              "etiqueta" => "31"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Outcome of delirium in critically ill patients&#58; systematic review and meta-analysis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "J&#46;I&#46; Salluh"
                            1 => "H&#46; Wang"
                            2 => "E&#46;B&#46; Schneider"
                            3 => "N&#46; Nagaraja"
                            4 => "G&#46; Yenokyan"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1136/bmj.h2538"
                      "Revista" => array:5 [
                        "tituloSerie" => "BMJ"
                        "fecha" => "2015"
                        "volumen" => "350"
                        "paginaInicial" => "h2538"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26041151"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            31 => array:3 [
              "identificador" => "bib0340"
              "etiqueta" => "32"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Interventions for preventing delirium in older people in institutional long-term care"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "A&#46; Clegg"
                            1 => "N&#46; Siddiqi"
                            2 => "A&#46; Heaven"
                            3 => "J&#46; Young"
                            4 => "R&#46; Holt"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/14651858.CD005619.pub3"
                      "Revista" => array:4 [
                        "tituloSerie" => "Cochrane Database Syst Rev"
                        "fecha" => "2014"
                        "volumen" => "1"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30707445"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            32 => array:3 [
              "identificador" => "bib0345"
              "etiqueta" => "33"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Gaps in patient care practices to prevent hospital-acquired delirium"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "K&#46; Alagiakrishnan"
                            1 => "T&#46; Marrie"
                            2 => "D&#46; Rolfson"
                            3 => "W&#46; Coke"
                            4 => "R&#46; Camicioli"
                            5 => "D&#46; Duggan"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Can Fam Phys"
                        "fecha" => "2009"
                        "volumen" => "55"
                        "paginaInicial" => "e41"
                        "paginaFinal" => "e46"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            33 => array:3 [
              "identificador" => "bib0350"
              "etiqueta" => "34"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Risk factors and prediction of postoperative delirium in elderly hip-surgery patients&#58; implementation and validation of a medical risk factor model"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "K&#46;J&#46; Kalisvaart"
                            1 => "R&#46; Vreeswijk"
                            2 => "J&#46;F&#46; de Jonghe"
                            3 => "T&#46; van der Ploeg"
                            4 => "W&#46;A&#46; van Gool"
                            5 => "P&#46; Eikelenboom"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Am Geriatr Soc"
                        "fecha" => "2006"
                        "volumen" => "54"
                        "paginaInicial" => "817"
                        "paginaFinal" => "822"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            34 => array:3 [
              "identificador" => "bib0355"
              "etiqueta" => "35"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Development and validation of a delirium predictive score in older people"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "M&#46;P&#46; Carrasco"
                            1 => "L&#46; Villarroel"
                            2 => "M&#46; Andrade"
                            3 => "J&#46; Calder&#243;n"
                            4 => "M&#46; Gonz&#225;lez"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/ageing/aft141"
                      "Revista" => array:5 [
                        "tituloSerie" => "Age Age"
                        "fecha" => "2014"
                        "volumen" => "43"
                        "paginaInicial" => "346"
                        "paginaFinal" => "351"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            35 => array:3 [
              "identificador" => "bib0360"
              "etiqueta" => "36"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "RECALMIN&#58; recursos y calidad en medicina interna"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46; Zapatero"
                            1 => "R&#46; Barba"
                            2 => "J&#46; Carretero"
                            3 => "E&#46; Casariego"
                            4 => "A&#46; Maestre"
                            5 => "J&#46; D&#237;ez Manglano"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Libro" => array:1 [
                        "fecha" => "2017"
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
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Article information
ISSN: 22548874
Original language: English
DOI:10.1016/j.rceng.2019.02.012
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