array:25 [
  "pii" => "S2254887418300468"
  "issn" => "22548874"
  "doi" => "10.1016/j.rceng.2018.02.005"
  "estado" => "S300"
  "fechaPublicacion" => "2018-05-01"
  "aid" => "1481"
  "copyright" => "Elsevier España, S.L.U. and Sociedad Española de Medicina Interna (SEMI)"
  "copyrightAnyo" => "2018"
  "documento" => "simple-article"
  "crossmark" => 1
  "subdocumento" => "edi"
  "cita" => "Rev Clin Esp. 2018;218:185-6"
  "abierto" => array:3 [
    "ES" => false
    "ES2" => false
    "LATM" => false
  ]
  "gratuito" => false
  "lecturas" => array:2 [
    "total" => 2
    "PDF" => 2
  ]
  "Traduccion" => array:1 [
    "es" => array:19 [
      "pii" => "S0014256518300626"
      "issn" => "00142565"
      "doi" => "10.1016/j.rce.2018.02.010"
      "estado" => "S300"
      "fechaPublicacion" => "2018-05-01"
      "aid" => "1481"
      "copyright" => "Elsevier España, S.L.U. and Sociedad Española de Medicina Interna (SEMI)"
      "documento" => "simple-article"
      "crossmark" => 1
      "subdocumento" => "edi"
      "cita" => "Rev Clin Esp. 2018;218:185-6"
      "abierto" => array:3 [
        "ES" => false
        "ES2" => false
        "LATM" => false
      ]
      "gratuito" => false
      "lecturas" => array:2 [
        "total" => 96
        "formatos" => array:2 [
          "HTML" => 56
          "PDF" => 40
        ]
      ]
      "es" => array:10 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Editorial</span>"
        "titulo" => "Escala de Norton y pron&#243;stico vital"
        "tienePdf" => "es"
        "tieneTextoCompleto" => "es"
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "185"
            "paginaFinal" => "186"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "en" => array:1 [
            "titulo" => "Norton scale and vital prognosis"
          ]
        ]
        "contieneTextoCompleto" => array:1 [
          "es" => true
        ]
        "contienePdf" => array:1 [
          "es" => true
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "J&#46; Ena"
            "autores" => array:1 [
              0 => array:2 [
                "nombre" => "J&#46;"
                "apellidos" => "Ena"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "es"
      "Traduccion" => array:1 [
        "en" => array:9 [
          "pii" => "S2254887418300468"
          "doi" => "10.1016/j.rceng.2018.02.005"
          "estado" => "S300"
          "subdocumento" => ""
          "abierto" => array:3 [
            "ES" => false
            "ES2" => false
            "LATM" => false
          ]
          "gratuito" => false
          "lecturas" => array:1 [
            "total" => 0
          ]
          "idiomaDefecto" => "en"
          "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2254887418300468?idApp=WRCEE"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0014256518300626?idApp=WRCEE"
      "url" => "/00142565/0000021800000004/v2_201805060410/S0014256518300626/v2_201805060410/es/main.assets"
    ]
  ]
  "itemSiguiente" => array:19 [
    "pii" => "S2254887418300365"
    "issn" => "22548874"
    "doi" => "10.1016/j.rceng.2018.02.003"
    "estado" => "S300"
    "fechaPublicacion" => "2018-05-01"
    "aid" => "1475"
    "copyright" => "Elsevier Espa&#241;a&#44; S&#46;L&#46;U&#46; and Sociedad Espa&#241;ola de Medicina Interna &#40;SEMI&#41;"
    "documento" => "simple-article"
    "crossmark" => 1
    "subdocumento" => "edi"
    "cita" => "Rev Clin Esp. 2018;218:187-9"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:2 [
      "total" => 3
      "PDF" => 3
    ]
    "en" => array:10 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Editorial</span>"
      "titulo" => "A geriatric assessment followed by geriatric intervention is essential for elderly hospitalized patients"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "187"
          "paginaFinal" => "189"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Es b&#225;sico realizar una valoraci&#243;n e intervenci&#243;n geri&#225;tricas en el paciente anciano hospitalizado"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "F&#46; Formiga, D&#46; Chivite"
          "autores" => array:2 [
            0 => array:2 [
              "nombre" => "F&#46;"
              "apellidos" => "Formiga"
            ]
            1 => array:2 [
              "nombre" => "D&#46;"
              "apellidos" => "Chivite"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S0014256518300560"
        "doi" => "10.1016/j.rce.2018.02.004"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => false
          "ES2" => false
          "LATM" => false
        ]
        "gratuito" => false
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "es"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0014256518300560?idApp=WRCEE"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2254887418300365?idApp=WRCEE"
    "url" => "/22548874/0000021800000004/v2_201805060420/S2254887418300365/v2_201805060420/en/main.assets"
  ]
  "itemAnterior" => array:19 [
    "pii" => "S225488741830047X"
    "issn" => "22548874"
    "doi" => "10.1016/j.rceng.2018.02.006"
    "estado" => "S300"
    "fechaPublicacion" => "2018-05-01"
    "aid" => "1480"
    "copyright" => "Elsevier Espa&#241;a&#44; S&#46;L&#46;U&#46; and Sociedad Espa&#241;ola de Medicina Interna &#40;SEMI&#41;"
    "documento" => "article"
    "crossmark" => 1
    "subdocumento" => "fla"
    "cita" => "Rev Clin Esp. 2018;218:177-84"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:2 [
      "total" => 3
      "PDF" => 3
    ]
    "en" => array:13 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>"
      "titulo" => "Norton scale score on admission and mortality of patients hospitalized in internal medicine departments"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "es"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "177"
          "paginaFinal" => "184"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Puntuaci&#243;n de la escala de Norton al ingreso y mortalidad en pacientes hospitalizados en Medicina Interna"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "es" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0005"
          "etiqueta" => "Figure 1"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr1.jpeg"
              "Alto" => 1235
              "Ancho" => 2168
              "Tamanyo" => 131999
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Flow diagram of the patients included in the study&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "J&#46; D&#237;ez-Manglano, M&#46;J&#46; Arnal-Longares, P&#46; Al-Cheikh-Felices, V&#46; Garc&#233;s-Horna, P&#46; Pueyo-Tejedor, P&#46; Mart&#237;nez-Rod&#233;s, F&#46; D&#237;ez-Mass&#243;, S&#46; Rubio-F&#233;lix, E&#46; del Corral-Beamonte, C&#46; Palaz&#243;n-Fraile"
          "autores" => array:11 [
            0 => array:2 [
              "nombre" => "J&#46;"
              "apellidos" => "D&#237;ez-Manglano"
            ]
            1 => array:2 [
              "nombre" => "M&#46;J&#46;"
              "apellidos" => "Arnal-Longares"
            ]
            2 => array:2 [
              "nombre" => "P&#46;"
              "apellidos" => "Al-Cheikh-Felices"
            ]
            3 => array:2 [
              "nombre" => "V&#46;"
              "apellidos" => "Garc&#233;s-Horna"
            ]
            4 => array:2 [
              "nombre" => "P&#46;"
              "apellidos" => "Pueyo-Tejedor"
            ]
            5 => array:2 [
              "nombre" => "P&#46;"
              "apellidos" => "Mart&#237;nez-Rod&#233;s"
            ]
            6 => array:2 [
              "nombre" => "F&#46;"
              "apellidos" => "D&#237;ez-Mass&#243;"
            ]
            7 => array:2 [
              "nombre" => "S&#46;"
              "apellidos" => "Rubio-F&#233;lix"
            ]
            8 => array:2 [
              "nombre" => "E&#46;"
              "apellidos" => "del Corral-Beamonte"
            ]
            9 => array:2 [
              "nombre" => "C&#46;"
              "apellidos" => "Palaz&#243;n-Fraile"
            ]
            10 => array:1 [
              "colaborador" => "on behalf of the investigadores del estudio IMPIMI"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S0014256518300614"
        "doi" => "10.1016/j.rce.2018.02.009"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => false
          "ES2" => false
          "LATM" => false
        ]
        "gratuito" => false
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "es"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0014256518300614?idApp=WRCEE"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S225488741830047X?idApp=WRCEE"
    "url" => "/22548874/0000021800000004/v2_201805060420/S225488741830047X/v2_201805060420/en/main.assets"
  ]
  "asociados" => array:1 [
    0 => array:19 [
      "pii" => "S225488741830047X"
      "issn" => "22548874"
      "doi" => "10.1016/j.rceng.2018.02.006"
      "estado" => "S300"
      "fechaPublicacion" => "2018-05-01"
      "aid" => "1480"
      "copyright" => "Elsevier Espa&#241;a&#44; S&#46;L&#46;U&#46; and Sociedad Espa&#241;ola de Medicina Interna &#40;SEMI&#41;"
      "documento" => "article"
      "crossmark" => 1
      "subdocumento" => "fla"
      "cita" => "Rev Clin Esp. 2018;218:177-84"
      "abierto" => array:3 [
        "ES" => false
        "ES2" => false
        "LATM" => false
      ]
      "gratuito" => false
      "lecturas" => array:2 [
        "total" => 3
        "PDF" => 3
      ]
      "en" => array:13 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>"
        "titulo" => "Norton scale score on admission and mortality of patients hospitalized in internal medicine departments"
        "tienePdf" => "en"
        "tieneTextoCompleto" => "en"
        "tieneResumen" => array:2 [
          0 => "en"
          1 => "es"
        ]
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "177"
            "paginaFinal" => "184"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "es" => array:1 [
            "titulo" => "Puntuaci&#243;n de la escala de Norton al ingreso y mortalidad en pacientes hospitalizados en Medicina Interna"
          ]
        ]
        "contieneResumen" => array:2 [
          "en" => true
          "es" => true
        ]
        "contieneTextoCompleto" => array:1 [
          "en" => true
        ]
        "contienePdf" => array:1 [
          "en" => true
        ]
        "resumenGrafico" => array:2 [
          "original" => 0
          "multimedia" => array:7 [
            "identificador" => "fig0005"
            "etiqueta" => "Figure 1"
            "tipo" => "MULTIMEDIAFIGURA"
            "mostrarFloat" => true
            "mostrarDisplay" => false
            "figura" => array:1 [
              0 => array:4 [
                "imagen" => "gr1.jpeg"
                "Alto" => 1235
                "Ancho" => 2168
                "Tamanyo" => 131999
              ]
            ]
            "descripcion" => array:1 [
              "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Flow diagram of the patients included in the study&#46;</p>"
            ]
          ]
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "J&#46; D&#237;ez-Manglano, M&#46;J&#46; Arnal-Longares, P&#46; Al-Cheikh-Felices, V&#46; Garc&#233;s-Horna, P&#46; Pueyo-Tejedor, P&#46; Mart&#237;nez-Rod&#233;s, F&#46; D&#237;ez-Mass&#243;, S&#46; Rubio-F&#233;lix, E&#46; del Corral-Beamonte, C&#46; Palaz&#243;n-Fraile"
            "autores" => array:11 [
              0 => array:2 [
                "nombre" => "J&#46;"
                "apellidos" => "D&#237;ez-Manglano"
              ]
              1 => array:2 [
                "nombre" => "M&#46;J&#46;"
                "apellidos" => "Arnal-Longares"
              ]
              2 => array:2 [
                "nombre" => "P&#46;"
                "apellidos" => "Al-Cheikh-Felices"
              ]
              3 => array:2 [
                "nombre" => "V&#46;"
                "apellidos" => "Garc&#233;s-Horna"
              ]
              4 => array:2 [
                "nombre" => "P&#46;"
                "apellidos" => "Pueyo-Tejedor"
              ]
              5 => array:2 [
                "nombre" => "P&#46;"
                "apellidos" => "Mart&#237;nez-Rod&#233;s"
              ]
              6 => array:2 [
                "nombre" => "F&#46;"
                "apellidos" => "D&#237;ez-Mass&#243;"
              ]
              7 => array:2 [
                "nombre" => "S&#46;"
                "apellidos" => "Rubio-F&#233;lix"
              ]
              8 => array:2 [
                "nombre" => "E&#46;"
                "apellidos" => "del Corral-Beamonte"
              ]
              9 => array:2 [
                "nombre" => "C&#46;"
                "apellidos" => "Palaz&#243;n-Fraile"
              ]
              10 => array:1 [
                "colaborador" => "on behalf of the investigadores del estudio IMPIMI"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "en"
      "Traduccion" => array:1 [
        "es" => array:9 [
          "pii" => "S0014256518300614"
          "doi" => "10.1016/j.rce.2018.02.009"
          "estado" => "S300"
          "subdocumento" => ""
          "abierto" => array:3 [
            "ES" => false
            "ES2" => false
            "LATM" => false
          ]
          "gratuito" => false
          "lecturas" => array:1 [
            "total" => 0
          ]
          "idiomaDefecto" => "es"
          "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0014256518300614?idApp=WRCEE"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S225488741830047X?idApp=WRCEE"
      "url" => "/22548874/0000021800000004/v2_201805060420/S225488741830047X/v2_201805060420/en/main.assets"
    ]
  ]
  "en" => array:12 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Editorial</span>"
    "titulo" => "Norton scale and vital prognosis"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "185"
        "paginaFinal" => "186"
      ]
    ]
    "autores" => array:1 [
      0 => array:3 [
        "autoresLista" => "J&#46; Ena"
        "autores" => array:1 [
          0 => array:3 [
            "nombre" => "J&#46;"
            "apellidos" => "Ena"
            "email" => array:1 [
              0 => "ena&#95;jav&#64;gva&#46;es"
            ]
          ]
        ]
        "afiliaciones" => array:1 [
          0 => array:2 [
            "entidad" => "Servicio de Medicina Interna&#44; Hospital Marina Baixa&#44; Villajoyosa&#44; Alicante&#44; Spain"
            "identificador" => "aff0005"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "Escala de Norton y pron&#243;stico vital"
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">In this issue of <span class="elsevierStyleItalic">Revista Cl&#237;nica Espa&#241;ola</span>&#44; Diez-Manglano et al&#46;<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">1</span></a> published the validity results of the Norton scale for predicting the short&#44; medium and long-term mortality of patients hospitalized in an internal medicine department&#46; The Norton scale was created by Doreen Norton in 1962<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">2</span></a> as a tool to predict the risk of developing pressure ulcers in elderly hospitalized patients&#46; The Norton scale evaluates 5 factors&#58; physical state&#44; mental state&#44; activity&#44; mobility and incontinence&#44; each of which is scored from 1 &#40;very poor&#41; to 4 &#40;very good&#41; points&#46; The total score ranges from 5 to 20 points&#44; with the higher scores associated with a low risk of developing pressure ulcers&#46; The final coding of the Norton scale is as follows&#58; very high risk &#40;fewer than 10 points&#41;&#44; high risk &#40;between 10 and 14 points&#41;&#44; moderate risk &#40;between 14 and 18 points&#41; and low risk &#40;more than 18 points&#41;&#46; The Norton scale is well known and is typically applied by nursing staff to assess at-risk patients and establish preventive measures&#46; A recent study evaluated the interobserver concordance of the various domains included in the Norton scale&#46; Among the factors included in the Norton scale&#44; 3 had substantial interobserver variability&#44; 1 had moderate interobserver variability and 1 had very high interobserver variability&#46; However&#44; the overall interobserver concordance in terms of the risk assessment was very high&#44; with a mean value of 0&#46;97 &#40;95&#37; confidence interval &#91;CI&#93; 0&#46;94&#8211;0&#46;98&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">3</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">The study presented by Diez-Manglano used the Norton scale as a prognostic factor&#44; not for the development of pressure ulcers but rather as a predictor of mortality in patients hospitalized in the internal medicine department&#46; The study included a total of 714 patients hospitalized in a tertiary university hospital and had a 3-year follow-up&#46; The Norton scale showed good predictive capacity for mortality at 1 year&#44; measured by an area under the curve &#40;AUC&#41; of the receiver operating characteristic of 0&#46;76&#46; The study used the assessment of the Norton scale performed by the nursing staff&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">It is well known that socioeconomic advances&#44; technological innovations and improvements in healthcare have increased the population&#39;s life expectancy&#46; As a result&#44; there has been an increase in the rates of patients with chronic disease&#46; Internal medicine departments in Spain currently treat approximately 19&#37; of the population admitted to hospitals&#46; This population is characterized by a mean age of 74 years and a high Charlson comorbidity index&#46;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">4</span></a> Since most of these patients have several chronic diseases and a wide range of disability&#44; predicting mortality has considerable significance&#44; because many patients could benefit from an early start of palliative care and social support measures&#46; However&#44; it is not easy for clinicians or managers to identify the start of the terminal phase of a chronic disease&#46; Therefore&#44; patients often undergo unnecessary diagnostic tests and futile treatments&#46; In many cases&#44; the lines between compliance with clinical practice guidelines&#44; nihilism and good clinical practice are difficult to establish&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">In the last decade&#44; several mortality prediction rules for complex chronic patients have been published&#46; A number of these well-known rules have been published by investigators for the Spanish Society of Internal Medicine and include the PALIAR and PROFUND indices&#46;<a class="elsevierStyleCrossRefs" href="#bib0100"><span class="elsevierStyleSup">5&#44;6</span></a> For both indices&#44; the patient cohorts included in the studies showed a mortality rate between 35&#37; and 40&#37; during the follow-up&#46; The PALIAR index estimated the mortality at 6 months of 1778 complex chronic patients&#44; and its predictive capacity measured by the AUC was 0&#46;69&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">5</span></a> The PROFUND index estimated the mortality at 1 year of 1632 chronically ill patients and showed a predictive capacity measured by an AUC of 0&#46;73&#46;<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">6</span></a> The PROFUND index has been externally validated&#44; and its prognostic capacity has been confirmed&#44; both for patients hospitalized in internal medicine departments<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">7</span></a> and those in cardiology departments&#46;<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">8</span></a> The PALIAR and PROFUND indices have the advantage of being developed in Spain and are therefore applicable to the Spanish health system&#46; Although the interobserver assessment of the 2 indices has not been explicitly evaluated&#44; the variables that make up the 2 indices allow for an objective quantification&#46; More recently&#44; Sakhnini et al&#46; published an index that predicts the hospital mortality of patients hospitalized in internal medicine departments&#46;<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">9</span></a> The hospital mortality in the study was 7&#46;1&#37;&#46; The prediction model was developed based on a cohort of 7268 patients and confirmed in an independent cohort of 7843 patients treated in a university hospital in Israel&#46; The prediction model used objective&#44; easy-to-collect variables&#44; such as age&#44; mean blood pressure&#44; body mass index&#44; history of hospitalization in the past 3 months&#44; presence of chronic disease &#40;heart failure or cancer&#41; and the use of particular drugs &#40;statins and antiplatelet agents&#41;&#46; The model&#39;s AUC in the independent validation cohort was 0&#46;81&#46; The authors highlighted as limitations of the study that their model was based on retrospective data and that it lacked external validation&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">As reported by Diez-Manglano et al&#46; in the present study&#44; the Norton index can be calculated with high reproducibility&#44; both by nursing staff and by physicians&#44; and conducting the index takes no more than 1&#8211;2<span class="elsevierStyleHsp" style=""></span>min&#46; The mortality observed by Diez-Manglano et al&#46; during the hospitalization&#44; at 6 months and at 1 year was 11&#46;9&#37;&#44; 28&#46;2&#37; and 34&#37;&#44; respectively&#46; The Norton index&#39;s capacity for predicting mortality during hospitalization&#44; at 6 months and at 1 year had AUCs of 0&#46;75&#44; 0&#46;74 and 0&#46;76&#44; respectively&#46; These AUC values help confirm that the Norton index is an easy-to-apply tool that is often available in the nursing records and is reliable for predicting the vital prognosis of complex chronic patients hospitalized in internal medicine departments&#46; The association between a low score on the Norton index and an increased risk of mortality has also been confirmed by Leshem-Rubino et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">10</span></a> in a study conducted in an Israeli hospital&#44; which included a population of 259 patients with a mean age of 81 years&#46; The hospital mortality was 3&#46;9&#37;&#44; and the mortality at 1 year was 28&#46;6&#37;&#46; Unfortunately&#44; the authors did not assess the prognostic capacity of the Norton index with a receiver operating curve&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">The Norton index has also been shown to be a valid prognostic index for predicting mortality in patients with acute myocardial infarction&#44;<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">11</span></a> those who undergo transcatheter aortic valve implantation<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">12</span></a> and those who have undergone leg amputations&#46;<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">13</span></a> The Norton index has also been used to predict the risk of falls for patients who have experienced hip fractures<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">14</span></a> and to determine the intensity and duration of rehabilitation for patients who have had a stroke&#46;<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">15</span></a></p></span>"
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "NotaPie" => array:1 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Ena J&#46; Escala de Norton y pron&#243;stico vital&#46; Rev Clin Esp&#46; 2018&#59;218&#58;185&#8211;186&#46;</p>"
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0015"
          "bibliografiaReferencia" => array:15 [
            0 => array:3 [
              "identificador" => "bib0080"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Puntuaci&#243;n de la escala de Norton al ingreso y mortalidad a corto&#44; medio y largo plazo en pacientes hospitalizados en medicina interna"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46; Diez-Manglano"
                            1 => "M&#46;J&#46; Arnal-Longares"
                            2 => "P&#46;A&#46; Cheikh-Felices"
                            3 => "V&#46; Garces-Horna"
                            4 => "P&#46; Pueyo-Tejedor"
                            5 => "P&#46; Martinez-Rodes"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Rev Clin Esp"
                        "fecha" => "2018"
                        "volumen" => "219"
                        "paginaInicial" => "177"
                        "paginaFinal" => "184"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0085"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "An investigation of geriatric nursing problems in hospital"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "D&#46; Norton"
                            1 => "R&#46; McLaren"
                            2 => "A&#46;N&#46; Exton-Smith"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Libro" => array:2 [
                        "fecha" => "1962"
                        "editorial" => "National Corporation for the Care of Old People London"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0090"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Inter-rater reliability of three most commonly used pressure ulcer risk assessment scales in clinical practice"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "L&#46;H&#46; Wang"
                            1 => "H&#46;L&#46; Chen"
                            2 => "H&#46;Y&#46; Yan"
                            3 => "J&#46;H&#46; Gao"
                            4 => "F&#46; Wang"
                            5 => "Y&#46; Ming"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/iwj.12376"
                      "Revista" => array:6 [
                        "tituloSerie" => "Int Wound J"
                        "fecha" => "2015"
                        "volumen" => "12"
                        "paginaInicial" => "590"
                        "paginaFinal" => "594"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25224688"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0095"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "RECALMIN II&#46; Eight years of hospitalisation in Internal Medicine Units &#40;2007&#8211;2014&#41;&#46; What has changed&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46; Zapatero-Gaviria"
                            1 => "R&#46; Barba-Mart&#237;n"
                            2 => "J&#46; Canora Lebrato"
                            3 => "C&#46; Fern&#225;ndez-P&#233;rez"
                            4 => "R&#46; G&#243;mez-Huelgas"
                            5 => "J&#46;L&#46; Bernal-Sobrino"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.rce.2017.07.008"
                      "Revista" => array:6 [
                        "tituloSerie" => "Rev Clin Esp"
                        "fecha" => "2017"
                        "volumen" => "217"
                        "paginaInicial" => "446"
                        "paginaFinal" => "453"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28851485"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0100"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Development of a six-month prognostic index in patients with advanced chronic medical conditions&#58; the PALIAR score"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46; Bernabeu-Wittel"
                            1 => "J&#46; Murcia-Zaragoza"
                            2 => "C&#46; Hern&#225;ndez-Quiles"
                            3 => "B&#46; Escolano-Fern&#225;ndez"
                            4 => "G&#46; Jarava-Rol"
                            5 => "M&#46; Oliver"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Pain Symptom Manag"
                        "fecha" => "2014"
                        "volumen" => "47"
                        "paginaInicial" => "551"
                        "paginaFinal" => "565"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0105"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Development of a new predictive model for polypathological patients The PROFUND index"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46; Bernabeu-Wittel"
                            1 => "M&#46; Ollero-Baturone"
                            2 => "L&#46; Moreno-Gavi&#241;o"
                            3 => "B&#46; Bar&#243;n-Franco"
                            4 => "A&#46; Fuertes"
                            5 => "J&#46; Murcia-Zaragoza"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.ejim.2010.11.012"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur J Intern Med"
                        "fecha" => "2011"
                        "volumen" => "22"
                        "paginaInicial" => "311"
                        "paginaFinal" => "317"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21570654"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0110"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "External validation of the PROFUND index in polypathological patients from internal medicine and acute geriatrics departments in Arag&#243;n"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46; D&#237;ez-Manglano"
                            1 => "J&#46;L&#46; Cabrerizo Garc&#237;a"
                            2 => "E&#46; Garc&#237;a-Arilla Calvo"
                            3 => "A&#46; Jimeno Sa&#237;nz"
                            4 => "E&#46; Calvo Beguer&#237;a"
                            5 => "R&#46;M&#46; Mart&#237;nez-&#193;lvarez"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s11739-015-1252-2"
                      "Revista" => array:6 [
                        "tituloSerie" => "Intern Emerg Med"
                        "fecha" => "2015"
                        "volumen" => "10"
                        "paginaInicial" => "915"
                        "paginaFinal" => "926"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25986479"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0115"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Prevalence of comorbidities and the prognostic value of the PROFUND index in a hospital cardiology unit"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46;A&#46; L&#243;pez-Garrido"
                            1 => "I&#46; Antequera Mart&#237;n-Portugu&#233;s"
                            2 => "V&#46;M&#46; Becerra-Mu&#241;oz"
                            3 => "H&#46;N&#46; Orellana-Figueroa"
                            4 => "F&#46;J&#46; S&#225;nchez-Lora"
                            5 => "L&#46; Morcillo-Hidalgo"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.rce.2016.10.007"
                      "Revista" => array:6 [
                        "tituloSerie" => "Rev Clin Esp"
                        "fecha" => "2017"
                        "volumen" => "217"
                        "paginaInicial" => "87"
                        "paginaFinal" => "94"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27908447"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0120"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The derivation and validation of a simple model for predicting in-hospital mortality of acutely admitted patients to internal medicine wards"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "A&#46; Sakhnini"
                            1 => "W&#46; Saliba"
                            2 => "N&#46; Schwartz"
                            3 => "N&#46; Bisharat"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "tituloSerie" => "Medicine &#40;Baltimore&#41;"
                        "fecha" => "2017"
                        "volumen" => "96"
                        "paginaInicial" => "e7284"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0125"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Norton scale&#44; hospitalization length&#44; complications&#44; and mortality in elderly patients admitted to internal medicine departments"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "E&#46; Leshem-Rubinow"
                            1 => "A&#46; Vaknin"
                            2 => "S&#46; Sherman"
                            3 => "D&#46; Justo"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1159/000353710"
                      "Revista" => array:6 [
                        "tituloSerie" => "Gerontology"
                        "fecha" => "2013"
                        "volumen" => "59"
                        "paginaInicial" => "507"
                        "paginaFinal" => "513"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23921132"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0130"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Decreased Norton&#39;s functional score is an independent long-term prognostic marker in hospital survivors of acute myocardial infarction Soroka Acute Myocardial Infarction II &#40;SAMI-II&#41; project"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "H&#46; Silber"
                            1 => "A&#46; Shiyovich"
                            2 => "H&#46; Gilutz"
                            3 => "H&#46; Ziedenberg"
                            4 => "M&#46; Abu Tailakh"
                            5 => "Y&#46; Plakht"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.ijcard.2016.11.112"
                      "Revista" => array:6 [
                        "tituloSerie" => "Int J Cardiol"
                        "fecha" => "2017"
                        "volumen" => "228"
                        "paginaInicial" => "694"
                        "paginaFinal" => "699"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27886612"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib0135"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Norton scale for predicting prognosis in elderly patients undergoing trans-catheter aortic valve implantation&#58; a historical prospective study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "E&#46; Rabinovitz"
                            1 => "A&#46; Finkelstein"
                            2 => "E&#46; Ben Assa"
                            3 => "A&#46; Steinvil"
                            4 => "M&#46; Konigstein"
                            5 => "Y&#46; Shacham"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jjcc.2016.01.017"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Cardiol"
                        "fecha" => "2016"
                        "volumen" => "67"
                        "paginaInicial" => "519"
                        "paginaFinal" => "525"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26936468"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib0140"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Norton scale scores and 1-year mortality in elderly patients following lower limb amputations"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "R&#46; Sever"
                            1 => "S&#46; Sherman"
                            2 => "N&#46; Rozen"
                            3 => "O&#46; Chechik"
                            4 => "S&#46; Hilu"
                            5 => "S&#46; Abdelrazek"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s00391-014-0812-9"
                      "Revista" => array:6 [
                        "tituloSerie" => "Z Gerontol Geriatr"
                        "fecha" => "2015"
                        "volumen" => "48"
                        "paginaInicial" => "365"
                        "paginaFinal" => "369"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25239682"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib0145"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Low admission Norton scale scores are associated with falls long after rehabilitation in the elderly with hip fractures"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "E&#46; Halperin"
                            1 => "T&#46; Engel"
                            2 => "S&#46; Sherman"
                            3 => "D&#46; Justo"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.2147/CIA.S35717"
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Interv Aging"
                        "fecha" => "2012"
                        "volumen" => "7"
                        "paginaInicial" => "431"
                        "paginaFinal" => "436"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23109805"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib0150"
              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Admission Norton scale scores correlate with rehabilitation outcome and length in elderly patients following cerebrovascular accident"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "D&#46; Justo"
                            1 => "V&#46; Fridman"
                            2 => "O&#46; Borodin"
                            3 => "F&#46; Rozenberg"
                            4 => "A&#46; Rabinovich"
                            5 => "Y&#46; Lerman"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Aging Clin Exp Res"
                        "fecha" => "2011"
                        "volumen" => "23"
                        "paginaInicial" => "445"
                        "paginaFinal" => "449"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22526076"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/22548874/0000021800000004/v2_201805060420/S2254887418300468/v2_201805060420/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "72714"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Editorials"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/22548874/0000021800000004/v2_201805060420/S2254887418300468/v2_201805060420/en/main.pdf?idApp=WRCEE&text.app=https://revclinesp.es/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2254887418300468?idApp=WRCEE"
]
Share
Journal Information
Share
Share
Download PDF
More article options
Editorial
Norton scale and vital prognosis
Escala de Norton y pronóstico vital
J. Ena
Servicio de Medicina Interna, Hospital Marina Baixa, Villajoyosa, Alicante, Spain
Related content
J. Díez-Manglano, M.J. Arnal-Longares, P. Al-Cheikh-Felices, V. Garcés-Horna, P. Pueyo-Tejedor, P. Martínez-Rodés, F. Díez-Massó, S. Rubio-Félix, E. del Corral-Beamonte, C. Palazón-Fraile

Purchase article

For the purchase of this article it is necessary to fill in the following form:

Afganistan
Albania
Alemania
Andorra
Angola
Anguilla
Antartica
Antigua and barbuda
Antillas holandesas
Arabia saudita
Argelia
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgica
Belice
Benin
Bermudas/antillas britanicas
Bhutan
Bolivia
Bosnia y herzegowina
Botswana
Brasil
Brunei darussalam
Bulgaria
Burkina faso
Burundi
Cabo verde
Camboya
Camerun
Canada
Chad
Chile
China
Chipre
Colombia
Comoros
Corea
Costa rica
Cote d´ivoire
Croacia
Cuba
Dinamarca
Djibouti
Dominica
East timor
Ecuador
Egipto
El salvador
Emiratos arabes unidos
Eritrea
Escocia
Eslovaquia
Eslovenia
España
Estados federados de micronesia
Estados unidos
Estonia
Etiopia
Fiji
Filipinas
Finlandia
Francia
Gabon
Gambia
Georgia
Ghana
Gibraltar
Grecia
Grenada
Groenlandia
Guadalupe
Guam
Guatemala
Guayana britanica
Guinea
Guinea ecuatorial
Guinea francesa
Guinea-bissau
Haiti
Holanda
Honduras
Hong kong
Hungria
India
Indonesia
Irak
Iran
Irlanda
Isla bouvet
Isla cocos (keeling)
Isla cook
Isla mauricio
Isla navidad
Isla norfolk
Islandia
Islas caiman
Islas falkland (malvinas)
Islas faroe
Islas georgia del sur y sandwich
Islas heard and mc donald
Islas marshall
Islas northern mariana
Islas salomon
Islas svalbard and jan mayen
Islas turks and caicos
Islas united states minor outlyi
Islas virgenes (britanicas)
Islas virgenes (u.s.a.)
Islas wallis and futuna
Israel
Italia
Jamaica
Japon
Jordania
Kazakhstan
Kenia
Kiribati
Kuwait
Kyrgyzstan
Lesoto
Letonia
Libano
Liberia
Libia arab jamahiriya
Liechtenstein
Lituania
Luxemburgo
Macao
Macedonia
Madagascar
Malasia
Malawi
Maldives
Mali
Malta
Marruecos
Martinica
Mauritania
Mayotte
Mexico
Monaco
Mongolia
Monserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Nicaragua
Niger
Nigeria
Niue
Noruega
Nueva caledonia
Nueva zelanda
Oman
Pakistan
Palau
Panama
Papua new guinea
Paraguay
Peru
Pitcairn
Polinesia francesa
Polonia
Portugal
Posesiones gran bretaña
Posesiones u.s.a.
Puerto rico
Qatar
Reino unido
Republica checa
Republica de africa central
Republica de cabo verde
Republica de congo
Republica de corea
Republica de moldova
Republica democratica de laos
Republica democratica del congo
Republica dominicana
Reunion
Ruanda
Rumania
Rusia
Sahara occidental
Saint kitts and nevis
Samoa
Samoa americana
San marino
San tomas y principe
San vincent and the grenadines
Santa lucia
Senegal
Serbia
Seychelles
Sierra leona
Singapur
Siria
Somalia
Sri lanka
St. helena
St. pierre and miquelon
Sudafrica
Sudan
Suecia
Suiza
Surinam
Swaziland
Tailandia
Taiwan republica de china
Tajikistan
Tanzania
Territorio de indias britanicas
Togo
Tokelau
Tonga
Trinidad and tobago
Tunisia
Turkmenistan
Turquia
Tuvalu
Ucrania
Uganda
Uruguay
Uzbekistan
Vanuatu
Vaticano
Venezuela
Vietnam
Yemen
Yugoslavia
Zambia
Zimbawe
Lebanon
Paises bajos
A coruña
Alava
Albacete
Alicante
Almeria
Asturias
Avila
Badajoz
Balears
Barcelona
Bizkaia
Burgos
Caceres
Cadiz
Cantabria
Castellon
Ceuta
Ciudad real
Cordoba
Cuenca
Girona
Granada
Guadalajara
Guipuzcoa
Huelva
Huesca
Jaen
La rioja
Las palmas
Leon
Lleida
Lugo
Madrid
Malaga
Melilla
Murcia
Navarra
Ourense
Palencia
Pontevedra
Salamanca
Segovia
Sevilla
Soria
Tarragona
Tenerife
Teruel
Toledo
Valencia
Valladolid
Zamora
Zaragoza
-- Not applicable --
I accept to receive information about Elsevier's special products and promotions by email
I accept to receive information about products and special promotions from Elsevier partners by email
I have read and understand the Privacy Policy and Terms and conditions and agree to be bound by all of its terms.
* Required fields
In addition to temporary access to the article, it will be sent by email.
Customer Support
Phone
Calls from Spain
932 415 960
Calls from abroad
+34 932 415 960
Hours from 9 a.m. to 6 p.m. except the months of July and August, which will be from 9 am to 3 pm.
Idiomas
Revista Clínica Española (English Edition)
es en

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?