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array:24 [ "pii" => "S2254887419301675" "issn" => "22548874" "doi" => "10.1016/j.rceng.2019.04.011" "estado" => "S300" "fechaPublicacion" => "2019-11-01" "aid" => "1670" "copyright" => "Elsevier España, S.L.U. and Sociedad Española de Medicina Interna (SEMI)" "copyrightAnyo" => "2019" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Rev Clin Esp. 2019;219:433-9" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "Traduccion" => array:1 [ "es" => array:19 [ "pii" => "S0014256519301110" "issn" => "00142565" "doi" => "10.1016/j.rce.2019.04.005" "estado" => "S300" "fechaPublicacion" => "2019-11-01" "aid" => "1670" "copyright" => "Elsevier España, S.L.U. and Sociedad Española de Medicina Interna (SEMI)" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Rev Clin Esp. 2019;219:433-9" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 201 "formatos" => array:2 [ "HTML" => 115 "PDF" => 86 ] ] "es" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original</span>" "titulo" => "Simplificación de la escala de Barthel para el cribado de fragilidad y dependencia severa en pacientes pluripatológicos" "tienePdf" => "es" "tieneTextoCompleto" => "es" "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "433" "paginaFinal" => "439" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Simplification of the Barthel scale for screening for frailty and severe dependency in polypathological patients" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1231 "Ancho" => 2083 "Tamanyo" => 167939 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Propuesta de abordaje práctico de evaluación de independencia funcional (índice de Barthel ≥<span class="elsevierStyleHsp" style=""></span>90 puntos) y de dependencia funcional severa (índice de Barthel <<span class="elsevierStyleHsp" style=""></span>60 puntos) mediante el índice de Barthel simplificado a tres dimensiones, en pacientes pluripatológicos, para el ulterior cribado de fragilidad.</p>" ] ] ] "autores" => array:2 [ 0 => array:2 [ "autoresLista" => "M. 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array:3 [ "nombre" => "Manuel" "apellidos" => "Montero Pérez-Barquero" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">al</span>" "identificador" => "aff0190" ] ] ] 36 => array:3 [ "nombre" => "Antonia" "apellidos" => "Mora-Rufete" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">am</span>" "identificador" => "aff0195" ] ] ] 37 => array:3 [ "nombre" => "Clotilde" "apellidos" => "Morales" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">an</span>" "identificador" => "aff0200" ] ] ] 38 => array:3 [ "nombre" => "Lourdes" "apellidos" => "Moreno-Gaviño" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">ao</span>" "identificador" => "aff0205" ] ] ] 39 => array:3 [ "nombre" => "Alberto" "apellidos" => "Muela-Molinero" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">ap</span>" "identificador" => "aff0210" ] ] ] 40 => array:3 [ "nombre" => "José" "apellidos" => "Murcia-Zaragoza" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">aq</span>" "identificador" => "aff0215" ] ] ] 41 => array:3 [ "nombre" => "M." 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"apellidos" => "Luisa Rodríguez-Benedito" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">ay</span>" "identificador" => "aff0255" ] ] ] 49 => array:3 [ "nombre" => "Virginia" "apellidos" => "Rodríguez-Martínez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">az</span>" "identificador" => "aff0260" ] ] ] 50 => array:3 [ "nombre" => "Manuel" "apellidos" => "Romero-Jiménez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">ba</span>" "identificador" => "aff0265" ] ] ] 51 => array:3 [ "nombre" => "Sixto" "apellidos" => "Ruiz" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">bb</span>" "identificador" => "aff0270" ] ] ] 52 => array:3 [ "nombre" => "Alberto" "apellidos" => "Ruiz-Cantero" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">bc</span>" "identificador" => "aff0275" ] ] ] 53 => array:3 [ "nombre" => "Emilio" "apellidos" => "Sacanella" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">bd</span>" "identificador" => "aff0280" ] ] ] 54 => array:3 [ "nombre" => "María" "apellidos" => "Sánchez-Ledesma" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">be</span>" "identificador" => "aff0285" ] ] ] 55 => array:3 [ "nombre" => "Antonio" "apellidos" => "Sanjosé-Laporte" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">bf</span>" "identificador" => "aff0290" ] ] ] 56 => array:3 [ "nombre" => "Carlos" "apellidos" => "Sanromán" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">bg</span>" "identificador" => "aff0295" ] ] ] 57 => array:3 [ "nombre" => "M." "apellidos" => "Ángeles Soria-López" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">bh</span>" "identificador" => "aff0300" ] ] ] 58 => array:3 [ "nombre" => "Alicia" "apellidos" => "Tejera-Concepción" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">bi</span>" "identificador" => "aff0305" ] ] ] 59 => array:3 [ "nombre" => "Pedro" "apellidos" => "Tenllado-Doblas" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">bj</span>" "identificador" => "aff0310" ] ] ] 60 => array:3 [ "nombre" => "Guillermo" "apellidos" => "Ternavasio" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">bk</span>" "identificador" => "aff0315" ] ] ] 61 => array:3 [ "nombre" => "Eulalia" "apellidos" => "Villegas-Bruguera" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">bl</span>" "identificador" => "aff0320" ] ] ] ] "afiliaciones" => array:61 [ 0 => array:3 [ "entidad" => "Hospital Nuestra Sra. de la Candelaria, Tenerife, Spain" "etiqueta" => "d" "identificador" => "aff0020" ] 1 => array:3 [ "entidad" => "Hospital Virgen Macarena, Sevilla, Spain" "etiqueta" => "e" "identificador" => "aff0025" ] 2 => array:3 [ "entidad" => "Hospital de Manacor, Mallorca, Spain" "etiqueta" => "f" "identificador" => "aff0030" ] 3 => array:3 [ "entidad" => "Hospital Morales Meseguer, Murcia, Spain" "etiqueta" => "g" "identificador" => "aff0035" ] 4 => array:3 [ "entidad" => "Hospital de Manresa, Barcelona, Spain" "etiqueta" => "h" "identificador" => "aff0040" ] 5 => array:3 [ "entidad" => "Hospital Vall d’Hebrón, Barcelona, Spain" "etiqueta" => "i" "identificador" => "aff0045" ] 6 => array:3 [ "entidad" => "Hospital Juan Ramón Jiménez, Huelva, Spain" "etiqueta" => "j" "identificador" => "aff0050" ] 7 => array:3 [ "entidad" => "Hospital Virgen del Rocío, Sevilla, Spain" "etiqueta" => "k" "identificador" => "aff0055" ] 8 => array:3 [ "entidad" => "Hospital Universitario, Salamanca, Spain" "etiqueta" => "l" "identificador" => "aff0060" ] 9 => array:3 [ "entidad" => "Hospital Virgen del Rocío, Sevilla, Spain" "etiqueta" => "m" "identificador" => "aff0065" ] 10 => array:3 [ "entidad" => "Hospital Dr. Moliner, Valencia, Spain" "etiqueta" => "n" "identificador" => "aff0070" ] 11 => array:3 [ "entidad" => "Hospital de Torrecárdenas, Almería, Spain" "etiqueta" => "o" "identificador" => "aff0075" ] 12 => array:3 [ "entidad" => "Hospital Royo Villanova, Zaragoza, Spain" "etiqueta" => "p" "identificador" => "aff0080" ] 13 => array:3 [ "entidad" => "Hospital Juan Ramón Jiménez, Huelva, Spain" "etiqueta" => "q" "identificador" => "aff0085" ] 14 => array:3 [ "entidad" => "Hospital General de Palma, Mallorca, Spain" "etiqueta" => "r" "identificador" => "aff0090" ] 15 => array:3 [ "entidad" => "Hospital Marqués de Valdecilla, Santander, Spain" "etiqueta" => "s" "identificador" => "aff0095" ] 16 => array:3 [ "entidad" => "Hospital San Juan de Dios del Aljarafe, Sevilla, Spain" "etiqueta" => "t" "identificador" => "aff0100" ] 17 => array:3 [ "entidad" => "Hospital de Bellvitge, Barcelona, Spain" "etiqueta" => "u" "identificador" => "aff0105" ] 18 => array:3 [ "entidad" => "Hospital Son Dureta, Mallorca, Spain" "etiqueta" => "v" "identificador" => "aff0110" ] 19 => array:3 [ "entidad" => "Hospital Universitario, Salamanca, Spain" "etiqueta" => "w" "identificador" => "aff0115" ] 20 => array:3 [ "entidad" => "Hospital Virgen del Rocío, Sevilla, Spain" "etiqueta" => "x" "identificador" => "aff0120" ] 21 => array:3 [ "entidad" => "Hospital San Cecilio, Granada, Spain" "etiqueta" => "y" "identificador" => "aff0125" ] 22 => array:3 [ "entidad" => "Hospital de la Serranía, Málaga, Spain" "etiqueta" => "z" "identificador" => "aff0130" ] 23 => array:3 [ "entidad" => "Hospital Universitario, Salamanca, Spain" "etiqueta" => "aa" "identificador" => "aff0135" ] 24 => array:3 [ "entidad" => "Hospital Universitario, Salamanca, Spain" "etiqueta" => "ab" "identificador" => "aff0140" ] 25 => array:3 [ "entidad" => "Hospital de la Serranía, Málaga, Spain" "etiqueta" => "ac" "identificador" => "aff0145" ] 26 => array:3 [ "entidad" => "Hospital de Guadalajara, Spain" "etiqueta" => "ad" "identificador" => "aff0150" ] 27 => array:3 [ "entidad" => "Hospital de la Serranía, Málaga, Spain" "etiqueta" => "ae" "identificador" => "aff0155" ] 28 => array:3 [ "entidad" => "Hospital Virgen Macarena, Sevilla, Spain" "etiqueta" => "af" "identificador" => "aff0160" ] 29 => array:3 [ "entidad" => "Hospital Juan Ramón Jiménez, Huelva, Spain" "etiqueta" => "ag" "identificador" => "aff0165" ] 30 => array:3 [ "entidad" => "Hospital de Benalmádena, Málaga, Spain" "etiqueta" => "ah" "identificador" => "aff0170" ] 31 => array:3 [ "entidad" => "Hospital de Villajoyosa, Alicante, Spain" "etiqueta" => "ai" "identificador" => "aff0175" ] 32 => array:3 [ "entidad" => "Hospital 12 de Octubre, Madrid, Spain" "etiqueta" => "aj" "identificador" => "aff0180" ] 33 => array:3 [ "entidad" => "Hospital de Albacete, Spain" "etiqueta" => "ak" "identificador" => "aff0185" ] 34 => array:3 [ "entidad" => "Hospital Reina Sofía, Córdoba, Spain" "etiqueta" => "al" "identificador" => "aff0190" ] 35 => array:3 [ "entidad" => "Hospital General de Elche, Spain" "etiqueta" => "am" "identificador" => "aff0195" ] 36 => array:3 [ "entidad" => "Hospital de Manresa, Barcelona, Spain" "etiqueta" => "an" "identificador" => "aff0200" ] 37 => array:3 [ "entidad" => "Hospital Virgen del Rocío, Sevilla, Spain" "etiqueta" => "ao" "identificador" => "aff0205" ] 38 => array:3 [ "entidad" => "Hospital de León, Spain" "etiqueta" => "ap" "identificador" => "aff0210" ] 39 => array:3 [ "entidad" => "Hospital General de Alicante, Spain" "etiqueta" => "aq" "identificador" => "aff0215" ] 40 => array:3 [ "entidad" => "Hospital Virgen del Rocío, Sevilla, Spain" "etiqueta" => "ar" "identificador" => "aff0220" ] 41 => array:3 [ "entidad" => "Hospital Universitario, Salamanca, Spain" "etiqueta" => "as" "identificador" => "aff0225" ] 42 => array:3 [ "entidad" => "Hospital Virgen del Rocío, Sevilla, Spain" "etiqueta" => "at" "identificador" => "aff0230" ] 43 => array:3 [ "entidad" => "Hospital Gregorio Marañón, Madrid, Spain" "etiqueta" => "au" "identificador" => "aff0235" ] 44 => array:3 [ "entidad" => "Hospital Virgen del Rocío, Sevilla, Spain" "etiqueta" => "av" "identificador" => "aff0240" ] 45 => array:3 [ "entidad" => "Hospital de la Axarquía, Málaga, Spain" "etiqueta" => "aw" "identificador" => "aff0245" ] 46 => array:3 [ "entidad" => "Hospital Virgen del Rocío, Sevilla, Spain" "etiqueta" => "ax" "identificador" => "aff0250" ] 47 => array:3 [ "entidad" => "Hospital General de Requena, Valencia, Spain" "etiqueta" => "ay" "identificador" => "aff0255" ] 48 => array:3 [ "entidad" => "Hospital de Torrecárdenas, Almería, Spain" "etiqueta" => "az" "identificador" => "aff0260" ] 49 => array:3 [ "entidad" => "Hospital Infanta Elena, Huelva, Spain" "etiqueta" => "ba" "identificador" => "aff0265" ] 50 => array:3 [ "entidad" => "Hospital de Inca, Mallorca, Spain" "etiqueta" => "bb" "identificador" => "aff0270" ] 51 => array:3 [ "entidad" => "Hospital de la Serranía, Málaga, Spain" "etiqueta" => "bc" "identificador" => "aff0275" ] 52 => array:3 [ "entidad" => "Hospital Clínic, Barcelona, Spain" "etiqueta" => "bd" "identificador" => "aff0280" ] 53 => array:3 [ "entidad" => "Hospital Universitario, Salamanca, Spain" "etiqueta" => "be" "identificador" => "aff0285" ] 54 => array:3 [ "entidad" => "Hospital Vall d’Hebrón, Barcelona, Spain" "etiqueta" => "bf" "identificador" => "aff0290" ] 55 => array:3 [ "entidad" => "Hospital de la Axarquía, Málaga, Spain" "etiqueta" => "bg" "identificador" => "aff0295" ] 56 => array:3 [ "entidad" => "Clínica Virgen de la Vega, Murcia, Spain" "etiqueta" => "bh" "identificador" => "aff0300" ] 57 => array:3 [ "entidad" => "Hospital Nuestra Sra. de la Candelaria, Tenerife, Spain" "etiqueta" => "bi" "identificador" => "aff0305" ] 58 => array:3 [ "entidad" => "Hospital Dr. Moliner, Valencia, Spain" "etiqueta" => "bj" "identificador" => "aff0310" ] 59 => array:3 [ "entidad" => "Hospital Universitario, Salamanca, Spain" "etiqueta" => "bk" "identificador" => "aff0315" ] 60 => array:3 [ "entidad" => "Hospital Dos de Maig, Barcelona, Spain" "etiqueta" => "bl" "identificador" => "aff0320" ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Simplificación de la escala de Barthel para el cribado de fragilidad y dependencia severa en pacientes pluripatológicos" ] ] "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" => 1231 "Ancho" => 2083 "Tamanyo" => 161138 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Proposed practical approach for assessing functional independence (Barthel index<span class="elsevierStyleHsp" style=""></span>≥<span class="elsevierStyleHsp" style=""></span>90 points) and severe functional dependence (Barthel index<span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>60 points), using the Barthel index simplified to 3 measures, in polypathological patients, for subsequent frailty screening.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Background</span><p id="par0005" class="elsevierStylePara elsevierViewall">Frailty is one of the main geriatric syndromes, and its prevalence in the elderly population is high.<a class="elsevierStyleCrossRefs" href="#bib0075"><span class="elsevierStyleSup">1,2</span></a> When chronic diseases and comorbidities coexist, the prevalence of frailty increases significantly; in polypathological patients (PPPs), the rate of frailty reaches 60%.<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">3</span></a> Frailty is an independent prognostic marker of mortality and poor health results in the short, medium and long term. Frailty is currently considered a pre-disability state with unstable homeostatic equilibrium and a risk of developing new disabilities from an incipient condition of functional limitation. However, the most important aspect is that frailty can be detected and treated, thereby preventing the onset of disability by acting on the frailty.<a class="elsevierStyleCrossRefs" href="#bib0090"><span class="elsevierStyleSup">4–6</span></a> The social and healthcare approach to frailty is therefore one of the pillars of healthcare systems in caring for elderly populations.<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">6</span></a> The Barthel index (BI) has been proposed as a method for screening for frailty, with scores<span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>90 indicating dependence. If patients score 90 or more points, specific performance tests can be conducted to diagnose frailty.<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">6</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Functional impairment for basic activities of daily life (BADL) and disability are highly prevalent in PPPs. In various multicenter studies, most PPPs presented dependence, which was severe in more than 30% (BI<span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>60 points).<a class="elsevierStyleCrossRefs" href="#bib0105"><span class="elsevierStyleSup">7,8</span></a> Identifying severe dependence is important when assessing and structuring healthcare interventions directed at PPPs, because these interventions will vary in type and intensity depending on the patient's disability threshold. Detecting PPPs with severe dependence will help establish specific support systems that mitigate the progressive cascade of disability and its consequent deleterious effects.</p><p id="par0015" class="elsevierStylePara elsevierViewall">Implementing the BI to assess functionality for BADL before proceeding to specific performance tests for diagnosing frailty increases the clinical time needed to conduct the assessment. Therefore, simplifying the prior screening as much as possible using the BI will facilitate the screening and reduce the time needed to implement it, thereby assisting clinicians in the diagnostic approach for frailty. For the screening of severe dependence and the subsequent healthcare programming, it would be useful to have a summarized version of the index that can help healthcare practitioners detect severe dependence. However, there is currently insufficient evidence to recommend a BADL assessment using a summarized version of the BI.</p><p id="par0020" class="elsevierStylePara elsevierViewall">We therefore established the study objectives of exploring the sensitivity, specificity and positive predictive (PPV) and negative predictive values (NPV) of the 10 measures of the BI compared with the total score and assessing whether an abbreviated version of 1 or 2 measures could be used to screen for frailty and severe dependence.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Materials and methods</span><p id="par0025" class="elsevierStylePara elsevierViewall">We conducted a cross-sectional study employing data from the inclusion of a consecutive multicenter sample of 1632 PPPs recruited in 37 Spanish hospitals (17 tertiary hospitals, 7 secondary hospitals and 12 regional hospitals) over the course of 17<span class="elsevierStyleHsp" style=""></span>months for the PROFUND project. The project was conducted within the Polypathological Patient and Advanced Age Workgroup of the Spanish Society of Internal Medicine. Seventy-five percent of the patients were recruited during the hospital discharge, 17.5% were recruited in outpatient clinics, and 7.5% were recruited from home hospitalizations. The project collected various demographic, clinical, laboratory, functional, psychometric and healthcare parameters from all included patients.</p><p id="par0030" class="elsevierStylePara elsevierViewall">The BI was determined for all included patients by the project researchers, considering scores <90 points as dependence and scores <60 points as severe dependence. These 2 values were considered the gold standard for the presence or absence of dependence and severe dependence, respectively. For each of the 10 measures in the index, we calculated the correlation using the kappa index, sensitivity, specificity, PPV and NPV compared with the previously mentioned gold standard. We then analyzed whether the diagnostic validity indices improved through the use of all possible combinations of 2 measures. We employed the SPSS statistical package version 20.0 for the calculations.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Results</span><p id="par0035" class="elsevierStylePara elsevierViewall">The study included 1632 PPPs (mean age, 77.9<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>9.8<span class="elsevierStyleHsp" style=""></span>years; 53% men). The patients’ main clinical and functional characteristics are shown in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>.</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0040" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRefs" href="#tbl0010">Tables 2 and 3</a> show the correlation and diagnostic validity indices for each of the 10 measures and for the combinations of 2 measures with higher indices.</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0045" class="elsevierStylePara elsevierViewall">With respect to performing the BI with a score of 90 or more points, the measures with the highest NPV were “feeding” and “grooming” (96.6% for both); the combination of the 2 measures did not increase the NPV (99%). The measures with the highest PPV were “walking” and “going up and down stairs autonomously” (81% and 92%, respectively); the combination of the 2 measures resulted in an increased PPV compared with the maximum obtained in the individually considered measures (increasing it to 95%).</p><p id="par0050" class="elsevierStylePara elsevierViewall">With respect to performing the BI with a score of 60 or more points, the measures with the highest NPV were also “feeding” and “grooming” (87% for both); the combination of the 2 measures did not increase the NPV (81%). The measures with the highest PPV were “walking” and “going up and down stairs autonomously” (92.2% and 95.5%, respectively); the combination of the 2 measures resulted in an increased PPV compared with the maximum obtained in the individually considered measures (increasing it to 99.5%).</p><p id="par0055" class="elsevierStylePara elsevierViewall">After obtaining these results, we proposed a simplified sequence for the functional stratification and approach to frailty screening for PPPs (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Discussion</span><p id="par0060" class="elsevierStylePara elsevierViewall">The recruited cohort's clinical characteristics are those of populations of PPPs in hospital settings: advanced age, significant comorbidity burden, symptomatic and functional repercussion and polypharmacy.<a class="elsevierStyleCrossRefs" href="#bib0110"><span class="elsevierStyleSup">8,9</span></a> It is notable that approximately 60% of these patients had moderate dependence, and approximately 30% showed severe dependence for BADL.</p><p id="par0065" class="elsevierStylePara elsevierViewall">When assessing functional independence for BADL, the measures that achieved the highest NPV were “feeding” and “grooming”, both when obtaining a BI<span class="elsevierStyleHsp" style=""></span>≥<span class="elsevierStyleHsp" style=""></span>90 points and when obtaining a BI<span class="elsevierStyleHsp" style=""></span>≥<span class="elsevierStyleHsp" style=""></span>60 points. However, the combination of being independent for both measures did not significantly increase the NPV of either of the 2 measures taken individually. Therefore, either of the 2 measures can be employed for screening dependence in PPPs. Thus, we have a high degree of certainty that patients with some degree of dependence in “feeding” or “grooming” would not score 60 or more points on the full BI. For the study algorithm, we opted for the “feeding” measure rather than “grooming” due to the former's smaller confidence interval between the outliers. In fact, the ability to feed oneself is one of the basic executive functions that is maintained up to the most advanced stages of dependence, with the other BADL being lost before it, as has been found in other studies.<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">10</span></a></p><p id="par0070" class="elsevierStylePara elsevierViewall">Independence for performing the measures “walking” and “going up and down stairs” achieved a high PPV, both for obtaining a BI<span class="elsevierStyleHsp" style=""></span>≥<span class="elsevierStyleHsp" style=""></span>90 points and for obtaining a BI<span class="elsevierStyleHsp" style=""></span>≥<span class="elsevierStyleHsp" style=""></span>60 points. Additionally, the combination of being independent for both measures increased the PPV to 95% and 99.6% for obtaining a BI<span class="elsevierStyleHsp" style=""></span>≥<span class="elsevierStyleHsp" style=""></span>90 and a BI<span class="elsevierStyleHsp" style=""></span>≥<span class="elsevierStyleHsp" style=""></span>60 points, respectively. This combination of measures could be employed for functional independence, such that a PPP capable of walking and going up and down stairs alone could be considered independent for performing BADL and would be candidate for frailty screening, as has been proposed in various consensus documents.<a class="elsevierStyleCrossRefs" href="#bib0100"><span class="elsevierStyleSup">6,11</span></a> Based on our results, functional independence and severe dependence could be determined with high reliability and time efficiency using this combination of 3 measures. Thus, in the recruited sample, 474 patients (31%) were independent for walking and going up and down stairs and had a BI<span class="elsevierStyleHsp" style=""></span>≥<span class="elsevierStyleHsp" style=""></span>90 points (true positives). Furthermore, 316 patients (21%) had some degree of dependence for feeding and had a BI<span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>60 points (true negatives). Therefore, more than 50% of the PPPs could be spared the implementation of the full BI. Other authors have performed simplifications of the BI to 3–5 measures but only in the setting of acute cerebrovascular disease and the assessment of its sequelae, comparing its utility with specific stroke scales; there is therefore no approach for patients with multimorbidity and polypathology.<a class="elsevierStyleCrossRefs" href="#bib0130"><span class="elsevierStyleSup">12–14</span></a></p><p id="par0075" class="elsevierStylePara elsevierViewall">The results of the present study lack validation and should therefore be validated in future studies using an independent patient cohort to confirm this studies’ reliability and external validity. Another possible limitation is the sample's high representation of hospitalized patients, enrolled at discharge, which could create uncertainty as to its validity in stable outpatients. The study's main strength, however, is that it was implemented using a broad multicenter sample with a wide geographical dispersion, which will likely maintain its validity in subsequent patient samples. The study's main clinical utility lies in facilitating and shortening the time needed to conduct screening for frailty and severe dependence in a high percentage of PPPs.</p><p id="par0080" class="elsevierStylePara elsevierViewall">In conclusion, the ability to feed oneself only achieved a high NPV in detecting severe dependence for BADL, while the ability to walk and go up and down stairs achieved a high PPV for the screening of functional independence.</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Funding</span><p id="par0085" class="elsevierStylePara elsevierViewall">The study was funded by the <span class="elsevierStyleGrantSponsor" id="gs1">Institute of Health Carlos <span class="elsevierStyleSmallCaps">III</span></span> (ISCIII, <span class="elsevierStyleGrantNumber" refid="gs1">FIS 07/0047</span>), <span class="elsevierStyleGrantSponsor" id="gs2">Ministry of Health and Consumer Affairs, Spain</span>.</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Authorship</span><p id="par0090" class="elsevierStylePara elsevierViewall">Concept and design of the manuscript: Máximo Bernabeu-Wittel.</p><p id="par0095" class="elsevierStylePara elsevierViewall">Data collection: Máximo Bernabeu-Wittel, Jesús Díez-Manglano, Dolores Nieto Martín, Nieves Ramírez-Duque and Manuel Ollero-Baturone.</p><p id="par0100" class="elsevierStylePara elsevierViewall">Data analysis and interpretation: Máximo Bernabeu-Wittel, Jesús Díez-Manglano and Dolores Nieto Martín.</p><p id="par0105" class="elsevierStylePara elsevierViewall">Drafting, review and approval of the submitted manuscript. Máximo Bernabeu-Wittel, Jesús Díez-Manglano, Dolores Nieto Martín, Nieves Ramírez-Duque and Manuel Ollero-Baturone.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:11 [ 0 => array:3 [ "identificador" => "xres1260004" "titulo" => "Abstract" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Objectives" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusions" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec1167026" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres1260005" "titulo" => "Resumen" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Objetivos" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusiones" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec1167027" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Background" ] 5 => array:2 [ "identificador" => "sec0010" "titulo" => "Materials and methods" ] 6 => array:2 [ "identificador" => "sec0015" "titulo" => "Results" ] 7 => array:2 [ "identificador" => "sec0020" "titulo" => "Discussion" ] 8 => array:2 [ "identificador" => "sec0025" "titulo" => "Funding" ] 9 => array:2 [ "identificador" => "sec0030" "titulo" => "Authorship" ] 10 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2019-02-09" "fechaAceptado" => "2019-04-08" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec1167026" "palabras" => array:6 [ 0 => "Polypathology" 1 => "Functional impairment" 2 => "Frailty" 3 => "Screening" 4 => "Barthel index" 5 => "Multimorbidity" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec1167027" "palabras" => array:6 [ 0 => "Pluripatología" 1 => "Deterioro funcional" 2 => "Fragilidad" 3 => "Cribado" 4 => "Índice de Barthel" 5 => "Multimorbilidad" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objectives</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">To analyze the sensitivity, specificity and positive predictive (PPV) and negative predictive (NPV) values of each measure of the Barthel index (BI) compared with the full questionnaire for polypathological patients (PPPs).</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Multicentre cross-sectional study. We considered 2 cut-off points for the BI (≥90 points for screening frailty and <60 points for diagnosing severe dependence). For each measure and combination of 2 measures, we calculated the sensitivity, specificity, PPV and NPV with respect to the full BI.</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">The mean BI of the 1632 included PPPs (mean age, 77.9<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>9.8<span class="elsevierStyleHsp" style=""></span>years; 53% men) was 69<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>31 (<90 for 58.7% and <60 for 31.4% of the patients). The “feeding” measure achieved the highest NPV, for a BI<span class="elsevierStyleHsp" style=""></span>≥<span class="elsevierStyleHsp" style=""></span>60 and ≥90 points (87% and 99.6%, respectively). The “walking” and “going up and down stairs” measures achieved the highest PPV, for a BI<span class="elsevierStyleHsp" style=""></span>≥<span class="elsevierStyleHsp" style=""></span>60 and ≥90 (99.2%/99.5% and 81%/92%), respectively. The combination of the 2 measures increased the PPV to 95% and 99.6%, respectively.</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">PPPs in hospital settings have a high rate of functional impairment. The measure for feeding achieved the highest NPV and can therefore be employed for diagnosing severe dependence. The combination of the measures for walking and going up and down stairs achieved the highest PPV and can therefore be employed to propose frailty screening for PPPs.</p></span>" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Objectives" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusions" ] ] ] "es" => array:3 [ "titulo" => "Resumen" "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Objetivos</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Analizar la sensibilidad (S), la especificidad (E) y los valores predictivos positivo (VPP) y negativo (VPN) de cada dimensión del índice de Barthel (IB) con respecto al cuestionario completo en pacientes pluripatológicos (PPP).</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Métodos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Estudio transversal multicéntrico. Se consideraron dos puntos de corte del IB (≥<span class="elsevierStyleHsp" style=""></span>90 puntos para el cribado de fragilidad y <<span class="elsevierStyleHsp" style=""></span>60 puntos para el diagnóstico de dependencia severa). Para cada dimensión y combinaciones de dos dimensiones se calcularon la S, la E, el VPP y el VPN con respecto al IB completo.</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">El IB medio de los 1.632 PPP incluidos (edad media de 77,9<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>9,8<span class="elsevierStyleHsp" style=""></span>años, 53% varones) fue 69<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>31 (<<span class="elsevierStyleHsp" style=""></span>90 en el 58,7% y <<span class="elsevierStyleHsp" style=""></span>60 en el 31,4% de pacientes). La dimensión «alimentación» obtuvo los mayores VPN para tener un IB<span class="elsevierStyleHsp" style=""></span>≥<span class="elsevierStyleHsp" style=""></span>60 y ≥<span class="elsevierStyleHsp" style=""></span>90 puntos (87% y 99,6%, respectivamente). Las dimensiones «deambular» y «subir y bajar escaleras» obtuvieron el mayor VPP para tener un IB<span class="elsevierStyleHsp" style=""></span>≥<span class="elsevierStyleHsp" style=""></span>60 y ≥<span class="elsevierStyleHsp" style=""></span>90 (99,2/99,5% y 81/92%), respectivamente; la combinación de ambas preguntas aumentó el VPP al 95 y al 99,6%, respectivamente.</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusiones</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Los PPP de ámbito hospitalario presentan con elevada frecuencia deterioro funcional. La dimensión referente a alimentarse obtuvo el mayor VPN, por lo que se puede utilizar para el diagnóstico de dependencia severa, mientras que la combinación de deambular y subir y bajar escaleras obtuvo el mayor VPP, pudiendo utilizarse para plantear el cribado de fragilidad de los PPP.</p></span>" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Objetivos" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusiones" ] ] ] ] "NotaPie" => array:2 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0035">Please cite this article as: Bernabeu-Wittel M, Díez-Manglano J, Nieto-Martín D, Ramírez-Duque N, Ollero-Baturone M. Simplificación de la escala de Barthel para el cribado de fragilidad y dependencia severa en pacientes pluripatológicos. Rev Clin Esp. 2019;219:433–439.</p>" ] 1 => array:3 [ "etiqueta" => "◊" "nota" => "<p class="elsevierStyleNotepara" id="npar0040">The rest of the PROFUND Project researchers are related in the <a class="elsevierStyleCrossRef" href="#sec0035">Appendix</a>.</p>" "identificador" => "fn0005" ] ] "apendice" => array:1 [ 0 => array:1 [ "seccion" => array:1 [ 0 => array:4 [ "apendice" => "<p id="par0110" class="elsevierStylePara elsevierViewall">Lucy Abella-Vázquez, Hospital Nuestra Sra. de la Candelaria, Tenerife.</p> <p id="par0115" class="elsevierStylePara elsevierViewall">Mariano Aguayo-Canela, Hospital Virgen Macarena, Seville.</p> <p id="par0120" class="elsevierStylePara elsevierViewall">Mónica Albert-Coll, Hospital de Manacor, Mallorca.</p> <p id="par0125" class="elsevierStylePara elsevierViewall">Antonio Alemán, Hospital Morales Meseguer, Murcia.</p> <p id="par0130" class="elsevierStylePara elsevierViewall">Jordi Aligué, Hospital de Manresa, Barcelona.</p> <p id="par0135" class="elsevierStylePara elsevierViewall">José Barbé Gil-Ortega, Hospital Vall d’Hebrón, Barcelona.</p> <p id="par0140" class="elsevierStylePara elsevierViewall">Bosco Barón-Franco, Hospital Juan Ramón Jiménez, Huelva.</p> <p id="par0145" class="elsevierStylePara elsevierViewall">Máximo Bernabeu-Wittel, Hospital Virgen del Rocío, Seville.</p> <p id="par0150" class="elsevierStylePara elsevierViewall">Cristina de la Calle-Cabrera, University Hospital, Salamanca.</p> <p id="par0155" class="elsevierStylePara elsevierViewall">Manuel Cassani-Garza, Hospital Virgen del Rocío, Seville.</p> <p id="par0160" class="elsevierStylePara elsevierViewall">Manuela Castillo-Blasco, Hospital Dr. Moliner, Valencia.</p> <p id="par0165" class="elsevierStylePara elsevierViewall">Felipe Díez, Hospital de Torrecárdenas, Almería.</p> <p id="par0170" class="elsevierStylePara elsevierViewall">Jesús Díez-Manglano, Hospital Royo Villanova, Zaragoza.</p> <p id="par0175" class="elsevierStylePara elsevierViewall">Alberto Escalera-Zalvide, Hospital Juan Ramón Jiménez, Huelva.</p> <p id="par0180" class="elsevierStylePara elsevierViewall">Luis Feliu-Mazaria, General Hospital of Palma, Mallorca.</p> <p id="par0185" class="elsevierStylePara elsevierViewall">Manuel Francisco Fernández-Miera, Hospital Marqués de Valdecilla, Santander.</p> <p id="par0190" class="elsevierStylePara elsevierViewall">Antonio Fernández-Moyano, Hospital San Juan de Dios del Aljarafe, Seville.</p> <p id="par0195" class="elsevierStylePara elsevierViewall">Francesc Formiga, Hospital de Bellvitge, Barcelona.</p> <p id="par0200" class="elsevierStylePara elsevierViewall">Jordy Forteza-Rey, Hospital Son Dureta, Mallorca.</p> <p id="par0205" class="elsevierStylePara elsevierViewall">Aurelio Fuertes-Martín, University Hospital, Salamanca.</p> <p id="par0210" class="elsevierStylePara elsevierViewall">Javier Galindo-Ocaña, Hospital Virgen del Rocío, Seville.</p> <p id="par0215" class="elsevierStylePara elsevierViewall">Pilar Giner, Hospital San Cecilio, Granada.</p> <p id="par0220" class="elsevierStylePara elsevierViewall">Montserrat Godoy, Hospital de la Serranía, Malaga.</p> <p id="par0225" class="elsevierStylePara elsevierViewall">Sandra Gómez-Lesmes, University Hospital, Salamanca.</p> <p id="par0230" class="elsevierStylePara elsevierViewall">Hernán Llorente-Cancho, University Hospital, Salamanca.</p> <p id="par0235" class="elsevierStylePara elsevierViewall">Carolina Luque-Amado, Hospital de la Serranía, Malaga.</p> <p id="par0240" class="elsevierStylePara elsevierViewall">José Manuel Machín-Lázaro, Hospital de Guadalajara.</p> <p id="par0245" class="elsevierStylePara elsevierViewall">María Maiz-Jiménez, Hospital de la Serranía, Malaga.</p> <p id="par0250" class="elsevierStylePara elsevierViewall">Francisco Martínez, Hospital Virgen Macarena, Seville.</p> <p id="par0255" class="elsevierStylePara elsevierViewall">Tomás Martínez, Hospital Juan Ramón Jiménez, Huelva.</p> <p id="par0260" class="elsevierStylePara elsevierViewall">Francisco Martos, Hospital de Benalmádena, Malaga.</p> <p id="par0265" class="elsevierStylePara elsevierViewall">Beatriz Massa, Hospital de Villajoyosa, Alicante.</p> <p id="par0270" class="elsevierStylePara elsevierViewall">Jesús Medina, Hospital 12 de Octubre, Madrid.</p> <p id="par0275" class="elsevierStylePara elsevierViewall">Francisco Medrano-González, Hospital de Albacete.</p> <p id="par0280" class="elsevierStylePara elsevierViewall">Manuel Montero Pérez-Barquero, Hospital Reina Sofía, Córdoba.</p> <p id="par0285" class="elsevierStylePara elsevierViewall">Antonia Mora-Rufete, General Hospital of Elche.</p> <p id="par0290" class="elsevierStylePara elsevierViewall">Clotilde Morales, Hospital de Manresa, Barcelona.</p> <p id="par0295" class="elsevierStylePara elsevierViewall">Lourdes Moreno-Gaviño, Hospital Virgen del Rocío, Seville.</p> <p id="par0300" class="elsevierStylePara elsevierViewall">Alberto Muela-Molinero, Hospital de León.</p> <p id="par0305" class="elsevierStylePara elsevierViewall">José Murcia-Zaragoza, General Hospital of Alicante.</p> <p id="par0310" class="elsevierStylePara elsevierViewall">M. Dolores Nieto-Martín, Hospital Virgen del Rocío, Seville.</p> <p id="par0315" class="elsevierStylePara elsevierViewall">Ignacio Novo Valeiro, University Hospital, Salamanca.</p> <p id="par0320" class="elsevierStylePara elsevierViewall">Manuel Ollero-Baturone, Hospital Virgen del Rocío, Seville.</p> <p id="par0325" class="elsevierStylePara elsevierViewall">Blanca Pinilla, Hospital Gregorio Marañón, Madrid.</p> <p id="par0330" class="elsevierStylePara elsevierViewall">Nieves Ramírez-Duque, Hospital Virgen del Rocío, Seville.</p> <p id="par0335" class="elsevierStylePara elsevierViewall">Carmen Ramos-Cantos, Hospital de la Axarquía, Malaga.</p> <p id="par0340" class="elsevierStylePara elsevierViewall">Manuel Rincón-Gómez, Hospital Virgen del Rocío, Seville.</p> <p id="par0345" class="elsevierStylePara elsevierViewall">M. Luisa Rodríguez-Benedito, General Hospital of Requena, Valencia.</p> <p id="par0350" class="elsevierStylePara elsevierViewall">Virginia Rodríguez-Martínez, Hospital de Torrecárdenas, Almería.</p> <p id="par0355" class="elsevierStylePara elsevierViewall">Manuel Romero-Jiménez, Hospital Infanta Elena, Huelva.</p> <p id="par0360" class="elsevierStylePara elsevierViewall">Sixto Ruiz, Hospital de Inca, Mallorca.</p> <p id="par0365" class="elsevierStylePara elsevierViewall">Alberto Ruiz-Cantero, Hospital de la Serranía, Malaga.</p> <p id="par0370" class="elsevierStylePara elsevierViewall">Emilio Sacanella, Hospital Clínic, Barcelona.</p> <p id="par0375" class="elsevierStylePara elsevierViewall">María Sánchez-Ledesma, University Hospital, Salamanca.</p> <p id="par0380" class="elsevierStylePara elsevierViewall">Antonio Sanjosé-Laporte, Hospital Vall d’Hebrón, Barcelona.</p> <p id="par0385" class="elsevierStylePara elsevierViewall">Carlos Sanromán, Hospital de la Axarquía, Malaga.</p> <p id="par0390" class="elsevierStylePara elsevierViewall">M. Ángeles Soria-López, Clínica Virgen de la Vega, Murcia.</p> <p id="par0395" class="elsevierStylePara elsevierViewall">Alicia Tejera-Concepción, Hospital Nuestra Sra. de la Candelaria, Tenerife.</p> <p id="par0400" class="elsevierStylePara elsevierViewall">Pedro Tenllado-Doblas, Hospital Dr. Moliner, Valencia.</p> <p id="par0405" class="elsevierStylePara elsevierViewall">Guillermo Ternavasio, University Hospital, Salamanca.</p> <p id="par0410" class="elsevierStylePara elsevierViewall">Eulalia Villegas-Bruguera, Hospital Dos de Maig, Barcelona.</p>" "etiqueta" => "Appendix" "titulo" => "Project PROFUND Researchers" "identificador" => "sec0035" ] ] ] ] "multimedia" => array:4 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1231 "Ancho" => 2083 "Tamanyo" => 161138 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Proposed practical approach for assessing functional independence (Barthel index<span class="elsevierStyleHsp" style=""></span>≥<span class="elsevierStyleHsp" style=""></span>90 points) and severe functional dependence (Barthel index<span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>60 points), using the Barthel index simplified to 3 measures, in polypathological patients, for subsequent frailty screening.</p>" ] ] 1 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Abbreviations: IQR, interquartile range; mMRC, modified Medical Research Council; NYHA, New York Heart Association; SD, standard deviation.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 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">Characteristic \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">Mean (DE)/Median [IQR]/<span class="elsevierStyleItalic">n</span> (%) \t\t\t\t\t\t\n \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"><span class="elsevierStyleBold">Number of categories/patient</span> \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">2.7<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>0.8 \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"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Patients with ≥3 categories</span> \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">808 (49.5%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleBold">Prevalence of defining categories in recruited PPPs</span></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"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Category A (heart disease)</span> \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">1264 (77.5%) \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"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Category C (lung disease)</span> \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">744 (45.6%) \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"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Category E (neurological disease)</span> \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">624 (38.2%) \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"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Category B (chronic/autoimmune kidney disease)</span> \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">526 (32.2%) \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"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Category G (active neoplasia/chronic anemia)</span> \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">418 (25.6%) \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"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Category F (peripheral artery disease/diabetes with neuropathy)</span> \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">411 (25.2%) \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"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Category H (degenerative osteoarticular disease)</span> \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">271 (16.6%) \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"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Category D (liver disease)</span> \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">112 (6.9%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></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"><span class="elsevierStyleBold">Number of other comorbidities per patient</span> \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">4.5 (2.7) \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"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Cardiovascular</span> \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">2.25 (1.5) \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"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Endocrine metabolic</span> \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">1.17 (1) \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"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Neuropsychiatric</span> \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">0.46 (0.7) \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"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Gastrointestinal</span> \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">0.3 (0.2) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleBold">Other more common comorbidities</span></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"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Hypertension</span> \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">1170 (71.7%) \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"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Arrhythmias</span> \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">603 (36.9) \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"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Atrial fibrillation \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">575 (35.2%) \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"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Other arrhythmias \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">28 (1.7%) \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"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Diabetes without visceral involvement</span> \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">478 (29.3%) \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"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Dyslipidemia</span> \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">473 (29%) \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"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Anxiety and depressive disorders</span> \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">179 (11%) \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"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Benign prostatic hyperplasia</span> \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">170 (10.4%) \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"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Osteoporosis</span> \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">114 (7%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></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"><span class="elsevierStyleBold">Charlson index/age-adjusted Charlson index</span> \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">4 [2]/6.3 [2.4] \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"><span class="elsevierStyleBold">Patients with baseline dyspnea NYHA<span class="elsevierStyleSmallCaps">III</span>-<span class="elsevierStyleSmallCaps">IV</span>/<span class="elsevierStyleSmallCaps">III</span>-<span class="elsevierStyleSmallCaps">IV</span> of the mMRC</span> \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">777 (47.6%)/855 (52.4%) \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"><span class="elsevierStyleBold">Patients with active neoplasia in the enrolment/metastatic disease</span> \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">188 (11.2%)/70 (37.5%) \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"><span class="elsevierStyleBold">Hospitalizations in the past 12 months/3 months</span> \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">1.9 (1.2)/1 (0.9) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></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"><span class="elsevierStyleBold">Baseline Barthel Index</span> \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">69 (31) \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"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Patients with baseline Barthel index</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic"><</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">90</span> \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 (58.7%) \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"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Patients with baseline Barthel index</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic"><</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">60</span> \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">512 (31.4%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></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"><span class="elsevierStyleBold">Number of long-term prescription drugs per patient</span> \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">8 (3) \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2155273.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Clinical and functional characteristics of the multicenter sample of 1632 polypathological patients.</p>" ] ] 2 => array:8 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at2" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 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">Dimension<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a> \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">Correlation (kappa index) \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">S \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">Sp \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">PPV \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">NPV \t\t\t\t\t\t\n \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">Feeding \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">0.44 (0.39–0.47) \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">99.8% (99–99.8%) \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">59% (56–62%) \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">63% (60–66%) \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"><span class="elsevierStyleBold">99.6%</span> (98.5–100%) \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">Bathing \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">0.79 (0.76–0.82) \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">92% (89.5–94%) \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">83% (80–85%) \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">79% (76–82%) \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">93.6% (91–95%) \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">Dressing \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">0.76 (0.73–0.8) \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">96% (94–97%) \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">83% (80–85%) \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">80% (77–83%) \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">96.6% (95–98%) \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">Grooming \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">0.46 (0.36–0.48) \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">99.8% (99–100%) \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">56.2% (53–59%) \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">62% (59–65%) \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"><span class="elsevierStyleBold">99.6%</span> (98–100%) \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">Bowels \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">0.43 (0.33–0.48) \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">97.6% (96–98%) \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% (42–49%) \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">56% (53–59%) \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">96% (94–98%) \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">Bladder \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">0.46 (0.41–0.5) \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">93% (90–94%) \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">56.6% (53–60%) \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% (57–63%) \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">92% (89–94%) \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">Toilet use \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">0.58 (0.54–0.62) \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">99.7% (99–99.9%) \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">62% (59–65%) \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">65% (62–68%) \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">99.5% (99–99.9%) \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">Transfers \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">0.71 (0.67–0.74) \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">98.4% (97–99%) \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">76% (73–78%) \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">74% (71–77%) \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">98.5% (97–99.2%) \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">Mobility \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">0.8 (0.76–0.82) \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">97% (95–98%) \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">84% (81–86%) \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"><span class="elsevierStyleBold">81%</span> (78–84%) \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">97.6% (96–99%) \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">Stairs \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">0.75 (0.71–0.78) \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">77% (74–80%) \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">95% (93–96%) \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"><span class="elsevierStyleBold">92%</span> (89–94%) \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">86% (83–88%) \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">Feeding<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>grooming \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">0.49 (0.44–0.53) \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">99.4% (98–99.7%) \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">54% (50–57%) \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% (57–63%) \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">99% (98–99.7%) \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">Walking<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>stairs \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">0.76 (0.72–0.79) \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">76% (73–79%) \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">97% (95.5–98%) \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"><span class="elsevierStyleItalic"><span class="elsevierStyleBold">95%</span></span> (92–96%) \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">85% (83–87%) \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2155272.png" ] ] ] "notaPie" => array:1 [ 0 => array:3 [ "identificador" => "tblfn0005" "etiqueta" => "a" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Considering the measure dichotomously (independence vs. any degree of dependence in performing this measure).</p> <p class="elsevierStyleNotepara" id="npar0010">Multicenter sample of 1632 polypathological patients. The maximum PPV and NPV obtained in the individual questions are in <span class="elsevierStyleBold">bold</span>; the maximum PPV and NPV obtained with the combinations of 2 measures are in <span class="elsevierStyleItalic"><span class="elsevierStyleBold">bold and italics</span></span>. The 95% confidence interval is shown in parentheses.</p> <p class="elsevierStyleNotepara" id="npar0015">Abbreviations: S, sensitivity; SP, specificity; PPV, positive predictive value; NPF, negative predictive value.</p>" ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Correlation results (index kappa), sensitivity, specificity, positive predictive value and negative predictive value of each measure of the Barthel index and its optimal combinations for the diagnosis of a Barthel index<span class="elsevierStyleHsp" style=""></span>≥<span class="elsevierStyleHsp" style=""></span>90 points and its use in screening frailty.</p>" ] ] 3 => array:8 [ "identificador" => "tbl0015" "etiqueta" => "Table 3" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at3" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 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">Dimension<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">a</span></a> \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">Correlation (kappa index) \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">S \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">Sp \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">PPV \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">NPV \t\t\t\t\t\t\n \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">Feeding \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">0.68 (0.62–0.70) \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">95.4% (94–96%) \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">67% (62–71%) \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">86% (84–88%) \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"><span class="elsevierStyleBold">87%</span> (83–90%) \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">Bathing \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">0.52 (0.48–0.56) \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">67% (64–70%) \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">94% (91–96%) \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">96% (94–97%) \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">57% (53–60%) \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">Dressing \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">0.61 (0.57–0.65) \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">72% (69–75%) \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">99% (98–99.7%) \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">99% (98–99.7%) \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">62% (58–65%) \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">Grooming \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">0.7 (0.66–0.74) \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">95% (93–96%) \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">72% (67–75%) \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">88% (86–90%) \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"><span class="elsevierStyleBold">87%</span> (81–90%) \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">Bowels \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">0.68 (0.64–0.72) \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">93% (91–94%) \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">73% (69–77%) \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">88% (86–90%) \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">82% (78–85%) \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">Bladder \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">0.61 (0.57–0.65) \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">84% (81–86%) \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">80% (76–83%) \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">90% (88–92%) \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">69% (65–73%) \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">Toilet use \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">0.4 (0.34–0.43) \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">90% (88–92%) \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">95% (93–97%) \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">98% (96–98%) \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">81% (78–84%) \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">Transfers \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">0.7 (0.65–0.72) \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">79% (76–81%) \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">98% (96–99%) \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">99% (98–99.3%) \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">68% (64–71%) \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">Mobility \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">0.6 (0.56–0.64) \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">72% (69–74%) \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">99% (97–99.4%) \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"><span class="elsevierStyleBold">99.2%</span> (98–99.6%) \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">61% (57–64%) \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">Stairs \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">0.8 (0.78–0.84) \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">50% (47–53%) \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">99.5% (98–99.8%) \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"><span class="elsevierStyleBold">99.5%</span> (98–99.8%) \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">48% (45–51%) \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">Feeding<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>grooming \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">0.75 (0.7–0.77) \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">91% (89–93%) \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">83% (79–86%) \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">92% (90–94%) \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">81% (77–84%) \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">Walking<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>stairs \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">0.47 (0.42–0.53) \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">49% (45–51%) \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">99.6% (98–99.9%) \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"><span class="elsevierStyleItalic"><span class="elsevierStyleBold">99.6%</span></span> (98.6–99.9%) \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">47% (43–50%) \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2155274.png" ] ] ] "notaPie" => array:1 [ 0 => array:3 [ "identificador" => "tblfn0010" "etiqueta" => "a" "nota" => "<p class="elsevierStyleNotepara" id="npar0020">Considering the measure dichotomously (independence vs. any degree of dependence in performing this measure).</p> <p class="elsevierStyleNotepara" id="npar0025">Multicenter sample of 1632 polypathological patients. The maximum PPV and NPV obtained in the individual questions are in <span class="elsevierStyleBold">bold</span>; the maximum PPV and NPV obtained with the combinations of 2 measures are in <span class="elsevierStyleItalic"><span class="elsevierStyleBold">bold and italics</span></span>. The 95% confidence interval is shown in parentheses.</p> <p class="elsevierStyleNotepara" id="npar0030">Abbreviations: S, sensitivity; SP, specificity; PPV, positive predictive value; NPF, negative predictive value.</p>" ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Correlation results (kappa index), sensitivity, specificity, positive predictive value and negative predictive value of each measure of the Barthel index and its optimal combinations for the diagnosis of a Barthel index<span class="elsevierStyleHsp" style=""></span>≥<span class="elsevierStyleHsp" style=""></span>60 points and its use in screening severe dependence.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:14 [ 0 => array:3 [ "identificador" => "bib0075" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The frailty syndrome: definition and natural history" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "Q.L. 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