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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introducci&#243;n</span><p id="par0010" class="elsevierStylePara elsevierViewall">La fractura de cadera es uno de los diagn&#243;sticos m&#225;s prevalentes en los departamentos de Traumatolog&#237;a y es una de las entidades traum&#225;ticas m&#225;s frecuentes en el anciano&#46; En Espa&#241;a&#44; en los &#250;ltimos a&#241;os&#44; la poblaci&#243;n de edad superior a los 65 a&#241;os ha crecido considerablemente&#44; desde el 14&#44;92&#37; en 1997 al 16&#44;62&#37; en el 2008&#44; y se espera un crecimiento similar para los pr&#243;ximos a&#241;os&#46; La incidencia de la fractura de cadera en Espa&#241;a&#44; en 2008&#44; fue de 103&#44;76 casos por 100&#46;000 habitantes&#44; un 17&#44;77&#37; m&#225;s que la registrada en 1997&#44; lo que muestra una tasa de crecimiento interanual del 1&#44;5&#37;&#46; Este crecimiento estuvo acompa&#241;ado por un aumento en la edad del paciente&#58; la media de edad de los pacientes que fueron atendidos fue de 78&#44;07 a&#241;os &#40;80&#44;13 a&#241;os para las mujeres&#44; 72&#44;08 a&#241;os para los hombres&#41;&#59; mientras que en 2008 esta fue de 80&#44;46 a&#241;os &#40;82&#44;13 para las mujeres&#59; 75&#44;71 para los hombres&#41;&#46; La fractura de cadera se asocia con una elevada prevalencia de morbimortalidad&#44; con una tasa de mortalidad anual que oscila entre el 20 y el 25&#37;<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">1</span></a>&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">El tratamiento tras la fractura es prolongado&#44; con una tasa de recuperaci&#243;n variable que exige un amplio apoyo por parte de m&#250;ltiples especialidades m&#233;dicas<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">2</span></a>&#46; Por todo ello&#44; la fractura de cadera ha ganado importancia en la sociedad&#44; tanto en t&#233;rminos econ&#243;micos como sociales&#44; que afecta directamente a los que la sufren e indirectamente a las estructuras que lo sostienen&#46; As&#237;&#44; en Espa&#241;a se estiman unos costes asociados con la fractura de cadera de alrededor a 395&#44;7 millones de euros<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">1</span></a> y en Estados Unidos de 9&#46;000&#160;millones de d&#243;lares<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">3</span></a>&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Debido a la magnitud actual del problema y de su aumento en el futuro&#44; resulta necesario protocolizar los modelos de cuidado y proporcionar una aproximaci&#243;n orientada a la poblaci&#243;n anciana con el fin de responder a sus necesidades espec&#237;ficas&#44; tanto de fragilidad como de multimorbilidad&#46; Existen experiencias previas de dichos protocolos estandarizados que se han demostrado beneficiosos en la atenci&#243;n de la fractura de cadera<a class="elsevierStyleCrossRefs" href="#bib0165"><span class="elsevierStyleSup">4-7</span></a>&#46; Estos modelos se basan en equipos multidisciplinares&#44; en los que cirujanos ortop&#233;dicos e internistas&#47;geriatras comparten una atenci&#243;n integral e individualizada de esta poblaci&#243;n con necesidades cl&#237;nicas especiales&#46; As&#237;&#44; el papel del especialista en Medicina Interna est&#225; creciendo como consecuencia de la gran morbilidad observada en estos pacientes&#46; Antes de estos modelos de comanejo&#44; el cuidado m&#233;dico de dichos pacientes se realizaba siguiendo los criterios del Departamento de Traumatolog&#237;a&#44; con una respuesta variable del departamento m&#233;dico&#44; normalmente&#44; una vez aparecidas las complicaciones&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">El objetivo de este estudio es demostrar el efecto de un modelo de comanejo entre los departamentos de Traumatolog&#237;a y Medicina Interna&#44; en pacientes ancianos con fractura de cadera&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Material y m&#233;todos</span><p id="par0030" class="elsevierStylePara elsevierViewall">Se dise&#241;&#243; un estudio de cohortes retrospectivas para pacientes de m&#225;s de 65 a&#241;os de edad hospitalizados con fractura de cadera&#46; La cohorte hist&#243;rica &#40;HIST&#41; incluy&#243; a aquellos pacientes ingresados entre enero de 2005 y agosto de 2006&#59; y la cohorte de comanejo &#40;COFRAC&#41; entre enero de 2008 y agosto de 2010&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Se evalu&#243; la incidencia de las complicaciones m&#233;dicas&#44; la mortalidad acontecida durante el ingreso&#44; as&#237; como el n&#250;mero de visitas a urgencias&#44; reingresos y mortalidad a los 30 d&#237;as tras el alta&#46; Adem&#225;s&#44; analizamos las caracter&#237;sticas demogr&#225;ficas del paciente y de su cuidador&#44; las caracter&#237;sticas cl&#237;nicas del paciente&#44; de la fractura y de su intervenci&#243;n quir&#250;rgica&#46; Se realiz&#243; un an&#225;lisis estad&#237;stico utilizando la prueba del chi-cuadrado para las variables cualitativas y el test Anova para las cuantitativas&#46; Se emple&#243; el paquete estad&#237;stico SPSS en su versi&#243;n 20&#46;0&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Resultados</span><p id="par0040" class="elsevierStylePara elsevierViewall">Se incluy&#243; a un total de 701 pacientes&#44; de los cuales 471 compon&#237;an la cohorte HIST y 230 la cohorte COFRAC&#46; Las caracter&#237;sticas demogr&#225;ficas y cl&#237;nicas mostraron diferencias en cuanto a la identificaci&#243;n de la pluripatolog&#237;a&#44; los d&#233;ficits motores&#44; arritmia diferente a fibrilaci&#243;n auricular&#44; osteoporosis y uso cr&#243;nico de f&#225;rmacos &#40;ver <a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a>&#41;&#46; No se encontraron diferencias entre cohortes en cuanto a las caracter&#237;sticas relacionadas con la fractura de cadera&#44; anestesia y cirug&#237;a &#40;ver <a class="elsevierStyleCrossRef" href="#tbl0010">tabla 2</a>&#41;&#46; En la <a class="elsevierStyleCrossRef" href="#tbl0015">tabla 3</a> se muestran las complicaciones hospitalarias&#44; con diferencias en cuanto a mortalidad&#44; estre&#241;imiento&#44; anemia y control de la funci&#243;n renal&#44; con una mayor utilizaci&#243;n de transfusiones de sangre y fluidoterapia intravenosa en la cohorte COFRAC&#46; No hubo diferencias estad&#237;sticas relativas a la presencia de delirium&#44; si bien fue m&#225;s diagnosticado en la COFRAC&#46; Se identific&#243; un cambio importante en el manejo de la analgesia en COFRAC&#44; con mayor uso de morfina&#44; bifosfonatos y suplementos de calcio-vitamina D y un menor empleo de petidina y f&#225;rmacos antiinflamatorios no esteroideos&#46; No hubo diferencia en la duraci&#243;n del ingreso entre las cohortes HIST y COFRAC&#46; En cuanto al impacto cl&#237;nico para los pacientes&#44; COFRAC mostr&#243; una menor mortalidad&#44; sin diferencias a los 30 d&#237;as tras el alta hospitalaria &#40;ver <a class="elsevierStyleCrossRef" href="#tbl0020">tabla 4</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><elsevierMultimedia ident="tbl0020"></elsevierMultimedia></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Discusi&#243;n</span><p id="par0045" class="elsevierStylePara elsevierViewall">La fractura de cadera es un acontecimiento relevante para los pacientes ancianos y con multimorbilidad&#46; Es una causa importante de incapacidad y de deterioro de la calidad de vida para estos pacientes fr&#225;giles&#44; que requiere un a&#241;o completo para recuperar el 60&#37; de la movilidad&#44; el 50&#37; de las actividades diarias b&#225;sicas y el 30&#37; de la actividad instrumental<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">8</span></a>&#46; Adem&#225;s&#44; la mortalidad despu&#233;s de la fractura de cadera sigue siendo significativa&#58; es del 11-23&#37; a los 6 meses tras la lesi&#243;n y del 22-29&#37; al a&#241;o<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">9</span></a>&#46; Se ha propuesto el comanejo para mejorar y optimizar los resultados de la fractura de cadera&#46; El comanejo permite una evaluaci&#243;n exhaustiva preoperatoria de las comorbilidades&#44; el manejo de la polimedicaci&#243;n&#44; as&#237; como la detecci&#243;n temprana de complicaciones como el delirium&#44; y se centra en no retrasar el tiempo para la cirug&#237;a desde el ingreso<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">10</span></a>&#46; Este modelo organizado de atenci&#243;n de fracturas geri&#225;tricas en comanejo con los geriatras ha dado como resultado un ahorro significativo en los costes durante un per&#237;odo de 50 meses&#44; acompa&#241;ado de una mejora de la calidad asociada<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">11</span></a>&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">Los principios del comanejo de la fractura de cadera fueron definidos por Mendelson y Friedman<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">12</span></a> de la siguiente manera&#58; 1&#41; la mayor&#237;a de los pacientes se benefician de la estabilizaci&#243;n quir&#250;rgica de su fractura&#44; ya que aliviar&#225; el dolor&#44; mejorar&#225; la movilidad y la funci&#243;n&#44; reducir&#225; la p&#233;rdida de sangre&#44; reducir&#225; la mortalidad y disminuir&#225; la institucionalizaci&#243;n en el alta&#46; 2&#41; Cuanto m&#225;s pronto sean intervenidos los pacientes&#44; menos tiempo dispondr&#225;n para desarrollar una enfermedad iatrog&#233;nica&#44; tales como delirium&#44; dolor&#44; neumon&#237;a&#44; &#250;lcera por presi&#243;n&#44; malnutrici&#243;n&#44; infecci&#243;n de orina y tromboembolia&#44; debilidad f&#237;sica y ca&#237;das y lesiones adicionales&#46; Esta agilidad en la actuaci&#243;n aumentar&#225; la satisfacci&#243;n del paciente&#44; de la familia y del personal&#44; y reducir&#225; los costes y la mortalidad&#46; 3&#41; El comanejo con comunicaci&#243;n cercana entre profesionales evita complicaciones m&#233;dicas y funcionales comunes&#46; Es necesario un verdadero sistema de colaboraci&#243;n interdisciplinario totalmente coordinado en el que la informaci&#243;n&#44; la toma de decisiones y la responsabilidad sea compartida por todos por igual y en el que la comunicaci&#243;n sea diaria&#59; cada disciplina emite por escrito &#243;rdenes y notas y se comunica con el paciente y con el equipo de atenci&#243;n del paciente&#46; Este modelo pionero fue desarrollado por el Geriatric Fracture Center<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">13</span></a>&#46; 4&#41; Los protocolos estandarizados reducen la variabilidad injustificada&#46; De esta manera&#44; la variabilidad es espec&#237;fica del paciente y est&#225; justificada en vez de ser aleatoria o estar basada en las preferencias del proveedor o de factores propios del sistema&#46; La estandarizaci&#243;n de los pedidos de material&#44; de los protocolos y de los planes de atenci&#243;n de enfermer&#237;a mejoran la calidad y contienen los costes&#44; ya que permite emplear medicamentos gen&#233;ricos de menor precio y hace posible alcanzar acuerdos favorables con los proveedores de implantes&#59; adem&#225;s&#44; la duraci&#243;n del ingreso se reduce y decrece el uso de servicios adicionales ya que evita las complicaciones y los reingresos<a class="elsevierStyleCrossRefs" href="#bib0200"><span class="elsevierStyleSup">11&#44;14&#44;15</span></a>&#46; 5&#41; La planificaci&#243;n del alta hospitalaria comienza en el ingreso&#46; Si el comanejo es eficaz&#44; la estancia hospitalaria ser&#225; m&#225;s corta y se dispondr&#225; de un breve per&#237;odo de tiempo para desarrollar un plan integral de alta&#46; La evaluaci&#243;n de las necesidades del alta y la comunicaci&#243;n y coordinaci&#243;n con la familia del paciente o con la entidad de apoyo en el momento del ingreso puede evitar retrasos en el alta y reducir las situaciones de temor&#46; Los resultados de nuestro estudio est&#225;n en consonancia con estos principios del comanejo de la fractura de cadera&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">En COFRAC la evaluaci&#243;n preoperatoria es mejor que en HIST&#46; En esta cohorte&#44; la identificaci&#243;n de los pacientes pluripatol&#243;gicos&#44; del d&#233;ficit motor&#44; de las arritmias distintas a la fibrilaci&#243;n auricular&#44; de la osteoporosis y del n&#250;mero de f&#225;rmacos de uso cr&#243;nico es mayor&#46; Estos &#237;tems son factores valiosos para establecer una correcta planificaci&#243;n durante el ingreso del paciente y en el alta hospitalaria&#46; Debido a la gran falta de datos en la cohorte HIST&#44; no ha sido posible analizar de manera comparativa variables como la altura&#44; el peso&#44; el estado funcional&#44; las comorbilidades &#40;mediante el &#237;ndice de Charlson&#41;&#44; el historial de ca&#237;das y el estatus sociofamiliar&#46; Todos estos datos son tambi&#233;n importantes en la evaluaci&#243;n preoperatoria para planear el comanejo hospitalario y el cuidado de alta&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">Esta evaluaci&#243;n preoperatoria detallada permite a los pacientes COFRAC un comanejo diferente&#44; que previene las complicaciones hospitalarias&#46; As&#237;&#44; la incidencia de deterioro renal fue menor al administrarse una fluidoterapia intravenosa m&#225;s agresiva&#44; evit&#243; el empleo de antiinflamatorios no esteroideos y redujo la repercusi&#243;n de la anemia mediante un mayor n&#250;mero de transfusiones llevadas a cabo durante el ingreso&#46; Tambi&#233;n se produjo un cambio en la prescripci&#243;n de la analgesia&#44; evitando la petidina y los antiinflamatorios no esteroideos en favor de la morfina&#46; Aunque este cambio de analgesia es adecuado para reducir el delirium en los pacientes geri&#225;tricos&#44; esta complicaci&#243;n fue m&#225;s prevalente en la cohorte COFRAC&#46; Se&#241;alamos que este resultado discrepante se debe a una mayor precisi&#243;n en el diagn&#243;stico del delirium en la cohorte COFRAC y a la subestimaci&#243;n del diagn&#243;stico en la HIST&#46; Esta hip&#243;tesis se ve apoyada por el hecho de que la prevalencia del delirium hospitalario durante el ingreso por fractura de cadera oscila alrededor del 24&#37; si hay comanejo y del 60&#37; si no lo hay<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">14</span></a>&#44; y en un tercio de los pacientes el delirium persistir&#225; en su domicilio tras el alta<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">16</span></a>&#46; Es bien conocida la importancia que tiene el manejo del delirium sobre los resultados del tratamiento de la fractura de cadera&#44; ya que este afecta al estado funcional&#44; a la movilidad del paciente y aumenta las tasas de mortalidad e institucionalizaci&#243;n<a class="elsevierStyleCrossRefs" href="#bib0230"><span class="elsevierStyleSup">17&#44;18</span></a>&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">Nuestro estudio no mostr&#243; ninguna diferencia en cuanto a las caracter&#237;sticas tanto de la anestesia como de la cirug&#237;a&#44; incluyendo tipo de anestesia y de cirug&#237;a y tiempo a la cirug&#237;a desde el ingreso&#46; Varios estudios han demostrado la importancia de la cirug&#237;a temprana&#44; ya que mejora el dolor&#44; la duraci&#243;n de la estancia hospitalaria y la incidencia de complicaciones mayores<a class="elsevierStyleCrossRefs" href="#bib0240"><span class="elsevierStyleSup">19-21</span></a>&#46; Se trata de un asunto importante porque&#44; aunque&#44; te&#243;ricamente&#44; el examen preoperatorio llevado a cabo por el internista puede identificar a algunos pacientes como pacientes no &#243;ptimos m&#233;dicamente y su fijaci&#243;n quir&#250;rgica va a retrasarse m&#225;s all&#225; de las 24-48&#160;h recomendadas&#44; de manera general no hay diferencias estad&#237;sticas entre ambas cohortes&#46; En Espa&#241;a&#44; la duraci&#243;n de la estancia entre los a&#241;os 1997 y 2008 muestra una tendencia a la baja&#44; desde los 16&#44;05 a los 13&#44;34 d&#237;as<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">1</span></a>&#46; En los estudios de comanejo la duraci&#243;n de la estancia&#44; antes del comanejo&#44; fue de 9&#44;9 d&#237;as&#44; y de 7&#44;1 despu&#233;s de &#233;l<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">22</span></a>&#46; Esta duraci&#243;n es parecida a la de los resultados de nuestro estudio&#44; excepto que no encontramos diferencias entre ambas cohortes&#46; La explicaci&#243;n de este hecho puede encontrarse en que nuestro protocolo estandarizado a&#250;n presenta algunas &#225;reas que mejorar para optimizar la planificaci&#243;n del cuidado&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">La fractura de cadera puede dar lugar a consecuencias desfavorables significativas&#44; con fallecimiento del 26&#37; de los pacientes al a&#241;o de la fractura de la cadera<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">23</span></a>&#46; La mortalidad hospitalaria es baja&#44; con una tasa del 4&#44;71 al 5&#44;85&#37; seg&#250;n las estad&#237;sticas oficiales de Espa&#241;a&#46; En los ensayos cl&#237;nicos&#44; el comanejo supone una reducci&#243;n de alrededor del 5&#37; en las tasas de mortalidad hospitalaria<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">24</span></a>&#44; con una mortalidad previa a la intervenci&#243;n del 2&#44;5-9&#44;7&#37; y del 1&#44;5-4&#44;5&#37; tras la cirug&#237;a<a class="elsevierStyleCrossRefs" href="#bib0160"><span class="elsevierStyleSup">3&#44;7&#44;14</span></a>&#46; Nuestros resultados concuerdan con los datos publicados&#58; en la HIST la mortalidad es del 4&#44;6&#37;&#44; como la tasa de Espa&#241;a&#44; y en la COFRAC la mortalidad se reduce casi un 3&#44;3&#37;&#46; Sin embargo&#44; en nuestro estudio no se han evidenciado diferencias en la mortalidad a los 30 d&#237;as tras el alta&#44; lo que indica que se necesita la planificaci&#243;n de otras &#225;reas del cuidado&#46; No retrasar la cirug&#237;a y reducir la mortalidad hospitalaria junto con no prolongar la estancia son los elementos que apoyan la aplicaci&#243;n del comanejo&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">En nuestro estudio&#44; el reingreso a los 30 d&#237;as tras la fractura de cadera fue muy bajo si se lo compara con estudios previos &#40;&#60;1 vs&#46; 10-15&#37;&#41; y no encontramos diferencias debidas a la intervenci&#243;n<a class="elsevierStyleCrossRefs" href="#bib0180"><span class="elsevierStyleSup">7&#44;14&#44;25</span></a>&#46; Probablemente en este punto intervengan algunos factores culturales&#46; En la cultura espa&#241;ola existe una gran aceptaci&#243;n del cuidado en la familia de los ancianos o de los pacientes dependientes&#44; especialmente por parte de las madres y de las hijas primog&#233;nitas&#46; No hay estudios que investiguen las causas que animan a las mujeres de la familia a hacerse cargo de esta tarea&#44; pero probablemente sean varios factores del tipo psicoeducativo&#44; del rol social aprendido y de las din&#225;micas familiares ancestrales&#46; Otro factor que puede desempe&#241;ar un importante papel sea que la sanidad espa&#241;ola no dispone de muchos hospitales de larga estancia&#44; por lo que las familias son la base del cuidado de los pacientes<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">26</span></a>&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">El estado funcional en el momento del alta fue semejante en las 2<span class="elsevierStyleHsp" style=""></span>cohortes de nuestro estudio&#44; con un 10&#37; de los pacientes encamados todo el d&#237;a&#44; un 50&#37; con permanencia de medio d&#237;a en cama y uso de andador ortop&#233;dico&#46; Estos datos son semejantes a los de los estudios publicados sobre comanejo en fractura de cadera&#44; con una p&#233;rdida de la movilidad en un 60 y un 50&#37; de los pacientes en el mes 6 y 12 desde el alta&#44; respectivamente<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">3</span></a>&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">La osteoporosis y la deficiencia de vitamina D son muy prevalentes en los ancianos y su presencia supone un riesgo elevado de presentaci&#243;n y gravedad de la fractura de cadera<a class="elsevierStyleCrossRefs" href="#bib0280"><span class="elsevierStyleSup">27&#44;28</span></a>&#44; pero tan solo el 10&#37; de los ancianos ingresados por fractura de cadera estaban tomando el tratamiento adecuado frente a estos procesos y&#44; adem&#225;s la mayor&#237;a no lo tomaban de forma correcta<a class="elsevierStyleCrossRef" href="#bib0290"><span class="elsevierStyleSup">29</span></a>&#46; Este hecho es evidente en nuestro estudio&#46; En HIST el diagn&#243;stico previo de osteoporosis y de prescripci&#243;n de bifosfonatos&#44; de suplementos de calcio y vitamina D en el alta fue menor que en la COFRAC&#46; Este es otro aspecto interesante sobre la importancia que tiene la evaluaci&#243;n peroperatoria&#44; ya que permite el tratamiento &#243;ptimo de la osteoporosis&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">Nuestro estudio tiene importantes limitaciones&#46; Al tratarse de un estudio retrospectivo&#44; carecemos de informaci&#243;n sobre la HIST&#44; lo que no nos ha permitido analizar algunas variables&#44; en concreto&#44; el estado funcional y la prevalencia real del delirium&#46; No hemos analizado la mortalidad en el a&#241;o desde el alta&#44; por lo que no podemos comparar los resultados a largo plazo de nuestra intervenci&#243;n con los de otros protocolos de comanejo&#46; La raz&#243;n de este hecho es que inicialmente solo quisimos analizar el impacto en hospital de nuestro protocolo&#46; Los resultados a corto plazo mostraron una mortalidad menor en COFRAC&#44; pero sin diferencias estad&#237;sticas<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">7</span></a>&#46; Della Rocca describi&#243; una tendencia similar a los 6 y 12 meses&#44; tambi&#233;n sin diferencias estad&#237;sticas&#46; Esto supone&#44; probablemente&#44; que&#44; en el anciano y en pacientes fr&#225;giles&#44; la fractura de cadera no es solo la fractura de un hueso&#46; La fractura de cadera en los pacientes fr&#225;giles da lugar a la rotura en el equilibrio biol&#243;gico de estos&#44; y en un porcentaje importante de los pacientes este equilibrio no puede recuperarse&#44; lo que origina un pron&#243;stico malo&#46; Necesitamos protocolos est&#225;ndar multidisciplinares en el alta en el que se compartan las responsabilidades entre atenci&#243;n primaria&#44; cirujanos ortop&#233;dicos&#44; internistas&#44; medicina f&#237;sica y de rehabilitaci&#243;n&#46; En este contexto&#44; la telemedicina y la vigilancia dom&#233;stica tendr&#237;an un papel importante&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Conclusi&#243;n</span><p id="par0095" class="elsevierStylePara elsevierViewall">El protocolo de comanejo entre los departamentos de Medicina Interna y de Traumatolog&#237;a desarrollados para pacientes ingresados por fractura de cadera permiten una mejor evaluaci&#243;n preoperatoria&#44; con mejor manejo de las complicaciones y una reducci&#243;n de la mortalidad a corto plazo&#46; Se necesitan protocolos de atenci&#243;n estandarizados y multidisciplinares en el momento del alta a fin de mejorar los resultados a medio y largo plazo&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Conflicto de intereses</span><p id="par0100" class="elsevierStylePara elsevierViewall">Los autores declaran no tener ning&#250;n conflicto de intereses&#46;</p></span></span>"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Introducci&#243;n</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">La fractura de cadera del anciano es de los diagn&#243;sticos m&#225;s prevalentes en los servicios de Traumatolog&#237;a&#44; con gran impacto en t&#233;rminos cl&#237;nicos&#44; econ&#243;micos y sociales&#46; Nuestro objetivo es analizar el impacto cl&#237;nico de un modelo de comanejo entre Traumatolog&#237;a y Medicina Interna para pacientes ancianos ingresados por fractura de cadera en un hospital de tercer nivel&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Material y m&#233;todos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Cohortes retrospectivas de pacientes mayores de 65 a&#241;os ingresados por fractura de cadera entre enero de 2005 y agosto de 2006 &#40;cohorte HIST&#41; sin modelo de comanejo&#44; y entre enero de 2008 y agosto de 2010 &#40;cohorte COFRAC&#41; con dicho modelo&#46; Se analizaron caracter&#237;sticas demogr&#225;ficas&#44; cl&#237;nicas y quir&#250;rgicas&#44; incidencia de complicaciones&#44; mortalidad y reingreso a los 30 d&#237;as&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Se incluy&#243; a 701 pacientes &#40;471 HIST&#44; 230 COFRAC&#41;&#46; No hubo diferencias en edad&#44; g&#233;nero&#44; demora quir&#250;rgica&#44; tiempo y tipo de cirug&#237;a e intervenci&#243;n&#44; estancia&#44; deambulaci&#243;n al alta&#44; consulta en urgencias ni reingreso o mortalidad a 30 d&#237;as&#46; Hubo diferencias en identificaci&#243;n de pluripatol&#243;gicos &#40;16&#44;8 vs&#46; 24&#44;4&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;02&#41;&#44; osteoporosis &#40;3&#44;9 vs&#46; 7&#44;6&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;03&#41; o d&#233;ficit motor &#40;3&#44;5 vs&#46; 8&#44;8&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;03&#41;&#44; f&#225;rmacos del tratamiento &#40;3&#44;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#44;5 vs&#46; 4&#44;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#44;2&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;01&#41;&#44; aparici&#243;n de delirium &#40;15&#44;6 vs&#46; 20&#44;9&#37;&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;048&#41; e hipomotilidad intestinal &#40;80&#44;3 vs&#46; 74&#44;7&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#44; seguimiento de anemia &#40;83&#44;3 vs&#46; 97&#44;1&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>0&#44;01&#41; y de funci&#243;n renal &#40;44&#44;5 vs&#46; 97&#44;3&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;01&#41; y mortalidad intrahospitalaria &#40;4&#44;6 vs&#46; 1&#44;3&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;02&#41;&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">El comanejo de pacientes ancianos ingresados por fractura de cadera permite mejorar la documentaci&#243;n de los problemas cr&#243;nicos previos y el control de complicaciones hospitalarias y disminuye la mortalidad intrahospitalaria&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0005"
            "titulo" => "Introducci&#243;n"
          ]
          1 => array:2 [
            "identificador" => "abst0010"
            "titulo" => "Material y m&#233;todos"
          ]
          2 => array:2 [
            "identificador" => "abst0015"
            "titulo" => "Resultados"
          ]
          3 => array:2 [
            "identificador" => "abst0020"
            "titulo" => "Conclusiones"
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        "titulo" => "Abstract"
        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Introduction</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Hip fracture in the elderly is one of the most prevalent diagnoses in Orthopedic Surgery Departments&#46; It has a great impact in medical&#44; economic and social terms&#46; Our objective is to analyze clinical impact of a co-management care model between orthopedic surgery and internal medicine departments for elderly patients admitted with hip fracture in a tertiary referral hospital&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Material and methods</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Retrospective cohort study of patients older than 65 years old admitted with hip fracture between January 2005-August 2006 &#40;HIST cohort&#41; without a co-management care model&#44; and between January 2008-August 2010 &#40;COFRAC cohort&#41; with a co-manEdadment care model&#46; Analysis of demographic&#44; clinical and surgery characteristics&#44; complications incidence and mortality and re-admissions at 30 days was made&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">A total of 701 patients were included &#40;471 HIST&#44; 230 COFRAC&#41;&#46; There were no differences in sex&#44; gender&#44; time to surgery&#44; type of anesthesia and surgery&#44; length of stay&#44; ambulation at discharge and 30-days emergency room consultation&#44; readmissions or mortality at 30 days&#46; There were differences in identification of polypatological patients &#40;16&#46;8 vs&#46; 24&#46;4&#37;&#44; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;02&#41;&#44; presence of osteoporosis &#40;3&#46;9 vs&#46; 7&#46;6&#37;&#44; <span class="elsevierStyleItalic">P<span class="elsevierStyleHsp" style=""></span></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;03&#41;&#44; motor deficit &#40;3&#46;5 vs&#46; 8&#46;8&#37;&#44; <span class="elsevierStyleItalic">P<span class="elsevierStyleHsp" style=""></span></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;03&#41;&#44; number of chronic drugs &#40;3&#46;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#46;5 vs&#46; 4&#46;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#46;2&#44; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;01&#41;&#44; diagnosis of delirium &#40;15&#46;6 vs&#46; 20&#46;9&#37;&#44; <span class="elsevierStyleItalic">P<span class="elsevierStyleHsp" style=""></span></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;048&#41;&#44; constipation &#40;80&#46;3 vs&#46; 74&#46;7&#37;&#44; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#44; monitoring of anemia &#40;83&#46;3 vs&#46; 97&#46;1&#37;&#44; <span class="elsevierStyleItalic">P<span class="elsevierStyleHsp" style=""></span></span>&#62;<span class="elsevierStyleHsp" style=""></span>0&#46;01&#41; and renal failure at discharge &#40;44&#46;5 vs&#46; 97&#46;3&#37;&#44; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;01&#41; and hospital mortality &#40;4&#46;6 vs&#46; 1&#46;3&#37;&#44; <span class="elsevierStyleItalic">P<span class="elsevierStyleHsp" style=""></span></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;02&#41;&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Co-management for elderly patients admitted with hip fracture provides a better information about previously chronic conditions&#44; a higher control of hospital complications and decreases hospital mortality&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0025"
            "titulo" => "Introduction"
          ]
          1 => array:2 [
            "identificador" => "abst0030"
            "titulo" => "Material and methods"
          ]
          2 => array:2 [
            "identificador" => "abst0035"
            "titulo" => "Results"
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          3 => array:2 [
            "identificador" => "abst0040"
            "titulo" => "Conclusions"
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">HIST &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>471&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Edad&#44; a&#241;os &#40;media &#177; desviaci&#243;n est&#225;ndar&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Necesidad de cuidador <span class="elsevierStyleItalic">n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">102 &#40;44&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Tiene un cuidador <span class="elsevierStyleItalic">n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">326 &#40;69&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">150 &#40;65&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Parentesco &#40;hija&#47;nuera&#41; <span class="elsevierStyleItalic">n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">300 &#40;63&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">126 &#40;55&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#44;89&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">Paciente pluripatol&#243;gico <span class="elsevierStyleItalic">n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">Hipertensi&#243;n <span class="elsevierStyleItalic">n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">292 &#40;62&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">137 &#40;60&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;337&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Diabetes mellitus <span class="elsevierStyleItalic">n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">129 &#40;27&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">71 &#40;30&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;184&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hiperlipidemia <span class="elsevierStyleItalic">n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">55 &#40;11&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">33 &#40;14&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;179&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Demencia <span class="elsevierStyleItalic">n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">73 &#40;15&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">48 &#40;20&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;056&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Deterioro cognitivo <span class="elsevierStyleItalic">n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">66 &#40;14&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">50 &#40;21&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;07&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Fibrilaci&#243;n auricular <span class="elsevierStyleItalic">n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">76 &#40;16&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">39 &#40;16&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;450&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Arritmias diferentes a la fibrilaci&#243;n auricular <span class="elsevierStyleItalic">n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#40;1&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11 &#40;4&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;021&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Infarto <span class="elsevierStyleItalic">n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">61 &#40;12&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">39 &#40;16&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;095&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Enfermedad arterial coronaria cr&#243;nica <span class="elsevierStyleItalic">n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">72 &#40;15&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">30 &#40;13&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;234&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Insuficiencia cardiaca <span class="elsevierStyleItalic">n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">37 &#40;7&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">26 &#40;11&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;084&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Osteoporosis <span class="elsevierStyleItalic">n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">18 &#40;3&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">17 &#40;7&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;03&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Depresi&#243;n <span class="elsevierStyleItalic">n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">36 &#40;7&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13 &#40;5&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;177&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Enfermedad pulmonar obstructiva cr&#243;nica <span class="elsevierStyleItalic">n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&#44;6 &#40;5&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13 &#40;5&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;500&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Enfermedad renal cr&#243;nica <span class="elsevierStyleItalic">n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">22 &#40;4&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">14 &#40;6&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;206&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#218;lcera p&#233;ptica <span class="elsevierStyleItalic">n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13 &#40;2&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">14 &#40;5&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;03&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Anemia <span class="elsevierStyleItalic">n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">16 &#40;3&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9 &#40;3&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;507&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Alcoholismo <span class="elsevierStyleItalic">n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#40;0&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;018&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t">131&#40;58&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">164 &#40;35&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">62&#40;27&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Artroplastia total&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">21 &#40;4&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12&#40;4&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab2207355.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "es" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Caracter&#237;sticas de la fractura de cadera y tratamiento quir&#250;rgico</p>"
        ]
      ]
      2 => array:8 [
        "identificador" => "tbl0015"
        "etiqueta" => "Tabla 3"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at3"
            "detalle" => "Tabla "
            "rol" => "short"
          ]
        ]
        "tabla" => array:1 [
          "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
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                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">HIST n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">COFRAC n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">p&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Mortalidad&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">22 &#40;4&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#40;1&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;02&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Duraci&#243;n del ingreso&#44; d&#237;as &#40;media &#177; desviaci&#243;n est&#225;ndar&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&#44;5 &#177; 4&#44;41&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&#44;39 &#177; 7&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;865&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Delirium&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">73 &#40;15&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">48 &#40;20&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;048&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Insuficiencia cardiaca&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">16 &#40;3&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12 &#40;5&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;208&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Enfermedad coronaria aguda&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13 &#40;2&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">26&#47; &#40;0&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;084&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Crisis de EPOC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10 &#40;2&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;305&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Neumon&#237;a&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#40;1&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6 &#40;2&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;293&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Infecci&#243;n de la herida quir&#250;rgica&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6 &#40;&#60;0&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;&#60;0&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;02&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Flebitis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#40;&#60;0&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;&#60;0&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Infecci&#243;n del tracto urinario&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;&#60;0&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#40;&#60;0&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Anemia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">377 &#40;78&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">215 &#40;90&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#44;01&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Ca&#237;da de hemoglobina<span class="elsevierStyleHsp" style=""></span>&#62;2 mg&#47;dl&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">330 &#40;87&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">192 &#40;91&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;144&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">P&#233;rdida de datos de anemizaci&#243;n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">17&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#44;01&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Transfusi&#243;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">105 &#40;22&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">84 &#40;36&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;011&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Transfusi&#243;n preoperatoria&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">20 &#40;19&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">20 &#40;23&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#44;01&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Transfusi&#243;n tras cirug&#237;a&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">85 &#40;81&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">64 &#40;76&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Creatinina en el ingreso&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;99 &#177; 0&#44;84&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;96 &#177; 0&#44;72&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">0&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Insuficiencia renal aguda&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">61 &#40;12&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">70 &#40;30&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#44;01&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">P&#233;rdida de datos de funci&#243;n renal &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">66&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#44;01&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Estre&#241;imiento&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \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">109 &#40;47&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#44;01&nbsp;\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="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Prescripci&#243;n de opioides&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">83 &#40;17&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">78 &#40;33&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
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                  \t\t\t\t\ttop\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">225 &#40;47&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9 &#40;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#60;0&#44;01&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">Morfina&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">166 &#40;72&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#44;01&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Fluido intravenoso&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">150 &#40;65&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;04&nbsp;\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="4" 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="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Uso espor&#225;dico&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">216 &#40;45&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">45 &#40;19&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#44;01&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Prescrito&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">446 &#40;94&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">134 &#40;58&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#44;01&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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                  \t\t\t\t\ttable-head\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">HIST n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">COFRAC n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">p&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">Mortalidad global&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">9 &#40;3&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t</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">Mortalidad hospitalaria&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">3 &#40;1&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#44;028&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t">Mortalidad a los 30 d&#237;as&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">14 &#40;3&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">6 &#40;2&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#44;543&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Visitas a urgencias a los 30 d&#237;as&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">32 &#40;7&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">18 &#40;12&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#44;09&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Ingresos a los 30 d&#237;as&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">14 &#40;3&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">4 &#40;2&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#44;512&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">19 &#40;3&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">13 &#40;5&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#44;516&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>50&#37; del tiempo en cama&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">263 &#40;55&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">115 &#40;50&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Andador ortop&#233;dico&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">189 &#40;40&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">102 &#40;44&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Tratamiento de osteoporosis</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Suplementos de calcio&#47;vitamina D&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">31 &#40;6&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">196 &#40;85&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#60;0&#44;01&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Bisfosfonatos&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">110 &#40;47&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#60;0&#44;01&nbsp;\t\t\t\t\t\t\n
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          "es" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Impacto cl&#237;nico en el momento del alta hospitalaria y a los 30 d&#237;as desde el alta</p>"
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                      "titulo" => "Clinical pathway for hip fractures in the elderly&#58; The hospital for joint diseases experience"
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                      "titulo" => "Clinical pathway for fractured neck of femur&#58; A prospective&#44; controlled study"
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                            0 => "P&#46;F&#46; Choong"
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                    0 => array:1 [
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                        "tituloSerie" => "Med J Aust&#46;"
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                      "titulo" => "The effectiveness of implementing a care pathway for femoral neck fracture in older people&#58; A prospective controlled before and after study"
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                          "autores" => array:6 [
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                    0 => array:2 [
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                          "etal" => true
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                            3 => "C&#46;D&#46; Schleck"
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                            5 => "P&#46;M&#46; Huddleston"
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                      "titulo" => "ComanEdadment of geriatric patients with hip fractures&#58; A retrospective&#44; controlled&#44; cohort study"
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                        0 => array:2 [
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                          "autores" => array:6 [
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                            2 => "B&#46;D&#46; Crist"
                            3 => "D&#46;A&#46; Volgas"
                            4 => "J&#46;P&#46; Stannard"
                            5 => "D&#46;R&#46; Mehr"
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                    ]
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                0 => array:2 [
                  "contribucion" => array:1 [
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                        0 => array:2 [
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                            0 => "J&#46; Magaziner"
                            1 => "E&#46;M&#46; Simonsick"
                            2 => "T&#46;M&#46; Kashner"
                            3 => "J&#46;R&#46; Hebel"
                            4 => "J&#46;E&#46; Kenzora"
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                    0 => array:2 [
                      "doi" => "10.1093/geronj/45.3.m101"
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                        "tituloSerie" => "J Gerontol&#46;"
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                        "volumen" => "45"
                        "paginaInicial" => "M101"
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Mortality following hip fracture&#58; Trends and geographical variations over the last 40 years"
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                        0 => array:2 [
                          "etal" => false
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                            0 => "S&#46; Haleem"
                            1 => "L&#46; Lutchman"
                            2 => "R&#46; Mayahi"
                            3 => "J&#46;E&#46; Grice"
                            4 => "M&#46;J&#46; Parker"
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                    0 => array:2 [
                      "doi" => "10.1016/j.injury.2008.03.022"
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ORIGINAL
Comanejo de la fractura de cadera del anciano en un hospital de tercer nivel: un estudio de cohortes
Hip fracture co-management in the elderly in a tertiary referral hospital: A cohorts study
M. Rincón Gómez
Autor para correspondencia
manuel.rincon.sspa@juntadeandalucia.es

Autor para correspondencia.
, C. Hernández Quiles, M. García Gutiérrez, J. Galindo Ocaña, R. Parra Alcaraz, V. Alfaro Lara, R. González León, M. Bernabeu Wittel, M. Ollero Baturone
Departamento de Medicina Interna, Hospitales Universitarios Virgen del Rocío, Sevilla, España

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