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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="par0005" class="elsevierStylePara elsevierViewall">La diabetes mellitus constituye un diagn&#243;stico secundario muy prevalente en pacientes hospitalizados por diversos problemas m&#233;dicos&#46; Se estima que aproximadamente un 20-25&#37; de todos los pacientes adultos hospitalizados padecen diabetes&#44; y que ello puede constituir un factor determinante de reingresos hospitalarios<a class="elsevierStyleCrossRefs" href="#bib0185"><span class="elsevierStyleSup">1&#44;2</span></a>&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">Los reingresos hospitalarios se clasifican habitualmente en precoces &#40;reingresos en los 30 d&#237;as siguientes al alta&#41; y tard&#237;os &#40;reingresos en los 90 d&#237;as siguientes al alta&#41;&#46; Las tasas de reingreso precoz de los pacientes en medicina interna se sit&#250;an alrededor del 12&#44;4&#37;<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">3</span></a>&#46; En estudios llevados a cabo en pacientes americanos pertenecientes al Medicare&#44; las tasas de reingreso a 90 d&#237;as suponen un 34&#37;<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">4</span></a>&#46; Los reingresos hospitalarios est&#225;n relacionados habitualmente con la severidad de la enfermedad&#44; la presencia de enfermedades coexistentes&#44; la edad&#44; el nivel socioecon&#243;mico&#44; as&#237; como la prestaci&#243;n de un cuidado sub&#243;ptimo tras el alta<a class="elsevierStyleCrossRefs" href="#bib0205"><span class="elsevierStyleSup">5&#8211;8</span></a>&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">La mayor&#237;a de los estudios que analizan los reingresos hospitalarios se han centrado en 3 enfermedades muy frecuentes&#44; tales como la insuficiencia cardiaca&#44; el infarto agudo de miocardio y la neumon&#237;a<a class="elsevierStyleCrossRefs" href="#bib0205"><span class="elsevierStyleSup">5&#44;9&#44;10</span></a>&#46; Sin embargo&#44; los determinantes de reingreso hospitalario en pacientes con diabetes tipo 2 son menos conocidos&#46; Los determinantes frecuentemente m&#225;s analizados en pacientes con diabetes mellitus han sido el grado de control gluc&#233;mico<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">11</span></a> o el impacto de la hipoglucemia<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">12</span></a> o la presencia de insuficiencia cardiaca como motivo de ingreso<a class="elsevierStyleCrossRefs" href="#bib0245"><span class="elsevierStyleSup">13&#8211;14</span></a>&#46; Sin embargo&#44; es posible que otros determinantes tales como el grado de comorbilidad&#44; la capacidad funcional y el tipo de tratamiento antihiperglucemiante tambi&#233;n influyan en el reingreso&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Por este motivo&#44; hemos llevado a cabo el presente estudio para examinar 2 aspectos&#58; cu&#225;l es la frecuencia de rehospitalizaci&#243;n a los 90 d&#237;as en pacientes con diabetes tipo 2 y qu&#233; factores son los determinantes de la rehospitalizaci&#243;n en un amplio colectivo de pacientes con diabetes mellitus ingresados en medicina interna&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">M&#233;todos</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Dise&#241;o del estudio</span><p id="par0025" class="elsevierStylePara elsevierViewall">Estudio de retrospectivo de cohorte&#46; En un d&#237;a determinado se registraron el n&#250;mero de pacientes con hiperglucemia o diabetes ingresados en servicios de medicina interna y cu&#225;ntos de ellos hab&#237;an presentado un ingreso en el hospital en los 3 meses previos&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Poblaci&#243;n estudiada</span><p id="par0030" class="elsevierStylePara elsevierViewall">La fuente de datos estuvo constituida por informaci&#243;n proveniente de 3 estudios transversales llevados a cabo en los a&#241;os 2015&#44; 2016 y 2017 en hospitales de pertenecientes al Sistema Nacional de Salud de Espa&#241;a&#46; Se dispon&#237;a de informaci&#243;n de un total de 1&#46;977 pacientes&#46; En estos estudios de corte transversal se recog&#237;a informaci&#243;n en un d&#237;a sobre el tama&#241;o de hospital participante&#44; n&#250;mero de pacientes ingresados en el servicio de medicina interna&#44; n&#250;mero de pacientes con diabetes o hiperglucemia ingresados y motivo de ingreso en el hospital&#44; ingresos previos en el hospital en los &#250;ltimos 90 d&#237;as&#44; estancia hospitalaria hasta el d&#237;a del estudio&#44; caracter&#237;sticas demogr&#225;ficas&#44; comorbilidad y grado de dependencia&#44; datos de laboratorio&#44; tratamiento antihiperglucemiante&#44; uso de tratamientos productores de hiperglucemia &#40;tratamiento con glucocorticoides sist&#233;micos&#41; o nutrici&#243;n enteral o parenteral&#44; desarrollo de hipoglucemia o hiperglucemia extrema a lo largo de la hospitalizaci&#243;n y valores de glucemia capilar en el d&#237;a del estudio&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Se consider&#243; que los pacientes presentaban diabetes mellitus si en la historia cl&#237;nica del paciente presentaban este diagn&#243;stico o si cumpl&#237;an los criterios de diagn&#243;stico de diabetes mellitus seg&#250;n la Asociaci&#243;n de Diabetes Americana<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">15</span></a>&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Variable respuesta</span><p id="par0040" class="elsevierStylePara elsevierViewall">Para los prop&#243;sitos del estudio los pacientes fueron clasificados 2 grupos&#58; reingreso hospitalario si el paciente hab&#237;a presentado un ingreso en el hospital en los 90 d&#237;as anteriores y no reingreso hospitalario si el paciente no hab&#237;a tenido ning&#250;n ingreso en los 90 d&#237;as previos&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Variables explicativas</span><p id="par0045" class="elsevierStylePara elsevierViewall">Las variables explicativas inclu&#237;an edad&#44; sexo&#44; motivo de ingreso hospitalario&#44; tipo de diabetes&#44; comorbilidad medida por la puntuaci&#243;n de Charlson<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">16</span></a>&#44; grado de dependencia medido por la escala modificada de Rankin<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">17</span></a>&#44; nivel de deterioro cognitivo medido por la <span class="elsevierStyleItalic">Global Deterioration Scale</span><a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">18</span></a>&#44; tipo de tratamiento de la diabetes previo al ingreso en el hospital&#44; grado de control gluc&#233;mico medido por valor de hemoglobina A1c&#44; filtrado glomerular medido por la ecuaci&#243;n <span class="elsevierStyleItalic">Chronic Kidney Disease Epidemiology Collaboration</span><a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">19</span></a>&#44; presencia de hipoglucemia &#40;glucosa inferior a 70<span class="elsevierStyleHsp" style=""></span>mg&#47;dl&#41; y presencia de hiperglucemia extrema &#40;glucosa superior a 350<span class="elsevierStyleHsp" style=""></span>mg&#47;dl&#41; durante el ingreso hospitalario&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">An&#225;lisis estad&#237;stico</span><p id="par0050" class="elsevierStylePara elsevierViewall">El an&#225;lisis estad&#237;stico descriptivo incluy&#243; las medidas de frecuencia y porcentajes para variables categ&#243;ricas&#44; y de media y desviaci&#243;n est&#225;ndar para variables continuas&#46; Para comparar las variables continuas entre los pacientes con reingreso a los 90 d&#237;as y los que no presentaban reingreso se utiliz&#243; el test de la &#171;t&#187; de Student&#46; La comparaci&#243;n entre variables categ&#243;ricas entre los pacientes con reingreso a los 90 d&#237;as y los que no presentaban reingreso se realiz&#243; mediante el test de la Chi cuadrado y el test de Fisher&#44; cuando el n&#250;mero de observaciones fue inferior a 5&#46; Se consideraron estad&#237;sticamente significativos los valores de p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05 estimados para 2 colas&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">Para la realizaci&#243;n del modelo predictivo se seleccion&#243; un 66&#44;6&#37; de la muestra &#40;cohorte de derivaci&#243;n&#41;&#46; Consideramos como variable respuesta el reingreso hospitalario en los 90 d&#237;as tras el alta&#46; Las variables explicativas fueron seleccionadas entre aquellas cuyo valor en el an&#225;lisis univariante presentaban p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;1&#46; La bondad de ajuste del modelo se midi&#243; con el test de Hosmer-Lemeshow&#46; La capacidad explicativa del modelo de predicci&#243;n fue medida con la R cuadrado de Nagelkerke&#44; y el rendimiento diagn&#243;stico del modelo final se evalu&#243; mediante la construcci&#243;n de la curva caracter&#237;stica operador receptor &#40;COR&#41; estimando el &#225;rea bajo la curva &#40;AUC&#41;&#46; Un AUC con un valor de 1 representa un test diagn&#243;stico perfecto&#44; para discriminar a los pacientes con reingreso de los que no van a presentar reingreso&#59; un AUC de 0&#44;5 representa un test sin valor diagn&#243;stico&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">Se confirm&#243; la validez del modelo aplicando los par&#225;metros al 33&#44;3&#37; de la muestra restante &#40;cohorte de validaci&#243;n&#41; y estimando de nuevo la curva COR y el AUC&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">El an&#225;lisis estad&#237;stico fue realizado con el paquete SPSS &#40;versi&#243;n 24&#46;0&#46; Armonk&#44; NY&#58; IBM Corp&#41;&#46;</p></span></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Resultados</span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Incidencia y causas de reingreso</span><p id="par0070" class="elsevierStylePara elsevierViewall">A lo largo del periodo estudiado hubo 704 &#40;35&#44;6&#37;&#41; reingresos en los primeros 90 d&#237;as tras el alta de un total de 1&#46;977 pacientes incluidos en el estudio&#46; Las tasas de reingreso se han mantenido sin variaciones significativas entre los a&#241;os 2015 a 2017&#46; Los hospitales de m&#225;s de 500 camas mostraron de forma estad&#237;sticamente significativa &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;02&#41; mayores tasas de reingreso que los de menor tama&#241;o &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a>&#41;&#46; Los principales motivos de reingreso hospitalario estuvieron constituidos por las enfermedades infecciosas &#40;29&#37;&#41;&#44; las enfermedades cardiovasculares &#40;24&#44;4&#37;&#41; y las enfermedades respiratorias &#40;14&#44;2&#37;&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">tabla 2</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><elsevierMultimedia ident="tbl0010"></elsevierMultimedia></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Caracter&#237;sticas de los pacientes que reingresan en el hospital</span><p id="par0075" class="elsevierStylePara elsevierViewall">Las caracter&#237;sticas de los pacientes que se asociaron de forma estad&#237;sticamente significativa con el reingreso hospitalario a los 90 d&#237;as fueron un rango de edad superior&#44; sexo var&#243;n&#44; presentar mayor &#237;ndice de comorbilidad de Charlson&#44; mayor &#237;ndice de discapacidad medido por la escala de Rankin y mayor deterioro cognitivo seg&#250;n la <span class="elsevierStyleItalic">Global Deterioration Scale</span>&#46; Respecto a las variables relacionadas con el control de la diabetes y el perfil gluc&#233;mico los pacientes que presentaron reingreso hab&#237;an sufrido mayor frecuencia de hipoglucemia en los 3 meses previos&#44; recib&#237;an tratamiento en mayor proporci&#243;n con insulina basal e insulina r&#225;pida y presentaban un mayor deterioro de la funci&#243;n renal respecto a los pacientes que no hab&#237;an sufrido reingreso&#46; As&#237; mismo&#44; una proporci&#243;n mayor de los pacientes con reingreso recib&#237;a tratamiento con glucocorticoides sist&#233;micos en comparaci&#243;n con aquellos que no hab&#237;an sufrido reingreso &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">tabla 3</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Modelo predictivo de reingreso hospitalario</span><p id="par0080" class="elsevierStylePara elsevierViewall">Las variables que mostraron mayor asociaci&#243;n con el reingreso hospitalario a 90 d&#237;as en el an&#225;lisis multivariante fueron el &#237;ndice de comorbilidad de Charlson&#44; el &#237;ndice de discapacidad de Rankin&#44; la edad del paciente&#44; los antecedentes de episodios de hipoglucemia en los 3 meses previos&#44; el uso de insulina basal y el tratamiento con glucocorticoides &#40;<a class="elsevierStyleCrossRef" href="#tbl0020">tabla 4</a>&#41;&#46; Tras comprobar que la presencia de interacciones no a&#241;ad&#237;a mayor precisi&#243;n al modelo&#44; estas no fueron consideradas&#46; El test de bondad de ajuste de Hosmer-Lemeshow mostr&#243; un valor p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;190&#44; lo que permite la utilizaci&#243;n del modelo para realizar predicciones&#46; La R cuadrado de Nagelkerke fue 0&#44;109&#46; El &#225;rea bajo la curva COR mostr&#243; un valor 0&#44;676 &#40;IC 95&#37;&#58; 0&#44;642-0&#44;709&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#46; Cuando los par&#225;metros del modelo de predicci&#243;n fueron aplicados a la cohorte de validaci&#243;n el AUC mostr&#243; un valor 0&#44;661 &#40;IC 95&#37;&#58; 0&#44;612-0&#44;710&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0005">fig&#46; 1</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia><elsevierMultimedia ident="fig0005"></elsevierMultimedia></span></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Discusi&#243;n</span><p id="par0085" class="elsevierStylePara elsevierViewall">En el presente estudio hemos analizado la frecuencia&#44; diagn&#243;sticos principales y determinantes de los pacientes con diabetes mellitus que sufren reingreso en el hospital en los 90 d&#237;as siguientes tras el alta&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">Hemos podido comprobar que la proporci&#243;n de pacientes que reingresa se ha mantenido estable en los &#250;ltimos 3 a&#241;os&#44; con un porcentaje alrededor del 35&#37;&#46; Las causas principales de reingreso est&#225;n constituidas por enfermedades infecciosas&#44; enfermedades cardiovasculares y enfermedades respiratorias&#46; Los reingresos relacionados con la diabetes&#44; tales como hipoglucemia&#44; coma hiperosmolar o cetoacidosis diab&#233;tica constituyeron solo el 2&#37; de las causas de reingreso&#46; El an&#225;lisis multivariante permiti&#243; detectar que los determinantes de reingreso est&#225;n constituidos por edad mayor de 65 a&#241;os&#44; mayor &#237;ndice de dependencia y comorbilidad&#44; presencia de episodios de hipoglucemia&#44; tratamiento con glucocorticoides sist&#233;micos y uso de f&#225;rmacos secretagogos o insulina&#46; El modelo multivariante de reingreso hospitalario tuvo una capacidad predictiva moderada&#44; con un AUC de 0&#44;68 en la cohorte de derivaci&#243;n y de 0&#44;66 en la cohorte de validaci&#243;n&#46; Efectivamente hemos podido comprobar que el tratamiento de la diabetes con determinados f&#225;rmacos es una causa independiente de ingreso hospitalario en los siguientes 90 d&#237;as tras el alta&#46;</p><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Comparaci&#243;n con los datos de la literatura</span><p id="par0095" class="elsevierStylePara elsevierViewall">Existen escasas publicaciones que examinen los determinantes de reingreso hospitalario en pacientes con diabetes mellitus&#46; Un estudio de casos y controles identific&#243; como posibles determinantes de reingreso a los 30 d&#237;as del alta&#44; la intensificaci&#243;n en el tratamiento de la diabetes&#44; la existencia de insuficiencia cardiaca congestiva y el n&#250;mero de interconsultas que recibi&#243; el paciente durante su ingreso hospitalario&#46; Los determinantes analizados tuvieron una capacidad predictiva modesta&#44; medida por un &#225;rea bajo la curva operador receptor de 0&#44;693<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">20</span></a>&#46; Collins et al&#46;&#44; evaluaron otro modelo de reingreso precoz a los 30 d&#237;as del alta en pacientes con diabetes tipo 2<a class="elsevierStyleCrossRef" href="#bib0285"><span class="elsevierStyleSup">21</span></a>&#46; Las variables que resultaron significativas en el modelo fueron la edad del paciente&#44; el sexo var&#243;n&#44; el n&#250;mero de visitas previas al servicio de urgencias y los d&#237;as de estancia hospitalaria&#46; El modelo mostr&#243; una capacidad predictiva robusta&#44; con un &#225;rea AUC de 0&#44;82&#46; Sin embargo&#44; la capacidad predictiva del modelo no fue comprobada en una cohorte independiente de pacientes&#46; Otros modelos de reingreso hospitalario espec&#237;ficos para pacientes con diabetes mellitus incorporan la medici&#243;n de la hemoglobina glucosilada&#46; Independientemente del valor obtenido de hemoglobina glucosilada&#44; el mero hecho de disponer de la informaci&#243;n se asoci&#243; de forma significativa con reducci&#243;n de la tasa reingresos&#44; aunque esta solo fue solicitada en un 18&#37; de los episodios<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">11</span></a>&#46; Disponer del resultado de hemoglobina glucosilada permiti&#243; realizar ajustes en el tratamiento durante el ingreso y al alta de los pacientes&#46; En estudios previos llevados a cabo por nuestro grupo la proporci&#243;n de pacientes con valores recientes de hemoglobina glucosilada se sit&#250;a habitualmente entre un 50-60&#37;<a class="elsevierStyleCrossRef" href="#bib0290"><span class="elsevierStyleSup">22</span></a>&#46; En nuestro an&#225;lisis la determinaci&#243;n de hemoglobina glucosilada no a&#241;adi&#243; poder discriminativo al modelo de predicci&#243;n&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">Los modelos predictivos que eval&#250;an el reingreso en el hospital en personas mayores de 65 a&#241;os de edad en Estados Unidos muestran unos grados de precisi&#243;n relativamente modestos&#46; Un estudio llevado a cabo en California mostr&#243; que el sistema de pago definido por el tipo de enfermedad cr&#243;nica y grado de discapacidad fue el determinante m&#225;s robusto de un modelo que tuvo un valor predictivo medido por AUC de 0&#44;71<a class="elsevierStyleCrossRef" href="#bib0295"><span class="elsevierStyleSup">23</span></a>&#46; En Canad&#225; se ha definido el &#237;ndice LACE como una buena herramienta para predecir el riesgo esperado de reingreso o mortalidad a 30 d&#237;as&#46; Los componentes del &#237;ndice LACE son los d&#237;as de estancia en el hospital&#44; el car&#225;cter urgente del ingreso&#44; el &#237;ndice de comorbilidad medido por la puntuaci&#243;n de Charlson y el n&#250;mero de visitas previas al servicio de urgencias<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">24</span></a>&#46; La puntuaci&#243;n del &#237;ndice de LACE var&#237;a entre 0 puntos &#40;2&#44;0&#37; de riesgo esperado&#41; y 19 puntos &#40;43&#44;7&#37; de riesgo esperado&#41;&#46; Se considera discriminativa una puntuaci&#243;n superior a 10 para predecir el reingreso hospitalario&#46; En la publicaci&#243;n original el AUC del &#237;ndice LACE mostr&#243; un valor de 0&#44;684&#46; Posteriormente este &#237;ndice se ha aplicado a otras cohortes de pacientes en otros pa&#237;ses y ha mostrado capacidades discriminativas muy variables&#44; con valores de AUC COR entre 0&#44;57 y 0&#44;71<a class="elsevierStyleCrossRefs" href="#bib0305"><span class="elsevierStyleSup">25&#8211;28</span></a>&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">Entre las limitaciones de nuestro estudio cabe destacar que el modelo tuvo una capacidad predictiva relativamente modesta&#46; Sin embargo&#44; el AUC hallada en nuestro modelo fue similar a los modelos de predicci&#243;n m&#225;s com&#250;nmente utilizados&#44; como el LACE&#46; El modelo predictivo incluy&#243; factores cl&#237;nicos&#44; pero no consider&#243; factores sociales o log&#237;sticos&#46; Los factores sociales o log&#237;sticos tradicionalmente asociados con reingreso hospitalario han sido la existencia de episodios previos de hospitalizaci&#243;n en los 6-12 meses previos<a class="elsevierStyleCrossRefs" href="#bib0325"><span class="elsevierStyleSup">29&#8211;30</span></a>&#44; ser de raza negra<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">7</span></a>&#44; tener escasos conocimientos sobre salud<a class="elsevierStyleCrossRef" href="#bib0335"><span class="elsevierStyleSup">31</span></a>&#44; vivir en soledad o sin apoyo familiar o social<a class="elsevierStyleCrossRef" href="#bib0340"><span class="elsevierStyleSup">32</span></a> o pertenecer a un nivel socioecon&#243;mico bajo<a class="elsevierStyleCrossRefs" href="#bib0345"><span class="elsevierStyleSup">33&#44;34</span></a>&#46; Desafortunadamente los factores sociales raramente son modificables para prevenir futuros reingresos&#46; Como limitaci&#243;n adicional cabe comentar que nuestro modelo solo analiza reingresos hospitalarios de pacientes con diabetes a los 90 d&#237;as del alta&#46; Una gran mayor&#237;a de modelos predictivos analiza el porcentaje de reingresos a los 30 d&#237;as de alta&#44; aunque en investigaci&#243;n de servicios de salud se utilizan tambi&#233;n otros l&#237;mites de tiempo para medir reingresos&#44; tales como 90 d&#237;as y un a&#241;o tras el alta&#46; En nuestro caso elegimos como l&#237;mite 90 d&#237;as con el fin de disponer de un plazo de tiempo que ofreciera un n&#250;mero de desenlaces suficientes para desarrollar el modelo predictivo de derivaci&#243;n y el de validaci&#243;n&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">La utilidad de nuestro estudio es permitir al cl&#237;nico identificar un subgrupo de pacientes que requerir&#225; una atenci&#243;n especial para evitar el reingreso hospitalario&#46; En esta poblaci&#243;n fr&#225;gil&#44; identificada por el modelo de predicci&#243;n&#44; la aplicaci&#243;n de programas integrados que incluyan aspectos educativos para el paciente y el cuidador principal&#44; y el establecimiento de objetivos de control gluc&#233;mico adaptados a la calidad y expectativa de vida del paciente pueden permitir reducir los reingresos&#46; En otras &#225;reas el uso de programas integrados ha permitido reducir la tasa de reingresos en pacientes con diabetes y amputaci&#243;n por enfermedad arterial perif&#233;rica<a class="elsevierStyleCrossRef" href="#bib0355"><span class="elsevierStyleSup">35</span></a>&#46; Otros programas que han resultado eficaces para reducir reingresos se han centrado en dotar a las unidades m&#233;dico-quir&#250;rgicas de personal de enfermer&#237;a entrenado en diabetes para mejorar el cuidado del paciente con hiperglucemia durante su ingreso en el hospital&#44; y mejorar la transici&#243;n del paciente al alta<a class="elsevierStyleCrossRef" href="#bib0360"><span class="elsevierStyleSup">36</span></a>&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">En conclusi&#243;n&#44; nuestro modelo de predicci&#243;n permite identificar a la poblaci&#243;n fr&#225;gil con diabetes ingresada en los servicios de medicina interna&#46; Esta poblaci&#243;n requiere estrategias adicionales para reducir la posibilidad de reingreso hospitalario en los siguientes 90 d&#237;as&#46; Estas estrategias deben ser la reducci&#243;n en la dosis de f&#225;rmacos secretagogos o en la dosis de insulina y el control de la comorbilidad con una revisi&#243;n preferente en consultas&#46;</p></span></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0130">Financiaci&#243;n</span><p id="par0120" class="elsevierStylePara elsevierViewall">Este estudio fue desarrollado con ayuda de los laboratorios Novo-Nordisk&#46; La ayuda consisti&#243; en la financiaci&#243;n de la hoja de recogida de datos electr&#243;nica y en la diseminaci&#243;n del proyecto&#46; La compa&#241;&#237;a Xolomon Tree dise&#241;&#243; la hoja de datos electr&#243;nica&#46; Novo-Nordisk y Xolomon Tree no participaron en el dise&#241;o del estudio&#44; en la recogida de datos&#44; en el an&#225;lisis de los datos&#44; en su interpretaci&#243;n&#44; en la redacci&#243;n del manuscrito&#44; en su aprobaci&#243;n&#44; ni en la decisi&#243;n de remitirlo a publicaci&#243;n&#46;</p><p id="par0145" class="elsevierStylePara elsevierViewall">J&#46;V&#46; Segura-Heras recibe ayuda del Ministerio de Econom&#237;a y Competitividad de Espa&#241;a n&#46;&#176; MTM2017-83850-P&#46;</p></span><span id="sec0075" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0135">Conflicto de intereses</span><p id="par0125" class="elsevierStylePara elsevierViewall">Los autores declaran que no tienen conflicto de intereses&#46;</p></span></span>"
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              "titulo" => "Incidencia y causas de reingreso"
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              "titulo" => "Caracter&#237;sticas de los pacientes que reingresan en el hospital"
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            2 => array:2 [
              "identificador" => "sec0055"
              "titulo" => "Modelo predictivo de reingreso hospitalario"
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    "fechaRecibido" => "2018-02-11"
    "fechaAceptado" => "2018-03-16"
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            0 => "Diabetes mellitus"
            1 => "Medicina hospitalaria"
            2 => "Reingreso de pacientes"
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            0 => "Diabetes mellitus"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objetivos</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Hemos desarrollado un modelo predictivo de reingreso hospitalario en pacientes con diabetes&#46; El objetivo es identificar aquella poblaci&#243;n fr&#225;gil que requiera estrategias adicionales para evitar reingresos a 90 d&#237;as&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">M&#233;todos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Utilizando datos recogidos en 3 estudios de prevalencia nacionales &#40;2015-2017&#41; que incluyeron un total de 1&#46;977 pacientes hemos desarrollado y validado un modelo predictivo de reingreso a 90 d&#237;as en pacientes con diabetes&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Se registraron un total de 704 &#40;36&#37;&#41; reingresos&#46; No hubo diferencias en la tasa de reingreso a lo largo de los 3 periodos de estudio&#46; Los hospitales de m&#225;s de 500 camas mostraron de forma estad&#237;sticamente significativa &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;02&#41; mayores tasas de reingreso que los de menor tama&#241;o&#46; Los motivos principales de reingreso fueron enfermedades infecciosas &#40;29&#37;&#41;&#44; enfermedades cardiovasculares &#40;24&#37;&#41; y enfermedades respiratorias &#40;14&#37;&#41;&#46; Los reingresos directamente relacionados con descompensaciones diab&#233;ticas fueron solo un 2&#37;&#46; Las variables independientes asociadas con reingresos hospitalarios fueron la edad del paciente&#44; el grado de cormobilidad&#44; el filtrado glomerular estimado&#44; el grado de discapacidad&#44; la presencia de episodios previos de hipoglucemia&#44; el uso de insulina en el tratamiento de la diabetes y el uso de glucocorticoides sist&#233;micos&#46; El modelo predictivo mostr&#243; en la cohorte de derivaci&#243;n un &#225;rea bajo de curva ROC&#58; 0&#44;676 &#40;intervalo de confianza al 95&#37; &#91;IC 95&#37;&#93;&#58; 0&#44;642-0&#44;709&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#46; En la cohorte de validaci&#243;n el modelo mostr&#243; un &#225;rea bajo la curva&#58; 0&#44;661 &#40;IC 95&#37;&#58; 0&#44;612-0&#44;710&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusi&#243;n</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">El modelo de predicci&#243;n de reingresos para pacientes con diabetes tipo 2 hospitalizados que hemos desarrollado permite identificar un subgrupo de pacientes fr&#225;giles con alto riesgo de reingreso&#46;</p></span>"
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        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Objectives</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">We developed a predictive model for the hospital readmission of patients with diabetes&#46; The objective was to identify the frail population that requires additional strategies to prevent readmissions at 90 days&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Methods</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Using data collected from 1977 patients in 3 studies on the national prevalence of diabetes &#40;2015-2017&#41;&#44; we developed and validated a predictive model of readmission at 90 days for patients with diabetes&#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 704 &#40;36&#37;&#41; readmissions were recorded&#46; There were no differences in the readmission rates over the course of the 3 studies&#46; The hospitals with more than 500 beds showed significantly &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;02&#41; higher readmission rates than those with fewer beds&#46; The main reasons for readmission were infectious diseases &#40;29&#37;&#41;&#44; cardiovascular diseases &#40;24&#41; and respiratory diseases &#40;14&#37;&#41;&#46; Readmissions directly related to diabetic decompensations accounted for only 2&#37; of all readmissions&#46; The independent variables associated with hospital readmission were patient&#39;s age&#44; degree of comorbidity&#44; estimated glomerular filtration rate&#44; degree of disability&#44; presence of previous episodes of hypoglycaemia&#44; use of insulin in treating diabetes and the use of systemic glucocorticoids&#46; The predictive model showed an area under the ROC curve &#40;AUC&#41; of 0&#46;676 &#40;95&#37; confidence interval &#91;95&#37; <span class="elsevierStyleSmallCaps">C</span>I&#93; 0&#46;642&#8211;0&#46;709&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;001&#41; in the referral cohort&#46; In the validation cohort&#44; the model showed an AUC of 0&#46;661 &#40;95&#37; CI 0&#46;612&#8211;0&#46;710&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;001&#41;&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusion</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">The model we developed for predicting readmissions for hospitalised patients with type 2 diabetes helps identify a subgroup of frail patients with a high risk of readmission&#46;</p></span>"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Los nombres de los miembros del Grupo de Diabetes&#44; Obesidad y Nutrici&#243;n de la Sociedad Espa&#241;ola de Medicina Interna se relacionan en el <a class="elsevierStyleCrossRef" href="#sec0080">Anexo 1</a>&#46;</p>"
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            "apendice" => "<p id="par0135" class="elsevierStylePara elsevierViewall">Pedro Abad Requejo &#40;Hospital del Oriente de Asturias&#41;&#44; Jos&#233; Nicol&#225;s Alcal&#225; Pedrajas &#40;Hospital Comarcal de Pozoblanco&#41;&#44; V&#237;ctor Arenas Garc&#237;a &#40;Hospital Universitario San Agust&#237;n&#41;&#44; Carlota Arg&#252;ello &#40;Hospital Universitario Central de Asturias&#41;&#44; Beatriz Calleja Arribas &#40;Hospital Universitario Central de Asturias&#41;&#44; Francisco Javier Carrasco S&#225;nchez &#40;Hospital Juan Ram&#243;n Jim&#233;nez&#41;&#44; Juana Carretero G&#243;mez &#40;Hospital de Zafra&#41;&#44; Elena Castellar Ot&#237;n &#40;Hospital de Barbastro&#44; Huesca&#41;&#44; Mar&#237;a Montserrat Chimeno Vi&#241;as &#40;Complejo Asistencial de Zamora&#41;&#44; Javier Ena &#40;Hospital Marina Baixa&#41;&#44; Bego&#241;a de Escalante Yang&#252;ela &#40;Hospital Cl&#237;nico Universitario Lozano Blesa&#41;&#44; Jos&#233; Mar&#237;a Fern&#225;ndez Rodr&#237;guez &#40;Hospital P&#250;blico Carmen y Severo Ochoa&#41;&#44; Mar&#237;a Jes&#250;s Folgueras Gomez &#40;Hospital Universitario Central de Asturias&#41;&#44; Sara Fuente Cos&#237;o &#40;Hospital Universitario San Agust&#237;n de Avil&#233;s&#41;&#44; Rosa Garc&#237;a Contreras &#40;Hospital Universitario Virgen del Roc&#237;o&#41;&#44; Concepci&#243;n Gonz&#225;lez Becerra &#40;Hospital San Juan de Dios&#44; Tenerife&#41;&#44; Ekaitz Gonz&#225;lez Duarte &#40;Hospital Universitario Central de Asturias&#41;&#44; Borja del Carmelo Gracia Tello &#40;Hospital Cl&#237;nico Universitario Lozano Blesa&#41;&#44; Mar&#237;a Jes&#250;s Ig&#250;zquiza Pellejero &#40;Hospital Reina Sof&#237;a de Tudela&#41;&#44; Ana Mar&#237;a Lizcano Lizcano &#40;Hospital Comarcal de Laredo&#41;&#44; Jeffrey Oskar Magallanes Gamboa &#40;Hospital Nuestra Se&#241;ora del Prado&#41;&#44; Juan Marti &#40;Hospital de Zum&#225;rraga&#41;&#44; Luc&#237;a Meijide Rodr&#237;guez &#40;Hospital Universitario Central de Asturias&#41;&#44; Inmaculada Mej&#237;as Real &#40;Hospital Infanta Margarita&#41;&#44; Juan Antonio Montes Romero &#40;Hospital de Poniente&#41;&#44; Carlos Moreno Lugris &#40;Hospital Lucus Augusti&#41;&#44; Bel&#233;n Murcia Casas &#40;Hospital Cl&#237;nico Universitario Virgen de la Victoria&#41;&#44; Mar&#237;a Victoria Pardo Ortega &#40;Consorci Sanitari de Terrassa-Hospital de Terrassa&#41;&#44; Estefan&#237;a Pereira Diaz &#40;Hospital Universitario Virgen del Roc&#237;o&#41;&#44; Ana Belkis Porto P&#233;rez &#40;Complexo Hospitalario Universitario A Coru&#241;a&#41;&#44; Rub&#233;n Baldomero Puerta Louro &#40;Hospital Povisa&#41;&#44; M&#243;nica R&#237;os Prego &#40;Complejo Hospitalario de Pontevedra&#41;&#44; Raquel Rodil Fraile &#40;Complejo Hospitalario de Navarra&#41;&#44; Marta Romero S&#225;nchez &#40;Hospital de Fuenlabrada&#41;&#44; Mar&#237;a Teresa S&#225;nchez Vidal &#40;Fundaci&#243;n Hospital de Jove&#41;&#44; Marta Nataya Sol&#237;s Marqu&#237;nez &#40;Hospital Universitario de Cabue&#241;es&#41;&#44; Jos&#233; Manuel Varela Aguilar &#40;Hospital Universitario Virgen del Roc&#237;o&#41;&#44; Patricia V&#225;zquez Rodr&#237;guez &#40;Complexo Hospitalario Universitario A Coru&#241;a&#41;&#44; Carmen Yllera Guti&#233;rrez &#40;Hospital Universitario Central de Asturias&#41;&#46;</p>"
            "titulo" => "Anexo 1&#46; Grupo de Estudio de Diabetes y Obesidad de la Sociedad Espa&#241;ola de Medicina Interna"
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          "es" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Curva COR para el modelo de derivaci&#243;n &#40;AUC&#58; 0&#44;676&#59; IC 95&#37;&#58; 0&#44;642-0&#44;709&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41; y para el modelo de validaci&#243;n &#40;AUC&#58; 0&#44;661&#59; IC 95&#37;&#58; 0&#44;612-0&#44;710&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#46; Un &#225;rea bajo la curva con un valor de 1 representa un test diagn&#243;stico perfecto&#44; para discriminar a los pacientes con reingreso de los que no van a presentar reingreso&#59; un &#225;rea bajo la curva de 0&#44;5 representa un test sin valor diagn&#243;stico&#46;</p>"
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                  \t\t\t\t</th><th class="td" title="table-head  " colspan="3" align="left" valign="top" scope="col" style="border-bottom: 2px solid black">A&#241;o de estudio</th></tr><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " colspan="3" align="left" valign="top" scope="col" style="border-bottom: 2px solid black">&#40;n&#250;mero de pacientes&#41;</th></tr><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Tama&#241;o&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#40;N<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>838&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#40;N<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>558&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#40;N<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>581&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">&#62;<span class="elsevierStyleHsp" style=""></span>500<span class="elsevierStyleHsp" style=""></span>camas&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">176 &#40;21&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">126 &#40;22&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">120 &#40;20&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">200-500<span class="elsevierStyleHsp" style=""></span>camas&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">68 &#40;8&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">26 &#40;4&#44;69&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">47 &#40;8&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">&#60;<span class="elsevierStyleHsp" style=""></span>200<span class="elsevierStyleHsp" style=""></span>camas&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">47 &#40;5&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">45 &#40;8&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">50 &#40;8&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
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        "descripcion" => array:1 [
          "es" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">N&#250;mero y porcentaje de reingresos en los a&#241;os estudiados seg&#250;n el tama&#241;o del hospital</p>"
        ]
      ]
      2 => array:8 [
        "identificador" => "tbl0010"
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        "tipo" => "MULTIMEDIATABLA"
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              "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="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Motivo de reingreso&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">N&#46;&#176; &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Enfermedad infecciosa&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">204 &#40;29&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Enfermedad cardiovascular&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">172 &#40;24&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Enfermedad respiratoria&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">100 &#40;14&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Enfermedad digestiva&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">63 &#40;8&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Enfermedad oncol&#243;gica&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">45 &#40;6&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Enfermedad neurol&#243;gica &#40;no vascular&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">18 &#40;2&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Enfermedad hematol&#243;gica&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">15 &#40;2&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Enfermedad renal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">15 &#40;2&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Enfermedades mentales y del comportamiento&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10 &#40;1&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Descompensaci&#243;n diab&#233;tica hiperosmolar&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8 &#40;1&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Enfermedad reumatol&#243;gica o autoinmune sist&#233;mica&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8 &#40;1&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Enfermedades endocrinas&#44; nutricionales y metab&#243;licas &#40;excepto diabetes&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5 &#40;0&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Descompensaci&#243;n diab&#233;tica&#44; hipoglucemia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4 &#40;0&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Descompensaci&#243;n diab&#233;tica&#44; cetoacidosis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2 &#40;0&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Otros motivos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">35 &#40;5&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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        "descripcion" => array:1 [
          "es" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Motivos de reingreso &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>704&#41; en pacientes con diabetes</p>"
        ]
      ]
      3 => 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"
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        "tabla" => array:2 [
          "leyenda" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Los resultados son expresados como media<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>DE o frecuencia &#40;porcentaje&#41;&#46;</p><p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">&#205;ndice de dependencia de Rankin&#58; 0&#58; asintom&#225;tico&#59; 1&#58; muy leve&#44; pueden realizar tareas y actividades habituales&#44; sin limitaciones&#59; 2&#58; leve&#44; incapacidad para realizar algunas actividades previas&#44; pero pueden valerse por s&#237; mismos sin necesidad de ayuda&#59; 3&#58; moderado&#44; requieren algo de ayuda&#44; pero pueden caminar solos&#59; 4&#58; moderadamente grave&#44; dependientes para actividades b&#225;sicas de la vida diaria&#44; pero sin necesidad de supervisi&#243;n continua&#59; 5&#58; grave&#44; totalmente dependientes&#59; 6&#58; muerte&#46;</p><p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Escala GDS <span class="elsevierStyleItalic">&#40;Global Deterioration Scale&#41;</span> de deterioro cognitivo&#58; 1&#58; ausencia de d&#233;ficit&#59; 2&#58; d&#233;ficit muy leve&#59; 3&#58; d&#233;ficit leve&#59; 4&#58; d&#233;ficit moderado&#59; 5&#58; d&#233;ficit moderadamente grave&#59; 6&#58; D&#233;ficit muy grave&#46;</p>"
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            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="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Reingreso s&#237;<br>&#40;N<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>704&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Reingreso no<br>&#40;N<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1273&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><br>p&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Edad&#44; a&#241;os&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">77&#44;38<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>10&#44;28&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">76&#44;63<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>11&#44;83&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;143&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Edad</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>65&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">67 &#40;9&#44;51&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">190 &#40;14&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>65-75&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">192 &#40;27&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">295 &#40;23&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>75&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">445 &#40;63&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">788 &#40;61&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Sexo</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;040&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Mujer&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">320 &#40;45&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">640 &#40;50&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Var&#243;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">384 &#40;54&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">633 &#40;49&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">&#205;ndice de comorbilidad de Charlson&#44; puntos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&#44;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&#44;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Duraci&#243;n de la diabetes&#44; a&#241;os&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10&#44;52<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>8&#44;37&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10&#44;08<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>8&#44;63&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;270&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Estancia hospitalaria&#44; d&#237;as&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9&#44;88<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>11&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10&#44;52<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>30&#44;05&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;583&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Hipoglucemia en 3 meses previos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">86 &#40;12&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">46 &#40;3&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">&#205;ndice de dependencia de Rankin</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">72 &#40;10&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">291 &#40;23&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">86 &#40;12&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">231&#40;16&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">112 &#40;16&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">149 &#40;11&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">145 &#40;20&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">195 &#40;15&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">144 &#40;20&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">185 &#40;14&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">139 &#40;19&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">215 &#40;17&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1 &#40;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0 &#40;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Escala GDS de deterioro cognitivo</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;027&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">278 &#40;39&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">625 &#40;49&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">108 &#40;15&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">154 &#40;12&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">88 &#40;12&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">134 &#40;10&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">93 &#40;13&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">118 &#40;9&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">56 &#40;8&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">90 &#40;7&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">44 &#40;6&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">89 &#40;7&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">29 &#40;4&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">49 &#40;3&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">&#218;ltimo valor de HbA1c&#44; &#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6&#44;82<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#44;06&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6&#44;95<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#44;24&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;212&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleItalic">Tratamiento de diabetes previo al ingreso</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Sulfonilurea&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">48 &#40;6&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">107 &#40;8&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;213&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Insulina basal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">269 &#40;38&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">338 &#40;26&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Insulina bif&#225;sica&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">39 &#40;5&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">79 &#40;6&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;554&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Insulina r&#225;pida&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">109 &#40;15&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">130 &#40;10&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Filtrado glomerular estimado&#44; ml&#47;min&#47;1&#44;73<span class="elsevierStyleHsp" style=""></span>m<span class="elsevierStyleSup">2</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">57&#44;21<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>26&#44;5<br>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">60&#44;78<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>25&#44;81<br>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;004<br>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Valor medio de glucosa en las &#250;ltimas 24<span class="elsevierStyleHsp" style=""></span>h&#44; mg&#47;dl&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">180&#44;75<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>62&#44;24<br>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">177&#44;43<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>59&#44;95<br>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;271&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Controles de glucosa capilar realizados en las &#250;ltimas 24<span class="elsevierStyleHsp" style=""></span>h&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#44;68<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;99<br>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#44;67<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;08<br>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;811<br>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Unidades totales de insulina administrada en las &#250;ltimas 24<span class="elsevierStyleHsp" style=""></span>h&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">22&#44;13<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>20&#44;8<br>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">22&#44;87<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>22&#44;74<br>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;534<br>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Glucosa<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>70 mg&#47;dl durante el ingreso&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">58 &#40;8&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">82 &#40;6&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;136&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Glucosa<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>350 mg&#47;dl durante el ingreso&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">142 &#40;20&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">224 &#40;17&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;167&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Glucocorticoides sist&#233;micos durante el ingreso&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">240 &#40;34&#44;1&#41;<br>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">325 &#40;25&#44;5&#41;<br>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;000<br>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Exp &#40;&#946;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Edad</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;023&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>65 a&#241;os&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>75 a&#241;os&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;023&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Ref&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>2 puntos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;524&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>3 puntos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;373&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;792-2&#44;380&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;259&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>4 puntos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#44;124&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;215-3&#44;714&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>5 puntos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;519&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;849-2&#44;722&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;160&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>6 puntos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;479&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;800-2&#44;732&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>7 puntos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#44;401&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;373-4&#44;200&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;002&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">&#205;ndice de discapacidad de Rankin</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;005&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Asintom&#225;tico &#40;0 puntos&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Ref&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Leve &#40;1 punto&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;607&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;041&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Moderada &#40;2-3 puntos&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#44;019&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Severa &#40;4-5 puntos&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#44;233&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;410-3&#44;537&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Hipoglucemia en los 3 meses previos&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Uso de insulina basal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;498&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;130-1&#44;988&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;005&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Tratamiento con glucocorticoides&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;222-2&#44;135&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Constante&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;127&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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          "es" => "<p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">Modelo predictivo de reingreso hospitalario en pacientes con diabetes mellitus</p>"
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                      "titulo" => "Hyperglycemia management in patients admitted to internal medicine in Spain&#58; A point-prevalence survey examining adequacy of glycemic control and guideline adherence"
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                          "autores" => array:6 [
                            0 => "J&#46; Ena"
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                            2 => "M&#46; Romero-S&#225;nchez"
                            3 => "A&#46;Z&#46; Gaviria"
                            4 => "A&#46; Calzada-Valle"
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                      "doi" => "10.1016/j.ejim.2015.04.020"
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                        "fecha" => "2015"
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                      "titulo" => "High prevalence of diabetes mellitus and hospital-related hyperglycaemia in French general wards"
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                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "S&#46; Feldman-Billard"
                            1 => "M&#46; Joubert"
                            2 => "R&#46; Morello"
                            3 => "F&#46; Dorey"
                            4 => "D&#46; Seret-Begue"
                            5 => "F&#46; Getin-Bouyer"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.diabet.2013.04.002"
                      "Revista" => array:6 [
                        "tituloSerie" => "Diabetes Metab"
                        "fecha" => "2013"
                        "volumen" => "39"
                        "paginaInicial" => "454"
                        "paginaFinal" => "458"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23726314"
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            2 => array:3 [
              "identificador" => "bib0195"
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                      "titulo" => "Predictive model of readmission to internal medicine wards"
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                          "etal" => true
                          "autores" => array:6 [
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Original
DOI: 10.1016/j.rce.2018.03.010
Derivación y validación de un modelo predictivo de reingreso en pacientes con diabetes mellitus atendidos en servicios de medicina interna
Derivation and validation of a predictive model for the readmission of patients with diabetes mellitus treated in internal medicine departments
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J. Enaa,
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ena_jav@gva.es

Autor para correspondencia.
, R. Gómez-Huelgasb, B.C. Gracia-Telloc, P. Vázquez-Rodríguezd, J.N. Alcalá-Pedrajase, F.J. Carrasco-Sánchezf, B. Murcia-Casasg, M. Romero-Sánchezh, J.V. Segura-Herasi, J. Carreteroj, Grupo de Diabetes, Obesidad y Nutrición de la Sociedad Española de Medicina Interna ◊
a Servicio de Medicina Interna, Hospital Marina Baixa, Villajoyosa, Alicante, España
b Servicio de Medicina Interna, Hospital Regional Universitario de Málaga, Málaga, España
c Servicio de Medicina Interna, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España
d Servicio de Medicina Interna, Complexo Hospitalario Universitario A Coruña, A Coruña, España
e Servicio de Medicina Interna, Hospital Comarcal de Pozoblanco, Pozoblanco, Córdoba, España
f Servicio de Medicina Interna, Hospital Juan Ramón Jiménez, Huelva, España
g Servicio de Medicina Interna, Hospital Clínico Universitario Virgen de la Victoria, Málaga, España
h Servicio de Medicina Interna, Hospital de Fuenlabrada, Fuenlabrada, Madrid, España
i Centro de Investigación Operativa, Universidad Miguel Hernández, Elche, Alicante, España
j Servicio de Medicina Interna, Hospital Comarcal de Zafra, Zafra, Badajoz, España
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