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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 &#40;DM&#41; es una enfermedad cr&#243;nica del metabolismo de los hidratos de carbono&#44; cuya incidencia y prevalencia han experimentado un incremento marcado en las 2 &#250;ltimas d&#233;cadas&#46; Aunque datos recientes en Estados Unidos reflejan una estabilizaci&#243;n desde el a&#241;o 2008&#44; la prevalencia es muy elevada en el momento actual<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a>&#46; Un estudio epidemiol&#243;gico publicado en el a&#241;o 2012 cifra la prevalencia de DM en nuestro pa&#237;s en el 13&#44;8&#37;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a>&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">El tratamiento hospitalario de pacientes con DM es un problema frecuente&#44; ya que se estima que suponen entre un 30 y 40&#37; de los pacientes atendidos en Urgencias y hasta un 25&#37; de los enfermos ingresados en el hospital&#44; tanto en plantas m&#233;dicas como quir&#250;rgicas<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a>&#46; A pesar de la falta de evidencia de que el tratamiento intensivo de la glucemia reduzca la mortalidad en el paciente ingresado<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a>&#44; hay estudios epidemiol&#243;gicos que demuestran que diversos par&#225;metros de control gluc&#233;mico&#44; como la glucemia media &#40;GM&#41;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a>&#44; pueden influir en el pron&#243;stico del paciente&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">Pacientes con igual GM pueden tener perfiles gluc&#233;micos muy diferentes&#46; Aunque no hay un est&#225;ndar de referencia para cuantificar la variabilidad gluc&#233;mica &#40;VG&#41;&#44; cada vez se acumulan m&#225;s datos que sugieren su importancia pron&#243;stica&#46; Los &#250;ltimos datos del estudio ADVANCE<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> demostraron que un incremento de la variabilidad visita a visita &#40;desviaci&#243;n est&#225;ndar&#41; en los niveles de HbA1c y de la glucemia en ayunas se asociaban a un incremento del riesgo de aparici&#243;n de complicaciones micro y macrovasculares&#46; Tambi&#233;n recientemente se ha reconocido la importancia de la VG intrahospitalaria&#44; tanto en el desarrollo de eventos cardiovasculares a medio plazo<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> &#40;un a&#241;o&#41; como en la mortalidad a los 90 d&#237;as<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a>&#46; Por ello se considera necesario realizar estudios de intervenci&#243;n que puedan responder definitivamente a la pregunta de si la reducci&#243;n de la VG puede disminuir el riesgo de aparici&#243;n de complicaciones en la DM<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a>&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">El objetivo del presente trabajo fue evaluar factores predictores de mortalidad en pacientes con hiperglucemia ingresados en un Servicio de Medicina Interna&#46; Espec&#237;ficamente&#44; analizamos la importancia pron&#243;stica de diversas medidas de control gluc&#233;mico que reflejaban no solo la GM&#44; sino tambi&#233;n la VG&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Material y m&#233;todos</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Dise&#241;o</span><p id="par0025" class="elsevierStylePara elsevierViewall">Estudio de cohortes retrospectivo longitudinal anal&#237;tico&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Pacientes</span><p id="par0030" class="elsevierStylePara elsevierViewall">Se incluy&#243; a pacientes dados de alta durante un periodo de 8 meses del Servicio de Medicina Interna del Hospital Cl&#237;nico Universitario &#171;Lozano Blesa&#187; de Zaragoza con alg&#250;n diagn&#243;stico &#40;principal o secundario&#41; incluido en la Clasificaci&#243;n Internacional de Enfermedades y su Modificaci&#243;n Cl&#237;nica de la 9&#46;&#170; edici&#243;n &#40;CIE-9-MC&#41; en relaci&#243;n con la DM &#40;DM&#44; DM secundaria&#44; glucosa anormal e hipoinsulinemia posquir&#250;rgica&#41;&#46; Se excluy&#243; a los pacientes cuyo manejo en el ingreso requiri&#243; tratamiento en la Unidad de Cuidados Intensivos &#40;UCI&#41; y a los pacientes cuyo diagn&#243;stico principal fue cetoacidosis diab&#233;tica o descompensaci&#243;n hipergluc&#233;mica hiperosmolar no cet&#243;sica con necesidad de utilizaci&#243;n de insulina por v&#237;a intravenosa inicial&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">La variable dependiente &#40;punto final cl&#237;nico&#41; fue la mortalidad intrahospitalaria&#46; Las variables independientes incluyeron&#58; <span class="elsevierStyleItalic">1&#41;</span> cl&#237;nicas&#58; edad en el momento del ingreso&#44; sexo&#44; motivo del ingreso&#44; presi&#243;n arterial sist&#243;lica &#40;PAS&#41;&#44; saturaci&#243;n de O2&#44; temperatura&#44; &#237;ndice de comorbilidad de Charlson&#44; tipo de DM&#44; tiempo de evoluci&#243;n de la DM&#44; tipo de tratamiento ambulatorio para la DM&#44; duraci&#243;n de la estancia hospitalaria&#44; ingesta o ayuno al ingreso y uso de corticoides durante el ingreso&#59; <span class="elsevierStyleItalic">2&#41;</span> variables relacionadas con el control gluc&#233;mico&#58; administraci&#243;n o no de insulina programada&#44; glucemia plasm&#225;tica al ingreso&#44; HbA1c obtenida durante el ingreso o en los 3 meses previos&#44; valores gluc&#233;micos obtenidos mediante monitorizaci&#243;n de glucemia capilar y frecuencia y gravedad de hipoglucemias &#40;se defini&#243; hipoglucemia como valores de glucemia &#60;70<span class="elsevierStyleHsp" style=""></span>mg&#47;dl&#44; siendo intensa si los valores de glucemia eran &#60; 40<span class="elsevierStyleHsp" style=""></span>mg&#47;dl o se acompa&#241;aban de p&#233;rdida de conciencia&#41;&#59; <span class="elsevierStyleItalic">3&#41;</span> variables bioqu&#237;micas&#58; glucosa&#44; creatinina&#44; iones&#44; HbA1c y hemograma inicial&#44; y <span class="elsevierStyleItalic">4&#41;</span> variables generadas&#58; El tratamiento ambulatorio de los pacientes antes del ingreso se recodific&#243; en 3 categor&#237;as &#40;dieta y&#47;o antidiab&#233;ticos orales como categor&#237;a de referencia&#44; insulina basal con o sin antidiab&#233;ticos orales y mezclas o basal-bolo&#41; debido al limitado n&#250;mero de pacientes en tratamiento basal-bolo&#46; A partir de los valores de glucemia capilar se determinaron como medidas de valoraci&#243;n del control gluc&#233;mico intrahospitalario&#58; glucemia m&#225;xima &#40;el valor de glucemia capilar m&#225;s elevado durante el ingreso&#41;&#44; GM en las primeras 24 h&#44; GM durante el ingreso&#44; definida como la media de todas las glucemias capilares del paciente&#44; GM corregida &#40;media de las medias diarias de glucemias capilares&#41;&#44; desviaci&#243;n est&#225;ndar de todas las glucemias capilares del paciente &#40;VG&#41; y coeficiente de variaci&#243;n &#40;CV&#41;&#44; definido como el cociente entre la desviaci&#243;n est&#225;ndar y la GM durante el ingreso &#40;VG&#47;GM&#41;&#46; Seg&#250;n su glucemia inicial&#44; los pacientes se clasificaron en 4 categor&#237;as&#44; con puntos de corte en 140&#44; 180 y 250<span class="elsevierStyleHsp" style=""></span>mg&#47;dl&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">M&#233;todos de laboratorio</span><p id="par0040" class="elsevierStylePara elsevierViewall">La glucemia plasm&#225;tica se determin&#243; mediante un m&#233;todo enzim&#225;tico con hexoquinasa&#44; la HbA1c mediante cromatograf&#237;a de alta resoluci&#243;n y la glucemia capilar con medidor Optium Xceed<span class="elsevierStyleSup">&#174;</span>&#44; cuya precisi&#243;n es de 3-3&#44;6&#37; &#40;CV&#41;&#44; con una exactitud r<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;98 respecto a la glucemia plasm&#225;tica y un cumplimiento de la norma ISO del 99&#37;&#46; El resto de los par&#225;metros bioqu&#237;micos y el hemograma se midieron mediante procedimientos rutinarios en un autoanalizador&#46; El filtrado glomerular &#40;FG&#41;&#44; expresado en ml&#47;minuto&#47;1&#44;73 m<span class="elsevierStyleSup">2</span>&#44; se calcul&#243; mediante f&#243;rmula de MDRD a partir de la edad y la creatinina plasm&#225;tica&#59; los pacientes se clasificaron en 4 categor&#237;as seg&#250;n su FG fuese &#8805; 60&#44; 45-59&#44; 30-44 o<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>30<span class="elsevierStyleHsp" style=""></span>ml&#47;minuto&#47;1&#44;73 m<span class="elsevierStyleSup">2</span>&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">M&#233;todos estad&#237;sticos</span><p id="par0045" class="elsevierStylePara elsevierViewall">Las variables cuantitativas se describen con su media &#177; desviaci&#243;n est&#225;ndar &#40;DE&#41;&#44; mientras que las variables cualitativas se describen con la distribuci&#243;n de frecuencias&#46; La comparaci&#243;n de variables cuantitativas se realiz&#243; con la t de Student para muestras independientes &#40;2 grupos&#41; o ANOVA &#40;m&#225;s de 2 grupos&#41; o con pruebas no param&#233;tricas de Mann-Whitney o Kruskal-Wallis&#44; respectivamente&#46; La comparaci&#243;n de variables cualitativas se realiz&#243; mediante &#967;<span class="elsevierStyleSup">2</span> o test exacto de Fisher&#44; con test de tendencia lineal en las variables predictivas con categor&#237;as ordenadas&#46; La correlaci&#243;n entre variables cuantitativas &#40;GM y GM corregida&#41; se evalu&#243; con el coeficiente de correlaci&#243;n de Pearson&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">La determinaci&#243;n de los factores predictores de mortalidad intrahospitalaria se realiz&#243; mediante regresi&#243;n log&#237;stica uni y multivariante&#46; Para determinar los mejores modelos predictivos se incluyeron en los modelos multivariante las variables seg&#250;n criterios estad&#237;sticos &#40;p &#8804; 0&#44;1 en an&#225;lisis univariante&#41; y seg&#250;n su sentido cl&#237;nico&#46; Posteriormente&#44; se comput&#243; un procedimiento de exclusi&#243;n secuencial para obtener el modelo finalmente seleccionado&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">Se realiz&#243; una comparaci&#243;n de la utilidad para predecir mortalidad intrahospitalaria de la adici&#243;n conjunta de variables relacionadas con el control gluc&#233;mico &#40;glucemia inicial&#44; HbA1c&#44; GM&#44; VG y administraci&#243;n de insulina programada&#41; a un modelo b&#225;sico &#40;compuesto por edad&#44; sexo&#44; ayuno&#44; tratamiento con corticoides&#44; &#237;ndice de Charlson&#44; FG&#44; PAS&#44; sodio y leucocitos iniciales&#41; mediante an&#225;lisis de curvas ROC y mediante el c&#225;lculo del &#237;ndice de mejor&#237;a de la discriminaci&#243;n &#40;IDI&#41;&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">Se consideraron significativas las asociaciones con p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#46; Los programas inform&#225;ticos utilizados fueron SPSS versi&#243;n 22&#46;0 y R versi&#243;n 3&#46;1&#46;2&#46;</p></span></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Resultados</span><p id="par0065" class="elsevierStylePara elsevierViewall">Se incluy&#243; a 384 pacientes&#44; de los cuales 193 &#40;50&#44;3&#37;&#41; fueron varones&#46; La edad media &#177; DE fue de 78&#44;5 &#177; 10&#44;3 a&#241;os&#46; Los motivos de ingreso m&#225;s frecuentes fueron disnea &#40;41&#44;1&#37;&#41; y s&#237;ndrome febril &#40;10&#44;4&#37;&#41;&#46; Los diagn&#243;sticos relacionados con la DM m&#225;s frecuentes fueron DM tipo 2 &#40;83&#44;6&#37;&#41; e hiperglucemia de estr&#233;s &#40;6&#44;8&#37;&#41;&#46; El tratamiento domiciliario de los pacientes con DM era con medidas higi&#233;nico-diet&#233;ticas de forma aislada &#40;16&#44;7&#37;&#41;&#44; antidiab&#233;ticos orales &#40;42&#44;9&#37;&#41;&#44; insulina basal &#40;26&#44;3&#37;&#41;&#44; mezclas de insulina &#40;10&#44;7&#37;&#41; o insulinizaci&#243;n bolo-basal &#40;3&#44;4&#37;&#41;&#46; El tiempo de evoluci&#243;n de la DM fue de 12&#44;1 &#177; 8&#44;6 a&#241;os y la puntuaci&#243;n media en el &#237;ndice de Charlson fue de 2&#44;9 &#177; 1&#44;6 puntos&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">Hubo un 17&#44;5&#37; de pacientes que precisaron ingreso en situaci&#243;n de ayuno y un 34&#44;4&#37; que necesitaron recibir tratamiento con corticoides&#46; La duraci&#243;n media del ingreso fue de 13&#44;8 &#177; 18&#44;5 d&#237;as&#46; Experimentaron durante el ingreso hipoglucemias un 27&#37; de los pacientes &#40;22&#44;8&#37; con hipoglucemias leves y 4&#44;2&#37; intensas&#41;&#46; La GM corregida tuvo un coeficiente de correlaci&#243;n respecto a la GM de 0&#44;99 &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;0001&#41;&#44; por lo que se utiliz&#243; la GM para todos los c&#225;lculos de los an&#225;lisis de regresi&#243;n&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">Se produjo el fallecimiento intrahospitalario en 31 &#40;8&#44;1&#37;&#41; pacientes&#59; no hubo diferencias significativas entre pacientes con hiperglucemia de estr&#233;s y pacientes con DM previa &#40;7&#44;7 vs&#46; 8&#44;7&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;86&#41;&#46; Las causas de muerte fueron infecciosas &#40;16&#41;&#44; cardiovasculares &#40;7&#41;&#44; respiratorias &#40;4&#41; u otras causas &#40;4&#41;&#46; En la <a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a> quedan reflejadas las caracter&#237;sticas generales de los pacientes en funci&#243;n de su glucemia inicial&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0080" class="elsevierStylePara elsevierViewall">En la <a class="elsevierStyleCrossRef" href="#tbl0010">tabla 2</a> se comparan las caracter&#237;sticas generales de los pacientes y en la <a class="elsevierStyleCrossRef" href="#tbl0015">tabla 3</a> las diversas medidas de glucemia en funci&#243;n de que los pacientes falleciesen o no&#46; Los pacientes que murieron durante su estancia hospitalaria presentaron mayor edad&#44; menor proporci&#243;n de tratamiento insul&#237;nico en domicilio&#44; menor FG y mayor puntuaci&#243;n en el &#237;ndice de Charlson&#59; adem&#225;s&#44; se encontraron con mayor frecuencia en situaci&#243;n de ayuno y precisaron tambi&#233;n con mayor frecuencia tratamiento con corticoides&#44; mientras que recibieron con menor probabilidad insulina programada&#46; En cuanto a las medidas de control gluc&#233;mico&#44; los pacientes que fallecieron ten&#237;an mayor glucemia inicial y&#44; en el l&#237;mite de la significaci&#243;n estad&#237;stica&#44; mayor GM las primeras 24 h y durante el ingreso&#44; as&#237; como mayor VG &#40;desviaci&#243;n est&#225;ndar&#41;&#46; Los predictores univariante con p &#8804; 0&#44;1 quedan reflejados en la <a class="elsevierStyleCrossRef" href="#tbl0020">tabla 4</a>&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><elsevierMultimedia ident="tbl0020"></elsevierMultimedia><p id="par0085" class="elsevierStylePara elsevierViewall">En an&#225;lisis multivariante el mejor modelo predictivo de mortalidad &#40;R<span class="elsevierStyleSup">2</span> 0&#44;326&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;0001&#41; fue el compuesto&#44; por orden de importancia pron&#243;stica&#44; por la edad &#40;&#967;<span class="elsevierStyleSup">2</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>8&#44;19&#59; OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#44;094&#59; IC del 95&#37;&#44; 1&#44;020-1&#44;174&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;004&#41;&#44; &#237;ndice de Charlson &#40;&#967;<span class="elsevierStyleSup">2</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>7&#44;28&#59; OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#44;48&#59; IC del 95&#37;&#44; 1&#44;11-1&#44;99&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;007&#41;&#44; glucemia inicial &#40;&#967;<span class="elsevierStyleSup">2</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>6&#44;05&#59; OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#44;007&#59; IC del 95&#37;&#44; 1&#44;001-1&#44;014&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;014&#41;&#44; &#250;ltima HbA1c &#40;&#967;<span class="elsevierStyleSup">2</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>5&#44;76&#59; OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;59&#59; IC del 95&#37;&#44; 0&#44;33-1&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;016&#41;&#44; VG &#40;&#967;<span class="elsevierStyleSup">2</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>4&#44;41&#59; OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#44;031&#59; IC del 95&#37;&#44; 1-1&#44;062&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;036&#41;&#44; necesidad de tratamiento con corticoides &#40;&#967;<span class="elsevierStyleSup">2</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>4&#44;03&#59; OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>3&#44;1&#59; IC del 95&#37;&#44; 1-9&#44;64&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;045&#41;&#44; administraci&#243;n de insulina programada &#40;&#967;<span class="elsevierStyleSup">2</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>3&#44;98&#59; OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;26&#59; IC del 95&#37;&#44; 0&#44;066-1&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;046&#41; y PAS &#40;&#967;<span class="elsevierStyleSup">2</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#44;92&#59; OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;985&#59; IC del 95&#37;&#44; 0&#44;97-1&#44;003&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;088&#41;&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">La adici&#243;n de las medidas de control gluc&#233;mico mejor&#243; la capacidad para predecir la mortalidad de los modelos &#40;&#225;rea bajo la curva ROC 0&#44;887 vs&#46; 0&#44;830&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;044&#59; <a class="elsevierStyleCrossRef" href="#fig0005">figura 1</a>&#41;&#44; as&#237; como su poder de discriminaci&#243;n &#40;IDI<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;079&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;009&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Discusi&#243;n</span><p id="par0095" class="elsevierStylePara elsevierViewall">Mediante una revisi&#243;n de las historias cl&#237;nicas de los pacientes dados de alta en nuestro hospital con un diagn&#243;stico relacionado con la presencia de DM&#44; hemos comprobado que la consideraci&#243;n de diversas medidas de control gluc&#233;mico puede mejorar la capacidad para predecir mortalidad intrahospitalaria&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">Las personas con DM tienen m&#225;s probabilidades de ser ingresadas en el hospital&#44; mayor duraci&#243;n de la estancia hospitalaria y mayor mortalidad intrahospitalaria que las personas sin DM<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a>&#46; Debido a ello se han intentado descubrir factores predictivos de mal pron&#243;stico hospitalario en el paciente con DM&#46; En un estudio reciente se encontr&#243; que la mortalidad intrahospitalaria de los pacientes con DM fue de un 5&#44;1&#37; y se consigui&#243; construir un modelo predictivo de mortalidad con variables cl&#237;nicas y anal&#237;ticas recogidas en las primeras 72 h de admisi&#243;n&#59; no obstante&#44; una limitaci&#243;n del estudio fue no disponer de las medidas de control gluc&#233;mico<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">11</span></a>&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">La hiperglucemia en el momento de la admisi&#243;n en el hospital se ha revelado como un marcador de mal pron&#243;stico hospitalario<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">12&#44;10</span></a>&#44; especialmente en los pacientes sin un diagn&#243;stico previo de DM<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">13</span></a>&#46; En nuestro estudio&#44; la glucemia en el momento de la admisi&#243;n fue un factor pron&#243;stico independiente de mortalidad&#44; aunque no hubo diferencias significativas de mortalidad entre pacientes con DM previamente conocida o no&#46; En el an&#225;lisis multivariante hubo relaci&#243;n inversa entre HbA1c y mortalidad&#44; lo que indicar&#237;a que es el control metab&#243;lico a corto plazo el que est&#225; asociado a un mal pron&#243;stico hospitalario&#46; De hecho&#44; en el estudio de Timmer et al&#46;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a> en pacientes con infarto agudo de miocardio con elevaci&#243;n de ST&#44; la glucemia inicial predijo la mortalidad a los 30 d&#237;as&#44; mientras que la HbA1c inicial predijo la mortalidad a largo plazo&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">Adem&#225;s de las medidas en el momento de la admisi&#243;n&#44; tambi&#233;n el control gluc&#233;mico durante la hospitalizaci&#243;n puede ser importante&#46; En pacientes hospitalizados con infarto agudo de miocardio<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> y en pacientes no cr&#237;ticos sometidos a tratamiento con nutrici&#243;n parenteral<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">15</span></a> se ha descrito un incremento de mortalidad asociado con la elevaci&#243;n de las cifras de GM intrahospitalarias&#46; Aunque en estos estudios<a class="elsevierStyleCrossRefs" href="#bib0025"><span class="elsevierStyleSup">5&#44;15</span></a> no se evaluaron medidas de VG&#44; recientes datos apoyan su importancia pron&#243;stica<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">7&#44;8</span></a>&#46; En el estudio de Mendez et al&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a> se incluy&#243; a 620 pacientes &#40;935 ingresos&#41; y se obtuvo para cada ingreso la GM &#40;182<span class="elsevierStyleHsp" style=""></span>mg&#47;dl&#41;&#44; la VG &#40;57&#44;9<span class="elsevierStyleHsp" style=""></span>mg&#47;dl&#41; y el CV &#40;31&#44;9&#37;&#41;&#44; constat&#225;ndose que la VG era un factor predictivo de mortalidad en los primeros 90 d&#237;as&#44; independiente de la GM y de la presencia de hipoglucemias&#46; En nuestro estudio&#44; las medidas de glucemia fueron totalmente superponibles a las del trabajo anterior&#44; y tambi&#233;n encontramos que la medida de control gluc&#233;mico m&#225;s asociada al riesgo de mortalidad fue la VG&#44; en el l&#237;mite de la significaci&#243;n en el an&#225;lisis univariante&#44; pero significativa en el multivariante&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">A pesar de la asociaci&#243;n epidemiol&#243;gica&#44; los estudios de intervenci&#243;n destinados a demostrar la eficacia del control gluc&#233;mico intensivo en pacientes hospitalizados fuera de la UCI son escasos&#46; Un metaan&#225;lisis reciente<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">16</span></a> demostraba que el tratamiento intensivo hospitalario de la hiperglucemia fuera de la UCI lograba reducir las infecciones &#40;RR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;41&#59; IC del 95&#37;&#44; 0&#44;21-0&#44;77&#41; pero no la mortalidad&#44; con un incremento en el l&#237;mite de la significaci&#243;n estad&#237;stica en el riesgo de hipoglucemias &#40;RR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#44;58&#59; IC del 95&#37;&#44; 0&#44;97-2&#44;57&#41;&#46; En nuestro trabajo&#44; la aparici&#243;n de hipoglucemias fue m&#225;s frecuente en los pacientes que fallecieron&#44; aunque la diferencia no fue significativa&#44; probablemente debido al limitado n&#250;mero de sujetos&#46; Utilizando la evidencia disponible sobre riesgos y beneficios del control metab&#243;lico en el paciente ingresado fuera de la UCI&#44; las sociedades cient&#237;ficas<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">17</span></a> recomiendan en la actualidad conseguir cifras de glucemia preprandiales &#60;140<span class="elsevierStyleHsp" style=""></span>mg&#47;dl y aleatorias &#60; 180<span class="elsevierStyleHsp" style=""></span>mg&#47;dl&#46; Aunque no hay recomendaciones espec&#237;ficas para evaluar y reducir la VG&#44; hay consenso en la necesidad de la realizaci&#243;n de ensayos de intervenci&#243;n que demuestren su papel etiol&#243;gico<a class="elsevierStyleCrossRefs" href="#bib0045"><span class="elsevierStyleSup">9&#44;18</span></a>&#46; En nuestro estudio&#44; la utilizaci&#243;n de insulina programada se asoci&#243; a una reducci&#243;n en el riesgo de mortalidad&#44; apoyando la necesidad de evitar el tratamiento aislado con pautas de insulina r&#225;pida<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">17</span></a> y la necesidad de implementar protocolos espec&#237;ficos de manejo intrahospitalario<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">19</span></a>&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">Como limitaciones del presente trabajo deber&#237;amos considerar su naturaleza observacional y retrospectiva&#44; que reduce la posibilidad de establecer inferencias causales&#44; y el limitado n&#250;mero de pacientes&#46; Como ventajas estar&#237;an la recogida de todas las medidas de glucemia intrahospitalaria&#44; lo que permiti&#243; la evaluaci&#243;n cuidadosa de su importancia pron&#243;stica&#44; y la posibilidad de ajuste en el an&#225;lisis multivariante para reconocidos factores predictores de mortalidad&#44; como el &#237;ndice de Charlson&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">En conclusi&#243;n&#44; en una muestra de pacientes hospitalizados en una planta de Medicina Interna hemos constatado que la evaluaci&#243;n de diversas medidas de control gluc&#233;mico a&#241;ade informaci&#243;n pron&#243;stica al riesgo de mortalidad&#46; El aumento de la glucemia inicial y de la VG intrahospitalaria incrementaron el riesgo de mortalidad&#44; mientras que la utilizaci&#243;n de insulina programada se asoci&#243; a una reducci&#243;n de la mortalidad intrahospitalaria&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Conflicto de intereses</span><p id="par0130" class="elsevierStylePara elsevierViewall">Los autores declaran que no tienen ning&#250;n conflicto de intereses&#46;</p></span></span>"
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          "titulo" => "Abstract"
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              "titulo" => "Introduction"
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              "titulo" => "Pacientes"
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    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2015-02-12"
    "fechaAceptado" => "2015-06-07"
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          "clase" => "keyword"
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          "palabras" => array:5 [
            0 => "Mortalidad hospitalaria"
            1 => "Diabetes"
            2 => "Insulina"
            3 => "Variabilidad gluc&#233;mica"
            4 => "Manejo hospitalario de la hiperglucemia"
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          "clase" => "keyword"
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          "palabras" => array:5 [
            0 => "Hospital mortality"
            1 => "Diabetes"
            2 => "Insulin"
            3 => "Glycaemic variability"
            4 => "Hospital management of hyperglycaemia"
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    "resumen" => array:2 [
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        "titulo" => "Resumen"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Introducci&#243;n</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">El objetivo fue evaluar la importancia pron&#243;stica de diversas medidas de control gluc&#233;mico sobre la mortalidad intrahospitalaria&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Material y m&#233;todos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Estudio de cohortes retrospectivo anal&#237;tico con inclusi&#243;n de pacientes ingresados en Medicina Interna con alg&#250;n diagn&#243;stico relacionado con la diabetes mellitus &#40;DM&#41;&#44; excluyendo descompensaciones agudas&#46; El punto final cl&#237;nico fue la mortalidad intrahospitalaria&#46; Se recogieron variables cl&#237;nicas&#44; anal&#237;ticas y relacionadas con el control gluc&#233;mico &#40;administraci&#243;n de insulina programada&#44; glucemia plasm&#225;tica al ingreso&#44; HbA1c&#44; glucemia media &#40;GM&#41; y variabilidad gluc&#233;mica &#40;VG&#41; intrahospitalarias e hipoglucemias&#41;&#46;</p><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">La determinaci&#243;n de los factores predictivos de mortalidad intrahospitalaria se realiz&#243; mediante regresi&#243;n log&#237;stica uni y multivariante&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Resultados</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Se incluy&#243; a 384 pacientes &#40;50&#44;3&#37; varones&#41;&#46; La edad media &#177; DE fue de 78&#44;5 &#177; 10&#44;3 a&#241;os&#46; Los diagn&#243;sticos relacionados con la DM fueron diabetes tipo 2 &#40;83&#44;6&#37;&#41; e hiperglucemia de estr&#233;s &#40;6&#44;8&#37;&#41;&#46; Se produjo el fallecimiento intrahospitalario en 31 &#40;8&#44;1&#37;&#41; pacientes&#46;</p><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">En el an&#225;lisis multivariante el mejor modelo predictivo de mortalidad &#40;R<span class="elsevierStyleSup">2</span> 0&#44;326&#59; p &#60; 0&#44;0001&#41; fue el compuesto&#44; por orden de importancia&#44; por la edad &#40;&#967;<span class="elsevierStyleSup">2</span> &#61; 8&#44;19&#59; OR &#61; 1&#44;094&#59; IC del 95&#37;&#44; 1&#44;020-1&#44;174&#59; p &#61; 0&#44;004&#41;&#44; &#237;ndice de Charlson &#40;&#967;<span class="elsevierStyleSup">2</span> &#61; 7&#44;28&#59; OR &#61; 1&#44;48&#59; IC del 95&#37;&#44; 1&#44;11-1&#44;99&#59; p &#61; 0&#44;007&#41;&#44; glucemia inicial &#40;&#967;<span class="elsevierStyleSup">2</span> &#61; 6&#44;05&#59; OR &#61; 1&#44;007&#59; IC del 95&#37;&#44; 1&#44;001-1&#44;014&#59; p &#61; 0&#44;014&#41;&#44; HbA1c &#40;&#967;<span class="elsevierStyleSup">2</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>5&#44;76&#59; OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;59&#59; IC del 95&#37;&#44; 0&#44;33-1&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;016&#41;&#44; VG &#40;&#967;<span class="elsevierStyleSup">2</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>4&#44;41&#59; OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#44;031&#59; IC del 95&#37; 1-1&#44;062&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;036&#41;&#44; necesidad de tratamiento con corticoides &#40;&#967;<span class="elsevierStyleSup">2</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>4&#44;03&#59; OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>3&#44;1&#59; IC del 95&#37;&#44; 1-9&#44;64&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;045&#41;&#44; administraci&#243;n de insulina programada &#40;&#967;<span class="elsevierStyleSup">2</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>3&#44;98&#59; OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;26&#59; IC del 95&#37;&#44; 0&#44;066-1&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;046&#41; y presi&#243;n arterial sist&#243;lica &#40;&#967;<span class="elsevierStyleSup">2</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#44;92&#59; OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;985&#59; IC del 95&#37;&#44; 0&#44;97-1&#44;003&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;088&#41;&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusi&#243;n</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Un incremento de glucemia inicial y de VG intrahospitalarias predice el riesgo de mortalidad en pacientes hospitalizados con DM&#46;</p></span>"
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            "titulo" => "Material y m&#233;todos"
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            "titulo" => "Conclusi&#243;n"
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      "en" => array:3 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Introduction</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">The objective was to assess the prognostic importance of various glycaemic control measures on hospital mortality&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Material and methods</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Retrospective&#44; analytical cohort study that included patients hospitalised in internal medicine departments with a diagnosis related to diabetes mellitus &#40;DM&#41;&#44; excluding acute decompensations&#46; The clinical endpoint was hospital mortality&#46; We recorded clinical&#44; analytical and glycaemic control-related variables &#40;scheduled insulin administration&#44; plasma glycaemia at admission&#44; HbA1c&#44; mean glycaemia &#40;MG&#41; and in-hospital glycaemic variability and hypoglycaemia&#41;&#46;</p><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">The measurement of hospital mortality predictors was performed using univariate and multivariate logistic regression&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Results</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">A total of 384 patients &#40;50&#46;3&#37; men&#41; were included&#46; The mean age was 78&#46;5 &#40;SD&#44; 10&#46;3&#41; years&#46; The DM-related diagnoses were type 2 diabetes &#40;83&#46;6&#37;&#41; and stress hyperglycaemia &#40;6&#46;8&#37;&#41;&#46; Thirty-one &#40;8&#46;1&#37;&#41; patients died while in hospital&#46;</p><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">In the multivariate analysis&#44; the best model for predicting mortality &#40;R<span class="elsevierStyleSup">2</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;326&#59; <span class="elsevierStyleItalic">P</span>&#60;&#46;0001&#41; consisted&#44; in order of importance&#44; of age &#40;&#967;<span class="elsevierStyleSup">2</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>8&#46;19&#59; OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#46;094&#59; 95&#37; CI 1&#46;020&#8211;1&#46;174&#59; <span class="elsevierStyleItalic">P</span>&#61;&#46;004&#41;&#44; Charlson index &#40;&#967;<span class="elsevierStyleSup">2</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>7&#46;28&#59; OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#46;48&#59; 95&#37; CI 1&#46;11&#8211;1&#46;99&#59; <span class="elsevierStyleItalic">P</span>&#61;&#46;007&#41;&#44; initial glycaemia &#40;&#967;<span class="elsevierStyleSup">2</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>6&#46;05&#59; OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#46;007&#59; 95&#37; CI 1&#46;001&#8211;1&#46;014&#59; <span class="elsevierStyleItalic">P</span>&#61;&#46;014&#41;&#44; HbA1c &#40;&#967;<span class="elsevierStyleSup">2</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>5&#46;76&#59; OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;59&#59; 95&#37; CI 0&#46;33&#8211;1&#59; <span class="elsevierStyleItalic">P</span>&#61;&#46;016&#41;&#44; glycaemic variability &#40;&#967;<span class="elsevierStyleSup">2</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>4&#46;41&#59; OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#46;031&#59; 95&#37; CI 1-1&#46;062&#59; <span class="elsevierStyleItalic">P</span>&#61;&#46;036&#41;&#44; need for corticosteroid treatment &#40;&#967;<span class="elsevierStyleSup">2</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>4&#46;03&#59; OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>3&#46;1&#59; 95&#37; CI 1&#8211;9&#46;64&#59; <span class="elsevierStyleItalic">P</span>&#61;&#46;045&#41;&#44; administration of scheduled insulin &#40;&#967;<span class="elsevierStyleSup">2</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>3&#46;98&#59; OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;26&#59; 95&#37; CI 0&#46;066&#8211;1&#59; <span class="elsevierStyleItalic">P</span>&#61;&#46;046&#41; and systolic blood pressure &#40;&#967;<span class="elsevierStyleSup">2</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#46;92&#59; OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;985&#59; 95&#37; CI 0&#46;97&#8211;1&#46;003&#59; <span class="elsevierStyleItalic">P</span>&#61;&#46;088&#41;&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusion</span><p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">An increase in initial glycaemia and in-hospital glycaemic variability predict the risk of mortality for hospitalised patients with DM&#46;</p></span>"
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          "es" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Comparaci&#243;n mediante curva ROC de la diferencia de poder predictivo de mortalidad de los modelos con &#40;pre&#95;4&#41; y sin &#40;pre&#95;3&#41; medidas relacionadas con el control gluc&#233;mico&#46;</p>"
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                  \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">Glucemia en mg&#47;dl &#40;n&#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">&#60; 140 &#40;105&#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">140-180 &#40;72&#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">141-250 &#40;94&#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">&#62; 250 &#40;85&#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">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" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Edad &#40;a&#241;os&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">78&#44;4 &#40;9&#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">78&#44;7 &#40;9&#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">78&#44;3 &#40;11&#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">78&#44;7&#40;11&#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">ns&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Sexo &#40;&#37; var&#243;n&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">56&#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">52&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">54&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">36&#44;5&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;017&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Insulina basal en domicilio &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">25&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">33&#44;8&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;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">26&#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">ns&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Mezclas o bolo-basal en domicilio &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">12&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7&#44;5&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;6&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  " align="left" valign="top"><span class="elsevierStyleItalic">Uso de insulina programada &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">51&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">63&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">48&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">81&#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;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  " align="left" valign="top"><span class="elsevierStyleItalic">Hipoglucemia &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">24&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">26&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">25&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">34&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">ns&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">&#205;ndice de Charlson &#40;puntos&#41;</span>&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;1 &#40;1&#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">2&#44;8 &#40;1&#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">2&#44;9 &#40;1&#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">2&#44;8 &#40;1&#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">ns&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Ayuno &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">12&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">15&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">17&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">27&#44;1&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;012&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Corticoides &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">30&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">40&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">35&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">34&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">ns&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">PAS inicial &#40;mmHg&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">137 &#40;25&#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">138 &#40;32&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">133 &#40;29&#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">136 &#40;32&#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">ns&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Saturaci&#243;n O2 inicial &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">94 &#40;4&#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">94 &#40;4&#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">92 &#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="left" valign="top">93 &#40;4&#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">ns&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Temperatura inicial &#40;&#176;C&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">36&#44;7 &#40;0&#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">36&#44;8 &#40;0&#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">36&#44;8 &#40;0&#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">37&#44;5 &#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">ns&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Filtrado glomerular &#40;ml&#47;min&#47;1&#44;73m</span><span class="elsevierStyleSup"><span class="elsevierStyleItalic">2</span></span><span class="elsevierStyleItalic">&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">49&#44;4 &#40;22&#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">49&#44;4 &#40;23&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">48&#44;3 &#40;22&#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">44&#44;4 &#40;22&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">ns&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="6" 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="6" align="left" valign="top"><span class="elsevierStyleItalic">Categor&#237;as filtrado glomerular &#40;&#37;&#41;</span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>&#8805; 60&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">33&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">27&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">29&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">25&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">ns&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>45-59&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">19&#44;4&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;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">20&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">17&#44;7&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  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>30-44&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">26&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">31&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">25&#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">27&#44;8&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  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>&#60; 30&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">20&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">18&#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">24&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">29&#44;1&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  " align="left" valign="top"><span class="elsevierStyleItalic">Sodio &#40;mEq&#47;l&#41;</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">139 &#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">138&#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">137&#40;7&#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">0&#44;012&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Hemoglobina &#40;g&#47;dl&#41;</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">11&#44;8 &#40;2&#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">12&#44;4 &#40;3&#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">12&#44;4 &#40;2&#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">ns&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Leucocitos &#40;n&#47;mm</span><span class="elsevierStyleSup"><span class="elsevierStyleItalic">3</span></span><span class="elsevierStyleItalic">&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10&#46;155 &#40;4&#46;678&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">11&#46;309 &#40;7&#46;286&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">13&#46;874 &#40;10&#46;050&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">12&#46;860 &#40;5834&#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;002&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Grupo total&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">77&#44;9 &#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">84&#44;8 &#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="left" valign="top">&#60; 0&#44;001&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">50&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">48&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">ns&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Hiperglucemia de estr&#233;s &#40;&#37;&#41;</span>&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;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7&#44;3&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;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">ns&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">27&#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">20&#44;7&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;05&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Mezclas o bolo-basal en domicilio &#40;&#37;&#41;</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">13&#44;8&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;4&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  " align="left" valign="top"><span class="elsevierStyleItalic">Utilizaci&#243;n insulina programada &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">56&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">62&#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">38&#44;7&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;011&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Hipoglucemia &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">27&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">26&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">32&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">ns&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">&#205;ndice de Charlson &#40;puntos&#41;</span>&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;9 &#40;1&#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">2&#44;8 &#40;1&#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">3&#44;5 &#40;1&#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">0&#44;047&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Ayuno &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">17&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">14&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">45&#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">&#60; 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  " align="left" valign="top"><span class="elsevierStyleItalic">Corticoides &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">34&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">32&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">54&#44;8&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;012&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Presi&#243;n arterial sist&#243;lica inicial &#40;mmHg&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">136 &#40;29&#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">137 &#40;29&#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">127 &#40;33&#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">0&#44;094&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Saturaci&#243;n O2 inicial &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">93&#44;4 &#40;5&#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">93&#44;4 &#40;5&#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">93&#44;1 &#40;5&#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">ns&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Temperatura inicial &#40;&#176;C&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">36&#44;9 &#40;2&#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">36&#44;9 &#40;2&#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">36&#44;9 &#40;0&#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">ns&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Filtrado glomerular &#40;ml&#47;min&#47;1&#44;73m</span><span class="elsevierStyleSup"><span class="elsevierStyleItalic">2</span></span><span class="elsevierStyleItalic">&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">47&#44;9 &#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">49&#44;2 &#40;22&#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">35&#44;3 &#40;16&#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">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="5" 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="5" align="left" valign="top"><span class="elsevierStyleItalic">Categor&#237;as filtrado glomerular</span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>&#8805; 60&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">29&#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">30&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">13&#44;3&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  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>45-59&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">20&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">20&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">16&#44;7&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  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>30-44&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">27&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">28&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">20&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  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>&#60; 30&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">23&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">20&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">50&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  " align="left" valign="top"><span class="elsevierStyleItalic">Sodio &#40;mEq&#47;l&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">138&#44;7 &#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">138&#44;4 &#40;7&#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">141&#44;3 &#40;12&#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">ns&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Hemoglobina &#40;g&#47;dl&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">12&#44;1 &#40;3&#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">12&#44;1 &#40;2&#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">12&#44;8 &#40;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">ns&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Leucocitos &#40;n&#47;mm</span><span class="elsevierStyleSup"><span class="elsevierStyleItalic">3</span></span><span class="elsevierStyleItalic">&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">12&#46;022 &#40;7&#46;337&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">11&#46;926 &#40;7&#46;439&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">13&#46;022 &#40;6&#46;183&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">ns&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="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">Grupo total&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">No fallecimiento&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">Fallecimiento&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">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" title="table-entry  " align="left" valign="top">Glucemia inicial &#40;mg&#47;dl&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">201 &#40;102&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">196 &#40;98&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">254 &#40;129&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;009&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">HbA1c &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7&#44;43 &#40;2&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7&#44;46 &#40;2&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7&#44;1 &#40;2&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">ns&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Glucemia media en ingreso &#40;mg&#47;dl&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">182 &#40;43&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">181 &#40;42&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">197 &#40;47&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;083&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Glucemia m&#225;xima en ingreso &#40;mg&#47;dl&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">302 &#40;82&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">302 &#40;82&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">322 &#40;82&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">ns&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Coeficiente variaci&#243;n en ingreso &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">30 &#40;11&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">30 &#40;10&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">32&#40;13&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">ns&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Variabilidad gluc&#233;mica ingreso &#40;mg&#47;dl&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">55&#44;8 &#40;23&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">55 &#40;23&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">62 &#40;23&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;084&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Glucemia primeras 24 h &#40;mg&#47;dl&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">204 &#40;78&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">202 &#40;78&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">224 &#40;68&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;060&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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                      "titulo" => "Impact of admission glycemic variability&#44; glucose and glycosylated hemoglobin on major adverse cardiac events after acute myocardial infarction"
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