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descriptivo&#44; retrospectivo y multic&#233;ntrico de 4 hospitales de la Comunidad de Madrid&#44; que prestan asistencia a poblaciones urbanas y rurales&#46; Se incluyeron todos aquellos pacientes fallecidos durante su ingreso&#46; No hubo criterios de exclusi&#243;n&#46; El periodo de estudio fue de 6 meses&#46; El estudio se realiz&#243; de acuerdo con los criterios de buena pr&#225;ctica cl&#237;nica y la Declaraci&#243;n de Helsinki<a class="elsevierStyleCrossRefs" href="#bib0235"><span class="elsevierStyleSup">16&#44;17</span></a>&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Se obtuvieron de las historias cl&#237;nicas las siguientes variables&#58; edad&#44; g&#233;nero&#44; tiempo de estancia hospitalaria&#44; procedencia del paciente &#40;instituci&#243;n&#47;residencia vs domicilio&#41;&#44; deterioro cognitivo &#40;seg&#250;n la escala <span class="elsevierStyleItalic">Clinical Dementia Rating</span>&#41;<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">18</span></a>&#44; comorbilidad &#40;&#237;ndice de Charlson ajustado a la edad&#58; ausencia de comorbilidad &#91;1-2 puntos&#93;&#44; comorbilidad leve &#91;3-4 puntos&#93;&#44; moderada &#91;5-6 puntos&#93;&#44; grave &#91;&#62;<span class="elsevierStyleHsp" style=""></span>7 puntos&#93;<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">19</span></a>&#41;&#44; criterios de terminalidad al ingreso &#40;seg&#250;n la Sociedad Espa&#241;ola de Cuidados Paliativos<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">20</span></a>&#41;&#44; motivo de ingreso y de fallecimiento&#46; Las medidas de LET analizadas fueron&#58; orden de no reanimaci&#243;n cardiopulmonar &#40;RCP&#41;&#44; ingreso en la unidad de cuidados intensivos&#44; uso de terapia renal sustitutiva&#44; transfusi&#243;n de hemoderivados&#44; realizaci&#243;n de alguna prueba diagn&#243;stica&#44; intervenciones quir&#250;rgicas&#44; nutrici&#243;n parenteral&#44; quimioterapia o radioterapia&#44; ventilaci&#243;n mec&#225;nica o intubaci&#243;n&#44; y la no realizaci&#243;n de &#171;medidas agresivas&#187;&#46; Solo se registraron aquellas &#243;rdenes que aparec&#237;an expl&#237;citas en las notas m&#233;dicas evolutivas&#46; Tambi&#233;n se recogi&#243; el tiempo transcurrido desde el ingreso hasta la orden de LET&#44; as&#237; como las medidas de sedaci&#243;n paliativa<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">1</span></a> y su duraci&#243;n&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">Los datos fueron analizados mediante SPSS&#44; versi&#243;n 17&#46;0 &#40;IBM Corp&#46;&#44; Armonk&#44; NY&#41;&#46; Se calcularon los intervalos de confianza al 95&#37; de la variable principal &#40;pauta de LET&#41;&#46; Las variables cualitativas se describieron mediante tablas de frecuencia &#40;porcentaje&#41; y las cuantitativas con la media y desviaci&#243;n est&#225;ndar&#46; Se analizaron las asociaciones entre las &#243;rdenes de LET&#44; abstenci&#243;n de RCP y sedaci&#243;n paliativa con las siguientes variables&#58; grado de demencia&#44; institucionalizaci&#243;n&#44; &#237;ndice de Charlson&#44; sexo y edad&#46; A efectos del an&#225;lisis&#44; el &#237;ndice de Charlson se categoriz&#243; utilizando como punto de corte la mediana &#40;8 puntos&#41;&#46; Asimismo&#44; el grado de demencia se agrup&#243; en 2 categor&#237;as&#58; ausente&#47;leve &#40;grados 0-1 de la escala <span class="elsevierStyleItalic">Clinical Dementia Rating</span>&#41; y demencia moderada&#47;grave &#40;grados 2-3&#41;&#46; Se calcularon las <span class="elsevierStyleItalic">odds ratio</span> &#40;OR&#41;&#44; sus intervalos de confianza y el nivel de significaci&#243;n utilizando para el contraste de hip&#243;tesis el test de la Chi cuadrado&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Resultados</span><p id="par0030" class="elsevierStylePara elsevierViewall">Se analizaron 382 pacientes&#44; cuya edad media fue de 85<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>10 a&#241;os&#59; 204 &#40;53&#44;4&#37;&#41; fueron mujeres &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a>&#41;&#46; La mayor&#237;a &#40;222&#44; 58&#44;1&#37;&#41; proced&#237;an del domicilio&#46; La estancia media del ingreso fue de 11<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>13 d&#237;as&#46; El 43&#44;2&#37; ten&#237;a demencia moderada-grave&#44; el 95&#44;5&#37; comorbilidad al menos moderada y el 51&#44;1&#37; presentaba criterios de terminalidad&#46; Hubo 39 &#40;10&#44;3&#37;&#41; muertes inesperadas&#44; entendidas como aquellas en las que no exist&#237;an comentarios indicativos de fallecimiento inminente en las notas m&#233;dicas y de enfermer&#237;a durante los d&#237;as previos&#46; Otras caracter&#237;sticas generales demogr&#225;ficas y cl&#237;nicas de la muestra se describen en la <a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a>&#46; Las causas de ingreso y de fallecimiento se indican en la <a class="elsevierStyleCrossRef" href="#tbl0010">tabla 2</a>&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0035" class="elsevierStylePara elsevierViewall">En 318 pacientes &#40;83&#44;7&#37;&#59; IC 95&#37;&#58; 79&#44;3-87&#44;1&#41; se estableci&#243; alguna medida de LET&#44; en 254 &#40;66&#44;5&#37;&#41; 2 y en 116 &#40;30&#44;4&#37;&#41; al menos 3&#46; Destacaron por su prevalencia las &#243;rdenes de LET sobre RCP&#44; medidas invasivas&#44; ingreso en UCI&#44; nutrici&#243;n parenteral&#44; antibioterapia&#44; pruebas diagn&#243;sticas y tratamiento quir&#250;rgico &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">tabla 3</a>&#41;&#46; El tiempo medio desde el ingreso hasta la toma de decisiones de LET fue de 78<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>18<span class="elsevierStyleHsp" style=""></span>horas tras el ingreso &#40;en el caso de &#171;no RCP&#187; de 85<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>222<span class="elsevierStyleHsp" style=""></span>h&#41;&#46; Se paut&#243; sedaci&#243;n terminal en 178 pacientes &#40;47&#44;6&#37;&#41;&#44; con una duraci&#243;n media hasta el fallecimiento de 38<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>45<span class="elsevierStyleHsp" style=""></span>horas&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0040" class="elsevierStylePara elsevierViewall">La <a class="elsevierStyleCrossRef" href="#tbl0020">tabla 4</a> recoge la asociaci&#243;n de la medida de LET&#44; la decisi&#243;n de &#171;no RCP&#187; y la aplicaci&#243;n de sedaci&#243;n paliativa&#44; con el grado de demencia&#44; la institucionalizaci&#243;n&#44; el &#237;ndice de Charlson&#44; el sexo y la edad de los pacientes&#46; Solo se observ&#243; asociaci&#243;n estad&#237;sticamente significativa entre la orden de &#171;no RCP&#187; y la presencia de demencia moderada o grave &#40;OR 1&#44;73&#59; IC 95&#37;&#58; 1&#44;03-2&#44;91&#59; X<span class="elsevierStyleSup">2</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>4&#44;33&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;03&#41;&#46;</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Discusi&#243;n</span><p id="par0045" class="elsevierStylePara elsevierViewall">Este estudio muestra que m&#225;s del 80&#37; de los pacientes fallecidos en &#225;reas de hospitalizaci&#243;n de medicina interna recibieron alguna medida de LET&#46; En general&#44; fueron sujetos de edad avanzada&#44; con comorbilidad elevada&#44; deterioro cognitivo y enfermedad terminal&#46; En ocasiones esta decisi&#243;n se refleja en la historia cl&#237;nica de forma poco concreta&#44; con expresiones como &#171;no realizar medidas agresivas&#187;&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">En nuestro entorno hay pocos trabajos que aborden la LET en servicios de medicina interna&#46; El estudio de Sol&#237;s et al&#46; se centr&#243; en las &#243;rdenes de &#171;no RCP&#187; en un hospital comarcal<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">14</span></a>&#46; Las caracter&#237;sticas basales de la poblaci&#243;n fueron similares a las del presente estudio&#44; salvo por una mayor proporci&#243;n de pacientes oncol&#243;gicos&#46; Sin embargo&#44; la documentaci&#243;n de &#243;rdenes de &#171;no RCP&#187; fue inferior a la de este estudio &#40;66&#37; frente al 76&#37;&#44; respectivamente&#41;<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">14</span></a>&#46; Por otra parte&#44; recientemente se comunicaron los datos de 1&#46;457 pacientes incluidos en el estudio Atenci&#243;n en sus &#218;ltimos D&#237;as de Vida a los pacientes en los servicios de Medicina Interna &#40;UDVIMI&#41;&#44; a&#250;n pendientes de publicaci&#243;n<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">21</span></a>&#46; Los resultados han sido an&#225;logos a los de este estudio&#44; aunque existen algunas diferencias&#44; como un porcentaje menor de los exitus esperables &#40;62&#37; frente a 90&#37;&#41;&#44; un tiempo mayor desde el ingreso hasta la sedaci&#243;n &#40;5 frente a 1&#44;5 d&#237;as&#41; y menor hasta el exitus &#40;7 frente a 11 d&#237;as&#41;&#46; Estas diferencias probablemente se expliquen&#44; adem&#225;s de por el diferente tama&#241;o muestral&#44; por el tiempo de duraci&#243;n de la inclusi&#243;n&#46; En el trabajo UDVIMI se incluyeron los 10 primeros pacientes fallecidos en servicios de medicina interna de cada centro a partir del 1 de diciembre de 2015&#44; momento de mayor carga asistencial del periodo invernal&#44; mientras que en el presente estudio la inclusi&#243;n se hizo durante un periodo de 6 meses<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">22</span></a>&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">De acuerdo con la definici&#243;n de la Sociedad Espa&#241;ola de Cuidados Paliativos&#44; m&#225;s de la mitad de los pacientes del presente estudio cumpl&#237;a criterios de enfermedad terminal al ingreso&#46; Sin embargo&#44; el tiempo transcurrido hasta la LET y la orden de &#171;no RCP&#187; fue elevado &#40;78 y 85<span class="elsevierStyleHsp" style=""></span>h&#44; respectivamente&#41;&#46; La mayor parte de los enfermos terminales que ingresan en medicina interna lo hacen por enfermedades no oncol&#243;gicas&#44; lo que puede llevar a demorar la identificaci&#243;n del proceso como terminal<a class="elsevierStyleCrossRefs" href="#bib0270"><span class="elsevierStyleSup">23&#44;24</span></a>&#46; El retraso en el diagn&#243;stico y el tratamiento paliativo en estos pacientes puede explicarse por la dificultad que supone consensuar los cuidados al final de la vida con los pacientes y sus familiares&#44; por la falta de formaci&#243;n en habilidades de comunicaci&#243;n y en cuidados paliativos &#40;es esencial identificar al paciente terminal no oncol&#243;gico&#41;&#44; por la sobrecarga de trabajo y por la fragmentaci&#243;n de la continuidad asistencial<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">25</span></a>&#46; Aunque este estudio se centra en el &#225;mbito hospitalario&#44; es importante la actuaci&#243;n de la atenci&#243;n primaria en estos pacientes&#46; En ocasiones&#44; tanto los pacientes como los familiares prefieren el medio hospitalario para los &#250;ltimos d&#237;as de su vida&#44; mientras que otros prefieren morir en casa<a class="elsevierStyleCrossRef" href="#bib0285"><span class="elsevierStyleSup">26</span></a>&#46; Por ello&#44; se requiere una mayor coordinaci&#243;n entre AP y especializada&#44; y promover los cuidados paliativos domiciliarios<a class="elsevierStyleCrossRef" href="#bib0290"><span class="elsevierStyleSup">27</span></a>&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">En el presente trabajo la presencia de demencia en grado al menos moderado aument&#243; un 73&#37; la probabilidad de que se pautase la orden de &#171;no RCP&#187;&#46; A diferencia de este estudio&#44; otros han mostrado una asociaci&#243;n de la decisi&#243;n de LET con la procedencia del paciente &#40;residencia o domicilio&#41;<a class="elsevierStyleCrossRef" href="#bib0295"><span class="elsevierStyleSup">28</span></a> y la edad<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">29</span></a>&#46; Otros aspectos relevantes&#44; no analizados en nuestro estudio&#44; son el grado sociocultural<a class="elsevierStyleCrossRef" href="#bib0305"><span class="elsevierStyleSup">30</span></a> y la persona que acuerda la decisi&#243;n sobre la LET&#44; sea el paciente o la familia<a class="elsevierStyleCrossRef" href="#bib0310"><span class="elsevierStyleSup">31</span></a>&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">En cuanto a las limitaciones del estudio se debe comentar que se trata de una ampliaci&#243;n de un estudio previo<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">15</span></a>&#44; por lo que las fechas de recogida de datos son distintas para cada uno de los centros&#46; Se han mantenido los mismos meses en todos los a&#241;os para evitar la posible variabilidad estacional&#46; Otra limitaci&#243;n es la inclusi&#243;n solo de pacientes fallecidos&#46; Posiblemente los pacientes con enfermedad terminal a los que se da de alta tengan tambi&#233;n medidas de LET y sus caracter&#237;sticas cl&#237;nicas sean diferentes&#46; Otras limitaciones son sesgos inherentes al car&#225;cter retrospectivo del estudio&#46; No obstante&#44; en relaci&#243;n con la posible falta de uniformidad en la identificaci&#243;n de las distintas variables recogidas&#44; como las medidas de LET&#44; el equipo investigador se reuni&#243; varias veces para clarificar su definici&#243;n&#46; Tambi&#233;n debe se&#241;alarse que no se pudo obtener informaci&#243;n fidedigna sobre cu&#225;l fue el motivo concreto sobre el que se bas&#243; el cl&#237;nico para adoptar medidas de LET&#46; Por &#250;ltimo&#44; no se recogieron las combinaciones farmacol&#243;gicas administradas en la sedaci&#243;n por no disponer de las hojas de tratamiento de los pacientes fallecidos en la mayor&#237;a de los centros&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">En conclusi&#243;n&#44; se puede afirmar que la prescripci&#243;n de medidas de LET es muy frecuente en los pacientes que fallecen en servicios de medicina interna&#44; siendo las m&#225;s prevalentes la orden de &#171;no RCP&#187; y la expresi&#243;n poco concreta de &#171;no usar medidas agresivas&#187;&#46; Es necesario mejorar la formaci&#243;n en cuidados paliativos&#44; en bio&#233;tica y en habilidades de comunicaci&#243;n en el final de la vida&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Conflicto de intereses</span><p id="par0075" class="elsevierStylePara elsevierViewall">Los autores declaran no tener ning&#250;n conflicto de intereses&#46;</p></span></span>"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Introducci&#243;n</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Existe escasa informaci&#243;n sobre la limitaci&#243;n del esfuerzo terap&#233;utico &#40;LET&#41; en pacientes ingresados en unidades de hospitalizaci&#243;n de medicina interna&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Objetivos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Describir las pautas de LET indicadas en los servicios de medicina interna y las caracter&#237;sticas de los pacientes que las reciben&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Pacientes y m&#233;todos</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Estudio observacional descriptivo y retrospectivo de 4 hospitales de la Comunidad de Madrid&#46; Se recogieron datos demogr&#225;ficos&#44; de comorbilidad y las &#243;rdenes de LET pautadas en todos los pacientes fallecidos en un periodo de 6 meses&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Resultados</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Se incluyeron 382 pacientes cuya edad media fue de 85<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>10 a&#241;os&#59; 204 eran mujeres &#40;53&#44;4&#37;&#41; y 222 &#40;58&#44;1&#37;&#41; proced&#237;an de su domicilio&#46; El 51&#44;1&#37; eran enfermos terminales&#44; el 43&#44;2&#37; ten&#237;an demencia moderada&#47;grave y el 95&#44;5&#37; presentaban comorbilidad al menos moderada&#46; En 318 pacientes &#40;83&#44;7&#37;&#41; se realiz&#243; alg&#250;n tipo de LET&#44; siendo las m&#225;s frecuentes las &#243;rdenes de &#171;no reanimaci&#243;n cardiopulmonar&#187; &#40;292 enfermos&#44; 76&#44;4&#37;&#59; IC 95&#37;&#58; 72&#44;1-80&#44;8&#41;&#44; &#171;no usar medidas agresivas&#187; &#40;113 pacientes&#44; 16&#44;4&#37;&#59; IC 95&#37;&#58; 13&#44;7-19&#44;4&#41; y &#171;no ingresar en unidad de cuidados intensivos&#187; &#40;102 casos&#44; 14&#44;8&#37;&#59; IC 95&#37;&#58; 12&#44;3-17&#44;7&#41;&#46;</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Conclusiones</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">La LET es muy frecuente en los pacientes que fallecen en medicina interna&#46; Las pautas m&#225;s utilizadas son &#171;no reanimaci&#243;n cardiopulmonar&#187; y la expresi&#243;n poco concreta de &#171;no usar medidas agresivas&#187;&#46; Los pacientes son de edad avanzada&#44; con importante comorbilidad&#44; enfermedad terminal y demencia avanzada&#46;</p></span>"
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        "resumen" => "<span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Introduction</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">There is little information on the limitation of therapeutic effort &#40;LTE&#41; in patients admitted to hospital internal medicine units&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Objectives</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">To describe the indicated LTE regimens in the departments of internal medicine and the characteristics of the patients who undergo them&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Patients and methods</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">An observational&#44; descriptive retrospective study was conducted on 4 hospitals of the Community of Madrid&#46; The study collected demographic and comorbidity data and the LTE orders prescribed for all patients who died during a period of 6 months&#46;</p></span> <span id="abst0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Results</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">The study included 382 patients with a mean age of 85<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>10 years&#59; 204 were women &#40;53&#46;4&#37;&#41; and 222 &#40;58&#46;1&#37;&#41; came from their homes&#46; Some 51&#46;1&#37; of the patients were terminal&#44; 43&#46;2&#37; had moderate to severe dementia&#44; and 95&#46;5&#37; presented at least moderate comorbidity&#46; Some type of LTE was performed in 318 patients &#40;83&#46;7&#37;&#41;&#59; the most common orders were &#8220;No cardiopulmonary resuscitation&#8221; &#40;292 patients&#44; 76&#46;4&#37;&#59; 95&#37; CI 72&#46;1-80&#46;8&#41;&#44; &#8220;Do not use aggressive measures&#8221; &#40;113 patients&#44; 16&#46;4&#37;&#59; 95&#37; CI 13&#46;7-19&#46;4&#41; and &#8220;Do not transfer to an intensive care unit&#8221; &#40;102 cases&#44; 14&#46;8&#37;&#44; 95&#37; CI 12&#46;3-17&#46;7&#41;&#46; Some type of LTE was performed in 318 patients &#40;83&#46;7&#37;&#41;&#59; the most common orders were &#8220;No cardiopulmonary resuscitation&#8221; &#40;292 patients&#44; 76&#46;4&#37;&#59; 95&#37; CI 72&#46;1-80&#46;8&#41;&#44; &#8220;Do not use aggressive measures&#8221; &#40;113 patients&#44; 16&#46;4&#37;&#59; 95&#37; CI 13&#46;7-19&#46;4&#41; and &#8220;Do not transfer to an intensive care unit&#8221; &#40;102 cases&#44; 14&#46;8&#37;&#44; 95&#37; CI 12&#46;3-17&#46;7&#41;&#46;</p></span> <span id="abst0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Conclusions</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">LTE is common among patients who die in Internal Medicine&#46; The most widely used regimens were &#8220;No CPR&#8221; and the unspecific statement &#8220;Do not use aggressive measures&#8221;&#46; The patients were elderly and had significant comorbidity&#44; terminal illness and advanced dementia&#46;</p></span>"
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        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0030">El estudio forma parte del proyecto de tesis doctoral de Rebeca Garc&#237;a Caballero&#46;</p>"
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          "leyenda" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Los resultados se expresan como n &#40;&#37;&#41; o como media<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>desviaci&#243;n est&#225;ndar&#46;</p><p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">LET&#58; limitaci&#243;n del esfuerzo terap&#233;utico&#59; RCP&#58; reanimaci&#243;n cardiopulmonar&#46;</p>"
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                  \t\t\t\t</th><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</td><td class="td" title="table-entry  " align="left" valign="top">11<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>13&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="2" 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="2" align="left" valign="top"><span class="elsevierStyleItalic">Lugar de residencia</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>Institucionalizado&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>Domicilio&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">147 &#40;38&#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"><span class="elsevierStyleHsp" style=""></span>Leve&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;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"><span class="elsevierStyleHsp" style=""></span>Moderada&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;15&#41;&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">109 &#40;29&#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"><span class="elsevierStyleHsp" style=""></span>Desconocido&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="2" 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="2" align="left" valign="top"><span class="elsevierStyleItalic">Comorbilidad</span><a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a></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>Ausente&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>Leve&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;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"><span class="elsevierStyleHsp" style=""></span>Moderada&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">101 &#40;27&#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"><span class="elsevierStyleHsp" style=""></span>Grave&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="2" 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">Paciente terminal</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">193 &#40;51&#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"><span class="elsevierStyleItalic">Muerte inesperada</span>&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="elsevierStyleItalic">Tiempo desde el ingreso hasta la orden de &#171;no RCP&#187;&#44; horas</span>&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="elsevierStyleItalic">Tiempo desde el ingreso hasta la LET&#44; horas</span>&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="elsevierStyleItalic">Tiempo desde la LET hasta que se pauta la sedaci&#243;n&#44; horas</span>&nbsp;\t\t\t\t\t\t\n
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              "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Seg&#250;n el &#237;ndice de Charlson ajustado por edad&#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">Causas de ingreso&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 &#40;&#37;&#41;&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">126 &#40;33&#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">Infecci&#243;n respiratoria&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">132 &#40;34&#44;5&#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">Insuficiencia card&#237;aca&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">Insuficiencia card&#237;aca&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;15&#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">Infecci&#243;n tracto urinario&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">C&#225;ncer&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">34 &#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">Otras infecciones&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">Infecci&#243;n tracto urinario&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">Accidente cerebrovascular agudo&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">Accidente cerebrovascular agudo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">27 &#40;7&#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">Insuficiencia renal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">12 &#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">Otras infecciones&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">23 &#40;6&#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 hepatobiliar&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">11 &#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">Cardiopat&#237;a isqu&#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">16 &#40;4&#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">Cardiopat&#237;a isqu&#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">7 &#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">Tromboembolia pulmonar&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9 &#40;2&#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">Tromboembolia pulmonar&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;50&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Otros&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">53 &#40;13&#44;8&#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&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">66 &#40;17&#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><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
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          "es" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Causas de ingreso y fallecimiento de los pacientes incluidos</p>"
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          "leyenda" => "<p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">RCP&#58; reanimaci&#243;n cardiopulmonar&#59; UCI&#58; unidad de cuidados intensivos&#46;</p>"
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                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">&#211;rdenes&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 &#40;&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0030"><span class="elsevierStyleSup">a</span></a>&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">IC 95&#37;&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">No RCP&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">292 &#40;76&#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">72&#44;1-80&#44;8&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">No medidas agresivas&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">113 &#40;16&#44;45&#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&#44;8-19&#44;4&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">No ingreso en UCI&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">102 &#40;14&#44;85&#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;3-17&#44;7&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">No nutrici&#243;n parenteral&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">60 &#40;8&#44;73&#41;&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;7-11&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">No antibioterapia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">40 &#40;5&#44;82&#41;&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;2-7&#44;8&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">No realizaci&#243;n de pruebas diagn&#243;sticas&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;09&#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;6-7&#44;0&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">No tratamiento quir&#250;rgico&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">34 &#40;4&#44;95&#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;5-6&#44;8&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">No terapia renal sustitutiva&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">17 &#40;2&#44;47&#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;4-3&#44;9&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">No transfusi&#243;n de hemoderivados&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">11 &#40;1&#44;60&#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;80-2&#44;8&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">No quimio o radioterapia&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;46&#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;70-2&#44;7&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">No ventilaci&#243;n&#47;intubaci&#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">5 &#40;0&#44;73&#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;23-1&#44;7&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">Otras&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&#44;15&#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;00-0&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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              "identificador" => "tblfn0030"
              "etiqueta" => "a"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0015">Un paciente puede tener varias &#243;rdenes prescritas&#46;</p>"
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        "descripcion" => array:1 [
          "es" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">&#211;rdenes de limitaci&#243;n del esfuerzo terap&#233;utico pautadas</p>"
        ]
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      3 => array:8 [
        "identificador" => "tbl0020"
        "etiqueta" => "Tabla 4"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at4"
            "detalle" => "Tabla "
            "rol" => "short"
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        ]
        "tabla" => array:3 [
          "leyenda" => "<p id="spar0090" class="elsevierStyleSimplePara elsevierViewall">IC&#58; intervalo de confianza&#59; LET&#58; limitaci&#243;n del esfuerzo terap&#233;utico&#59; OR&#58; <span class="elsevierStyleItalic">odds ratio</span>&#59; RCP&#58; reanimaci&#243;n cardiopulmonar&#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="left" valign="top" scope="col" style="border-bottom: 2px solid black">Asociaciones&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">OR&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">IC 95&#37;&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">X<span class="elsevierStyleSup">2</span>&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  " colspan="5" align="left" valign="top"><span class="elsevierStyleItalic">Entre orden de LET y&#58;</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>Grado de demencia<a class="elsevierStyleCrossRef" href="#tblfn0020"><span class="elsevierStyleSup">a</span></a>&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;97&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;55-1&#44;72&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;008&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;93&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>Institucionalizaci&#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">0&#44;77&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;43-1&#44;36&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;79&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;37&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>&#205;ndice de Charlson<a class="elsevierStyleCrossRef" href="#tblfn0025"><span class="elsevierStyleSup">b</span></a>&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;18&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;66-2&#44;09&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;33&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;56&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>Sexo&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;00&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;58-1&#44;74&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><td class="td" title="table-entry  " align="left" valign="top">0&#44;97&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>Edad&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">U de Mann-Whitney&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;97&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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            1 => 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="left" valign="top" scope="col" style="border-bottom: 2px solid black">Asociaciones&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">OR&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">IC 95&#37;&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">X<span class="elsevierStyleSup">2</span>&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  " colspan="5" align="left" valign="top"><span class="elsevierStyleItalic">Entre orden de no RCP y&#58;</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>Grado de demencia<a class="elsevierStyleCrossRef" href="#tblfn0020"><span class="elsevierStyleSup">a</span></a>&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;73&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;03-2&#44;91&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;33&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;03&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Institucionalizaci&#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">0&#44;96&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;57-1&#44;60&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;02&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;88&nbsp;\t\t\t\t\t\t\n
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                  "contribucion" => array:1 [
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                          "etal" => false
                          "autores" => array:6 [
                            0 => "B&#46; Herreros"
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                  "contribucion" => array:1 [
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                            0 => "A&#46;L&#46; Trujillo-Cari&#241;o"
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                            2 => "E&#46; Ver&#225;stegui-Avil&#233;s"
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                    0 => array:1 [
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                        "tituloSerie" => "GAMO"
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                          "etal" => true
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                      "doi" => "10.1016/j.annfar.2014.04.007"
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