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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introducci&#243;n</span><p id="par0010" class="elsevierStylePara elsevierViewall">La fractura de cadera es uno de los diagn&#243;sticos m&#225;s prevalentes en los departamentos de Traumatolog&#237;a y es una de las entidades traum&#225;ticas m&#225;s frecuentes en el anciano&#46; En Espa&#241;a&#44; en los &#250;ltimos a&#241;os&#44; la poblaci&#243;n de edad superior a los 65 a&#241;os ha crecido considerablemente&#44; desde el 14&#44;92&#37; en 1997 al 16&#44;62&#37; en el 2008&#44; y se espera un crecimiento similar para los pr&#243;ximos a&#241;os&#46; La incidencia de la fractura de cadera en Espa&#241;a&#44; en 2008&#44; fue de 103&#44;76 casos por 100&#46;000 habitantes&#44; un 17&#44;77&#37; m&#225;s que la registrada en 1997&#44; lo que muestra una tasa de crecimiento interanual del 1&#44;5&#37;&#46; Este crecimiento estuvo acompa&#241;ado por un aumento en la edad del paciente&#58; la media de edad de los pacientes que fueron atendidos fue de 78&#44;07 a&#241;os &#40;80&#44;13 a&#241;os para las mujeres&#44; 72&#44;08 a&#241;os para los hombres&#41;&#59; mientras que en 2008 esta fue de 80&#44;46 a&#241;os &#40;82&#44;13 para las mujeres&#59; 75&#44;71 para los hombres&#41;&#46; La fractura de cadera se asocia con una elevada prevalencia de morbimortalidad&#44; con una tasa de mortalidad anual que oscila entre el 20 y el 25&#37;<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">1</span></a>&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">El tratamiento tras la fractura es prolongado&#44; con una tasa de recuperaci&#243;n variable que exige un amplio apoyo por parte de m&#250;ltiples especialidades m&#233;dicas<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">2</span></a>&#46; Por todo ello&#44; la fractura de cadera ha ganado importancia en la sociedad&#44; tanto en t&#233;rminos econ&#243;micos como sociales&#44; que afecta directamente a los que la sufren e indirectamente a las estructuras que lo sostienen&#46; As&#237;&#44; en Espa&#241;a se estiman unos costes asociados con la fractura de cadera de alrededor a 395&#44;7 millones de euros<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">1</span></a> y en Estados Unidos de 9&#46;000&#160;millones de d&#243;lares<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">3</span></a>&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Debido a la magnitud actual del problema y de su aumento en el futuro&#44; resulta necesario protocolizar los modelos de cuidado y proporcionar una aproximaci&#243;n orientada a la poblaci&#243;n anciana con el fin de responder a sus necesidades espec&#237;ficas&#44; tanto de fragilidad como de multimorbilidad&#46; Existen experiencias previas de dichos protocolos estandarizados que se han demostrado beneficiosos en la atenci&#243;n de la fractura de cadera<a class="elsevierStyleCrossRefs" href="#bib0165"><span class="elsevierStyleSup">4-7</span></a>&#46; Estos modelos se basan en equipos multidisciplinares&#44; en los que cirujanos ortop&#233;dicos e internistas&#47;geriatras comparten una atenci&#243;n integral e individualizada de esta poblaci&#243;n con necesidades cl&#237;nicas especiales&#46; As&#237;&#44; el papel del especialista en Medicina Interna est&#225; creciendo como consecuencia de la gran morbilidad observada en estos pacientes&#46; Antes de estos modelos de comanejo&#44; el cuidado m&#233;dico de dichos pacientes se realizaba siguiendo los criterios del Departamento de Traumatolog&#237;a&#44; con una respuesta variable del departamento m&#233;dico&#44; normalmente&#44; una vez aparecidas las complicaciones&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">El objetivo de este estudio es demostrar el efecto de un modelo de comanejo entre los departamentos de Traumatolog&#237;a y Medicina Interna&#44; en pacientes ancianos con fractura de cadera&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Material y m&#233;todos</span><p id="par0030" class="elsevierStylePara elsevierViewall">Se dise&#241;&#243; un estudio de cohortes retrospectivas para pacientes de m&#225;s de 65 a&#241;os de edad hospitalizados con fractura de cadera&#46; La cohorte hist&#243;rica &#40;HIST&#41; incluy&#243; a aquellos pacientes ingresados entre enero de 2005 y agosto de 2006&#59; y la cohorte de comanejo &#40;COFRAC&#41; entre enero de 2008 y agosto de 2010&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Se evalu&#243; la incidencia de las complicaciones m&#233;dicas&#44; la mortalidad acontecida durante el ingreso&#44; as&#237; como el n&#250;mero de visitas a urgencias&#44; reingresos y mortalidad a los 30 d&#237;as tras el alta&#46; Adem&#225;s&#44; analizamos las caracter&#237;sticas demogr&#225;ficas del paciente y de su cuidador&#44; las caracter&#237;sticas cl&#237;nicas del paciente&#44; de la fractura y de su intervenci&#243;n quir&#250;rgica&#46; Se realiz&#243; un an&#225;lisis estad&#237;stico utilizando la prueba del chi-cuadrado para las variables cualitativas y el test Anova para las cuantitativas&#46; Se emple&#243; el paquete estad&#237;stico SPSS en su versi&#243;n 20&#46;0&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Resultados</span><p id="par0040" class="elsevierStylePara elsevierViewall">Se incluy&#243; a un total de 701 pacientes&#44; de los cuales 471 compon&#237;an la cohorte HIST y 230 la cohorte COFRAC&#46; Las caracter&#237;sticas demogr&#225;ficas y cl&#237;nicas mostraron diferencias en cuanto a la identificaci&#243;n de la pluripatolog&#237;a&#44; los d&#233;ficits motores&#44; arritmia diferente a fibrilaci&#243;n auricular&#44; osteoporosis y uso cr&#243;nico de f&#225;rmacos &#40;ver <a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a>&#41;&#46; No se encontraron diferencias entre cohortes en cuanto a las caracter&#237;sticas relacionadas con la fractura de cadera&#44; anestesia y cirug&#237;a &#40;ver <a class="elsevierStyleCrossRef" href="#tbl0010">tabla 2</a>&#41;&#46; En la <a class="elsevierStyleCrossRef" href="#tbl0015">tabla 3</a> se muestran las complicaciones hospitalarias&#44; con diferencias en cuanto a mortalidad&#44; estre&#241;imiento&#44; anemia y control de la funci&#243;n renal&#44; con una mayor utilizaci&#243;n de transfusiones de sangre y fluidoterapia intravenosa en la cohorte COFRAC&#46; No hubo diferencias estad&#237;sticas relativas a la presencia de delirium&#44; si bien fue m&#225;s diagnosticado en la COFRAC&#46; Se identific&#243; un cambio importante en el manejo de la analgesia en COFRAC&#44; con mayor uso de morfina&#44; bifosfonatos y suplementos de calcio-vitamina D y un menor empleo de petidina y f&#225;rmacos antiinflamatorios no esteroideos&#46; No hubo diferencia en la duraci&#243;n del ingreso entre las cohortes HIST y COFRAC&#46; En cuanto al impacto cl&#237;nico para los pacientes&#44; COFRAC mostr&#243; una menor mortalidad&#44; sin diferencias a los 30 d&#237;as tras el alta hospitalaria &#40;ver <a class="elsevierStyleCrossRef" href="#tbl0020">tabla 4</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><elsevierMultimedia ident="tbl0020"></elsevierMultimedia></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Discusi&#243;n</span><p id="par0045" class="elsevierStylePara elsevierViewall">La fractura de cadera es un acontecimiento relevante para los pacientes ancianos y con multimorbilidad&#46; Es una causa importante de incapacidad y de deterioro de la calidad de vida para estos pacientes fr&#225;giles&#44; que requiere un a&#241;o completo para recuperar el 60&#37; de la movilidad&#44; el 50&#37; de las actividades diarias b&#225;sicas y el 30&#37; de la actividad instrumental<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">8</span></a>&#46; Adem&#225;s&#44; la mortalidad despu&#233;s de la fractura de cadera sigue siendo significativa&#58; es del 11-23&#37; a los 6 meses tras la lesi&#243;n y del 22-29&#37; al a&#241;o<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">9</span></a>&#46; Se ha propuesto el comanejo para mejorar y optimizar los resultados de la fractura de cadera&#46; El comanejo permite una evaluaci&#243;n exhaustiva preoperatoria de las comorbilidades&#44; el manejo de la polimedicaci&#243;n&#44; as&#237; como la detecci&#243;n temprana de complicaciones como el delirium&#44; y se centra en no retrasar el tiempo para la cirug&#237;a desde el ingreso<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">10</span></a>&#46; Este modelo organizado de atenci&#243;n de fracturas geri&#225;tricas en comanejo con los geriatras ha dado como resultado un ahorro significativo en los costes durante un per&#237;odo de 50 meses&#44; acompa&#241;ado de una mejora de la calidad asociada<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">11</span></a>&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">Los principios del comanejo de la fractura de cadera fueron definidos por Mendelson y Friedman<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">12</span></a> de la siguiente manera&#58; 1&#41; la mayor&#237;a de los pacientes se benefician de la estabilizaci&#243;n quir&#250;rgica de su fractura&#44; ya que aliviar&#225; el dolor&#44; mejorar&#225; la movilidad y la funci&#243;n&#44; reducir&#225; la p&#233;rdida de sangre&#44; reducir&#225; la mortalidad y disminuir&#225; la institucionalizaci&#243;n en el alta&#46; 2&#41; Cuanto m&#225;s pronto sean intervenidos los pacientes&#44; menos tiempo dispondr&#225;n para desarrollar una enfermedad iatrog&#233;nica&#44; tales como delirium&#44; dolor&#44; neumon&#237;a&#44; &#250;lcera por presi&#243;n&#44; malnutrici&#243;n&#44; infecci&#243;n de orina y tromboembolia&#44; debilidad f&#237;sica y ca&#237;das y lesiones adicionales&#46; Esta agilidad en la actuaci&#243;n aumentar&#225; la satisfacci&#243;n del paciente&#44; de la familia y del personal&#44; y reducir&#225; los costes y la mortalidad&#46; 3&#41; El comanejo con comunicaci&#243;n cercana entre profesionales evita complicaciones m&#233;dicas y funcionales comunes&#46; Es necesario un verdadero sistema de colaboraci&#243;n interdisciplinario totalmente coordinado en el que la informaci&#243;n&#44; la toma de decisiones y la responsabilidad sea compartida por todos por igual y en el que la comunicaci&#243;n sea diaria&#59; cada disciplina emite por escrito &#243;rdenes y notas y se comunica con el paciente y con el equipo de atenci&#243;n del paciente&#46; Este modelo pionero fue desarrollado por el Geriatric Fracture Center<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">13</span></a>&#46; 4&#41; Los protocolos estandarizados reducen la variabilidad injustificada&#46; De esta manera&#44; la variabilidad es espec&#237;fica del paciente y est&#225; justificada en vez de ser aleatoria o estar basada en las preferencias del proveedor o de factores propios del sistema&#46; La estandarizaci&#243;n de los pedidos de material&#44; de los protocolos y de los planes de atenci&#243;n de enfermer&#237;a mejoran la calidad y contienen los costes&#44; ya que permite emplear medicamentos gen&#233;ricos de menor precio y hace posible alcanzar acuerdos favorables con los proveedores de implantes&#59; adem&#225;s&#44; la duraci&#243;n del ingreso se reduce y decrece el uso de servicios adicionales ya que evita las complicaciones y los reingresos<a class="elsevierStyleCrossRefs" href="#bib0200"><span class="elsevierStyleSup">11&#44;14&#44;15</span></a>&#46; 5&#41; La planificaci&#243;n del alta hospitalaria comienza en el ingreso&#46; Si el comanejo es eficaz&#44; la estancia hospitalaria ser&#225; m&#225;s corta y se dispondr&#225; de un breve per&#237;odo de tiempo para desarrollar un plan integral de alta&#46; La evaluaci&#243;n de las necesidades del alta y la comunicaci&#243;n y coordinaci&#243;n con la familia del paciente o con la entidad de apoyo en el momento del ingreso puede evitar retrasos en el alta y reducir las situaciones de temor&#46; Los resultados de nuestro estudio est&#225;n en consonancia con estos principios del comanejo de la fractura de cadera&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">En COFRAC la evaluaci&#243;n preoperatoria es mejor que en HIST&#46; En esta cohorte&#44; la identificaci&#243;n de los pacientes pluripatol&#243;gicos&#44; del d&#233;ficit motor&#44; de las arritmias distintas a la fibrilaci&#243;n auricular&#44; de la osteoporosis y del n&#250;mero de f&#225;rmacos de uso cr&#243;nico es mayor&#46; Estos &#237;tems son factores valiosos para establecer una correcta planificaci&#243;n durante el ingreso del paciente y en el alta hospitalaria&#46; Debido a la gran falta de datos en la cohorte HIST&#44; no ha sido posible analizar de manera comparativa variables como la altura&#44; el peso&#44; el estado funcional&#44; las comorbilidades &#40;mediante el &#237;ndice de Charlson&#41;&#44; el historial de ca&#237;das y el estatus sociofamiliar&#46; Todos estos datos son tambi&#233;n importantes en la evaluaci&#243;n preoperatoria para planear el comanejo hospitalario y el cuidado de alta&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">Esta evaluaci&#243;n preoperatoria detallada permite a los pacientes COFRAC un comanejo diferente&#44; que previene las complicaciones hospitalarias&#46; As&#237;&#44; la incidencia de deterioro renal fue menor al administrarse una fluidoterapia intravenosa m&#225;s agresiva&#44; evit&#243; el empleo de antiinflamatorios no esteroideos y redujo la repercusi&#243;n de la anemia mediante un mayor n&#250;mero de transfusiones llevadas a cabo durante el ingreso&#46; Tambi&#233;n se produjo un cambio en la prescripci&#243;n de la analgesia&#44; evitando la petidina y los antiinflamatorios no esteroideos en favor de la morfina&#46; Aunque este cambio de analgesia es adecuado para reducir el delirium en los pacientes geri&#225;tricos&#44; esta complicaci&#243;n fue m&#225;s prevalente en la cohorte COFRAC&#46; Se&#241;alamos que este resultado discrepante se debe a una mayor precisi&#243;n en el diagn&#243;stico del delirium en la cohorte COFRAC y a la subestimaci&#243;n del diagn&#243;stico en la HIST&#46; Esta hip&#243;tesis se ve apoyada por el hecho de que la prevalencia del delirium hospitalario durante el ingreso por fractura de cadera oscila alrededor del 24&#37; si hay comanejo y del 60&#37; si no lo hay<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">14</span></a>&#44; y en un tercio de los pacientes el delirium persistir&#225; en su domicilio tras el alta<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">16</span></a>&#46; Es bien conocida la importancia que tiene el manejo del delirium sobre los resultados del tratamiento de la fractura de cadera&#44; ya que este afecta al estado funcional&#44; a la movilidad del paciente y aumenta las tasas de mortalidad e institucionalizaci&#243;n<a class="elsevierStyleCrossRefs" href="#bib0230"><span class="elsevierStyleSup">17&#44;18</span></a>&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">Nuestro estudio no mostr&#243; ninguna diferencia en cuanto a las caracter&#237;sticas tanto de la anestesia como de la cirug&#237;a&#44; incluyendo tipo de anestesia y de cirug&#237;a y tiempo a la cirug&#237;a desde el ingreso&#46; Varios estudios han demostrado la importancia de la cirug&#237;a temprana&#44; ya que mejora el dolor&#44; la duraci&#243;n de la estancia hospitalaria y la incidencia de complicaciones mayores<a class="elsevierStyleCrossRefs" href="#bib0240"><span class="elsevierStyleSup">19-21</span></a>&#46; Se trata de un asunto importante porque&#44; aunque&#44; te&#243;ricamente&#44; el examen preoperatorio llevado a cabo por el internista puede identificar a algunos pacientes como pacientes no &#243;ptimos m&#233;dicamente y su fijaci&#243;n quir&#250;rgica va a retrasarse m&#225;s all&#225; de las 24-48&#160;h recomendadas&#44; de manera general no hay diferencias estad&#237;sticas entre ambas cohortes&#46; En Espa&#241;a&#44; la duraci&#243;n de la estancia entre los a&#241;os 1997 y 2008 muestra una tendencia a la baja&#44; desde los 16&#44;05 a los 13&#44;34 d&#237;as<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">1</span></a>&#46; En los estudios de comanejo la duraci&#243;n de la estancia&#44; antes del comanejo&#44; fue de 9&#44;9 d&#237;as&#44; y de 7&#44;1 despu&#233;s de &#233;l<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">22</span></a>&#46; Esta duraci&#243;n es parecida a la de los resultados de nuestro estudio&#44; excepto que no encontramos diferencias entre ambas cohortes&#46; La explicaci&#243;n de este hecho puede encontrarse en que nuestro protocolo estandarizado a&#250;n presenta algunas &#225;reas que mejorar para optimizar la planificaci&#243;n del cuidado&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">La fractura de cadera puede dar lugar a consecuencias desfavorables significativas&#44; con fallecimiento del 26&#37; de los pacientes al a&#241;o de la fractura de la cadera<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">23</span></a>&#46; La mortalidad hospitalaria es baja&#44; con una tasa del 4&#44;71 al 5&#44;85&#37; seg&#250;n las estad&#237;sticas oficiales de Espa&#241;a&#46; En los ensayos cl&#237;nicos&#44; el comanejo supone una reducci&#243;n de alrededor del 5&#37; en las tasas de mortalidad hospitalaria<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">24</span></a>&#44; con una mortalidad previa a la intervenci&#243;n del 2&#44;5-9&#44;7&#37; y del 1&#44;5-4&#44;5&#37; tras la cirug&#237;a<a class="elsevierStyleCrossRefs" href="#bib0160"><span class="elsevierStyleSup">3&#44;7&#44;14</span></a>&#46; Nuestros resultados concuerdan con los datos publicados&#58; en la HIST la mortalidad es del 4&#44;6&#37;&#44; como la tasa de Espa&#241;a&#44; y en la COFRAC la mortalidad se reduce casi un 3&#44;3&#37;&#46; Sin embargo&#44; en nuestro estudio no se han evidenciado diferencias en la mortalidad a los 30 d&#237;as tras el alta&#44; lo que indica que se necesita la planificaci&#243;n de otras &#225;reas del cuidado&#46; No retrasar la cirug&#237;a y reducir la mortalidad hospitalaria junto con no prolongar la estancia son los elementos que apoyan la aplicaci&#243;n del comanejo&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">En nuestro estudio&#44; el reingreso a los 30 d&#237;as tras la fractura de cadera fue muy bajo si se lo compara con estudios previos &#40;&#60;1 vs&#46; 10-15&#37;&#41; y no encontramos diferencias debidas a la intervenci&#243;n<a class="elsevierStyleCrossRefs" href="#bib0180"><span class="elsevierStyleSup">7&#44;14&#44;25</span></a>&#46; Probablemente en este punto intervengan algunos factores culturales&#46; En la cultura espa&#241;ola existe una gran aceptaci&#243;n del cuidado en la familia de los ancianos o de los pacientes dependientes&#44; especialmente por parte de las madres y de las hijas primog&#233;nitas&#46; No hay estudios que investiguen las causas que animan a las mujeres de la familia a hacerse cargo de esta tarea&#44; pero probablemente sean varios factores del tipo psicoeducativo&#44; del rol social aprendido y de las din&#225;micas familiares ancestrales&#46; Otro factor que puede desempe&#241;ar un importante papel sea que la sanidad espa&#241;ola no dispone de muchos hospitales de larga estancia&#44; por lo que las familias son la base del cuidado de los pacientes<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">26</span></a>&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">El estado funcional en el momento del alta fue semejante en las 2<span class="elsevierStyleHsp" style=""></span>cohortes de nuestro estudio&#44; con un 10&#37; de los pacientes encamados todo el d&#237;a&#44; un 50&#37; con permanencia de medio d&#237;a en cama y uso de andador ortop&#233;dico&#46; Estos datos son semejantes a los de los estudios publicados sobre comanejo en fractura de cadera&#44; con una p&#233;rdida de la movilidad en un 60 y un 50&#37; de los pacientes en el mes 6 y 12 desde el alta&#44; respectivamente<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">3</span></a>&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">La osteoporosis y la deficiencia de vitamina D son muy prevalentes en los ancianos y su presencia supone un riesgo elevado de presentaci&#243;n y gravedad de la fractura de cadera<a class="elsevierStyleCrossRefs" href="#bib0280"><span class="elsevierStyleSup">27&#44;28</span></a>&#44; pero tan solo el 10&#37; de los ancianos ingresados por fractura de cadera estaban tomando el tratamiento adecuado frente a estos procesos y&#44; adem&#225;s la mayor&#237;a no lo tomaban de forma correcta<a class="elsevierStyleCrossRef" href="#bib0290"><span class="elsevierStyleSup">29</span></a>&#46; Este hecho es evidente en nuestro estudio&#46; En HIST el diagn&#243;stico previo de osteoporosis y de prescripci&#243;n de bifosfonatos&#44; de suplementos de calcio y vitamina D en el alta fue menor que en la COFRAC&#46; Este es otro aspecto interesante sobre la importancia que tiene la evaluaci&#243;n peroperatoria&#44; ya que permite el tratamiento &#243;ptimo de la osteoporosis&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">Nuestro estudio tiene importantes limitaciones&#46; Al tratarse de un estudio retrospectivo&#44; carecemos de informaci&#243;n sobre la HIST&#44; lo que no nos ha permitido analizar algunas variables&#44; en concreto&#44; el estado funcional y la prevalencia real del delirium&#46; No hemos analizado la mortalidad en el a&#241;o desde el alta&#44; por lo que no podemos comparar los resultados a largo plazo de nuestra intervenci&#243;n con los de otros protocolos de comanejo&#46; La raz&#243;n de este hecho es que inicialmente solo quisimos analizar el impacto en hospital de nuestro protocolo&#46; Los resultados a corto plazo mostraron una mortalidad menor en COFRAC&#44; pero sin diferencias estad&#237;sticas<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">7</span></a>&#46; Della Rocca describi&#243; una tendencia similar a los 6 y 12 meses&#44; tambi&#233;n sin diferencias estad&#237;sticas&#46; Esto supone&#44; probablemente&#44; que&#44; en el anciano y en pacientes fr&#225;giles&#44; la fractura de cadera no es solo la fractura de un hueso&#46; La fractura de cadera en los pacientes fr&#225;giles da lugar a la rotura en el equilibrio biol&#243;gico de estos&#44; y en un porcentaje importante de los pacientes este equilibrio no puede recuperarse&#44; lo que origina un pron&#243;stico malo&#46; Necesitamos protocolos est&#225;ndar multidisciplinares en el alta en el que se compartan las responsabilidades entre atenci&#243;n primaria&#44; cirujanos ortop&#233;dicos&#44; internistas&#44; medicina f&#237;sica y de rehabilitaci&#243;n&#46; En este contexto&#44; la telemedicina y la vigilancia dom&#233;stica tendr&#237;an un papel importante&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Conclusi&#243;n</span><p id="par0095" class="elsevierStylePara elsevierViewall">El protocolo de comanejo entre los departamentos de Medicina Interna y de Traumatolog&#237;a desarrollados para pacientes ingresados por fractura de cadera permiten una mejor evaluaci&#243;n preoperatoria&#44; con mejor manejo de las complicaciones y una reducci&#243;n de la mortalidad a corto plazo&#46; Se necesitan protocolos de atenci&#243;n estandarizados y multidisciplinares en el momento del alta a fin de mejorar los resultados a medio y largo plazo&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Conflicto de intereses</span><p id="par0100" class="elsevierStylePara elsevierViewall">Los autores declaran no tener ning&#250;n conflicto de intereses&#46;</p></span></span>"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Introducci&#243;n</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">La fractura de cadera del anciano es de los diagn&#243;sticos m&#225;s prevalentes en los servicios de Traumatolog&#237;a&#44; con gran impacto en t&#233;rminos cl&#237;nicos&#44; econ&#243;micos y sociales&#46; Nuestro objetivo es analizar el impacto cl&#237;nico de un modelo de comanejo entre Traumatolog&#237;a y Medicina Interna para pacientes ancianos ingresados por fractura de cadera en un hospital de tercer nivel&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Material y m&#233;todos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Cohortes retrospectivas de pacientes mayores de 65 a&#241;os ingresados por fractura de cadera entre enero de 2005 y agosto de 2006 &#40;cohorte HIST&#41; sin modelo de comanejo&#44; y entre enero de 2008 y agosto de 2010 &#40;cohorte COFRAC&#41; con dicho modelo&#46; Se analizaron caracter&#237;sticas demogr&#225;ficas&#44; cl&#237;nicas y quir&#250;rgicas&#44; incidencia de complicaciones&#44; mortalidad y reingreso a los 30 d&#237;as&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Se incluy&#243; a 701 pacientes &#40;471 HIST&#44; 230 COFRAC&#41;&#46; No hubo diferencias en edad&#44; g&#233;nero&#44; demora quir&#250;rgica&#44; tiempo y tipo de cirug&#237;a e intervenci&#243;n&#44; estancia&#44; deambulaci&#243;n al alta&#44; consulta en urgencias ni reingreso o mortalidad a 30 d&#237;as&#46; Hubo diferencias en identificaci&#243;n de pluripatol&#243;gicos &#40;16&#44;8 vs&#46; 24&#44;4&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;02&#41;&#44; osteoporosis &#40;3&#44;9 vs&#46; 7&#44;6&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;03&#41; o d&#233;ficit motor &#40;3&#44;5 vs&#46; 8&#44;8&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;03&#41;&#44; f&#225;rmacos del tratamiento &#40;3&#44;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#44;5 vs&#46; 4&#44;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#44;2&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;01&#41;&#44; aparici&#243;n de delirium &#40;15&#44;6 vs&#46; 20&#44;9&#37;&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;048&#41; e hipomotilidad intestinal &#40;80&#44;3 vs&#46; 74&#44;7&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#44; seguimiento de anemia &#40;83&#44;3 vs&#46; 97&#44;1&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>0&#44;01&#41; y de funci&#243;n renal &#40;44&#44;5 vs&#46; 97&#44;3&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;01&#41; y mortalidad intrahospitalaria &#40;4&#44;6 vs&#46; 1&#44;3&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;02&#41;&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">El comanejo de pacientes ancianos ingresados por fractura de cadera permite mejorar la documentaci&#243;n de los problemas cr&#243;nicos previos y el control de complicaciones hospitalarias y disminuye la mortalidad intrahospitalaria&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0005"
            "titulo" => "Introducci&#243;n"
          ]
          1 => array:2 [
            "identificador" => "abst0010"
            "titulo" => "Material y m&#233;todos"
          ]
          2 => array:2 [
            "identificador" => "abst0015"
            "titulo" => "Resultados"
          ]
          3 => array:2 [
            "identificador" => "abst0020"
            "titulo" => "Conclusiones"
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        "titulo" => "Abstract"
        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Introduction</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Hip fracture in the elderly is one of the most prevalent diagnoses in Orthopedic Surgery Departments&#46; It has a great impact in medical&#44; economic and social terms&#46; Our objective is to analyze clinical impact of a co-management care model between orthopedic surgery and internal medicine departments for elderly patients admitted with hip fracture in a tertiary referral hospital&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Material and methods</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Retrospective cohort study of patients older than 65 years old admitted with hip fracture between January 2005-August 2006 &#40;HIST cohort&#41; without a co-management care model&#44; and between January 2008-August 2010 &#40;COFRAC cohort&#41; with a co-manEdadment care model&#46; Analysis of demographic&#44; clinical and surgery characteristics&#44; complications incidence and mortality and re-admissions at 30 days was made&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">A total of 701 patients were included &#40;471 HIST&#44; 230 COFRAC&#41;&#46; There were no differences in sex&#44; gender&#44; time to surgery&#44; type of anesthesia and surgery&#44; length of stay&#44; ambulation at discharge and 30-days emergency room consultation&#44; readmissions or mortality at 30 days&#46; There were differences in identification of polypatological patients &#40;16&#46;8 vs&#46; 24&#46;4&#37;&#44; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;02&#41;&#44; presence of osteoporosis &#40;3&#46;9 vs&#46; 7&#46;6&#37;&#44; <span class="elsevierStyleItalic">P<span class="elsevierStyleHsp" style=""></span></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;03&#41;&#44; motor deficit &#40;3&#46;5 vs&#46; 8&#46;8&#37;&#44; <span class="elsevierStyleItalic">P<span class="elsevierStyleHsp" style=""></span></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;03&#41;&#44; number of chronic drugs &#40;3&#46;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#46;5 vs&#46; 4&#46;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#46;2&#44; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;01&#41;&#44; diagnosis of delirium &#40;15&#46;6 vs&#46; 20&#46;9&#37;&#44; <span class="elsevierStyleItalic">P<span class="elsevierStyleHsp" style=""></span></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;048&#41;&#44; constipation &#40;80&#46;3 vs&#46; 74&#46;7&#37;&#44; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#44; monitoring of anemia &#40;83&#46;3 vs&#46; 97&#46;1&#37;&#44; <span class="elsevierStyleItalic">P<span class="elsevierStyleHsp" style=""></span></span>&#62;<span class="elsevierStyleHsp" style=""></span>0&#46;01&#41; and renal failure at discharge &#40;44&#46;5 vs&#46; 97&#46;3&#37;&#44; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;01&#41; and hospital mortality &#40;4&#46;6 vs&#46; 1&#46;3&#37;&#44; <span class="elsevierStyleItalic">P<span class="elsevierStyleHsp" style=""></span></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;02&#41;&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Co-management for elderly patients admitted with hip fracture provides a better information about previously chronic conditions&#44; a higher control of hospital complications and decreases hospital mortality&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0025"
            "titulo" => "Introduction"
          ]
          1 => array:2 [
            "identificador" => "abst0030"
            "titulo" => "Material and methods"
          ]
          2 => array:2 [
            "identificador" => "abst0035"
            "titulo" => "Results"
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          3 => array:2 [
            "identificador" => "abst0040"
            "titulo" => "Conclusions"
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">HIST &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>471&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Edad&#44; a&#241;os &#40;media &#177; desviaci&#243;n est&#225;ndar&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Necesidad de cuidador <span class="elsevierStyleItalic">n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">102 &#40;44&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Tiene un cuidador <span class="elsevierStyleItalic">n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">326 &#40;69&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">150 &#40;65&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Parentesco &#40;hija&#47;nuera&#41; <span class="elsevierStyleItalic">n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">300 &#40;63&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">126 &#40;55&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#44;89&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">Paciente pluripatol&#243;gico <span class="elsevierStyleItalic">n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">Hipertensi&#243;n <span class="elsevierStyleItalic">n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">292 &#40;62&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">137 &#40;60&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;337&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Diabetes mellitus <span class="elsevierStyleItalic">n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">129 &#40;27&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">71 &#40;30&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;184&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hiperlipidemia <span class="elsevierStyleItalic">n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">55 &#40;11&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">33 &#40;14&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;179&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Demencia <span class="elsevierStyleItalic">n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">73 &#40;15&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">48 &#40;20&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;056&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Deterioro cognitivo <span class="elsevierStyleItalic">n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">66 &#40;14&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">50 &#40;21&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;07&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Fibrilaci&#243;n auricular <span class="elsevierStyleItalic">n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">76 &#40;16&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">39 &#40;16&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;450&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Arritmias diferentes a la fibrilaci&#243;n auricular <span class="elsevierStyleItalic">n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#40;1&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11 &#40;4&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;021&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Infarto <span class="elsevierStyleItalic">n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">61 &#40;12&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">39 &#40;16&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;095&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Enfermedad arterial coronaria cr&#243;nica <span class="elsevierStyleItalic">n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">72 &#40;15&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">30 &#40;13&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;234&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Insuficiencia cardiaca <span class="elsevierStyleItalic">n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">37 &#40;7&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">26 &#40;11&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;084&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Osteoporosis <span class="elsevierStyleItalic">n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">18 &#40;3&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">17 &#40;7&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;03&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Depresi&#243;n <span class="elsevierStyleItalic">n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">36 &#40;7&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13 &#40;5&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;177&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Enfermedad pulmonar obstructiva cr&#243;nica <span class="elsevierStyleItalic">n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&#44;6 &#40;5&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13 &#40;5&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;500&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Enfermedad renal cr&#243;nica <span class="elsevierStyleItalic">n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">22 &#40;4&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">14 &#40;6&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;206&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#218;lcera p&#233;ptica <span class="elsevierStyleItalic">n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13 &#40;2&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">14 &#40;5&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;03&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Anemia <span class="elsevierStyleItalic">n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">16 &#40;3&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9 &#40;3&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;507&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Alcoholismo <span class="elsevierStyleItalic">n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#40;0&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;018&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t">131&#40;58&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">164 &#40;35&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">62&#40;27&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Artroplastia total&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">21 &#40;4&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12&#40;4&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab2207355.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "es" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Caracter&#237;sticas de la fractura de cadera y tratamiento quir&#250;rgico</p>"
        ]
      ]
      2 => array:8 [
        "identificador" => "tbl0015"
        "etiqueta" => "Tabla 3"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at3"
            "detalle" => "Tabla "
            "rol" => "short"
          ]
        ]
        "tabla" => array:1 [
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
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                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">HIST n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">COFRAC n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">p&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Mortalidad&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">22 &#40;4&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#40;1&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;02&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Duraci&#243;n del ingreso&#44; d&#237;as &#40;media &#177; desviaci&#243;n est&#225;ndar&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&#44;5 &#177; 4&#44;41&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&#44;39 &#177; 7&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;865&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Delirium&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">73 &#40;15&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">48 &#40;20&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;048&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Insuficiencia cardiaca&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">16 &#40;3&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12 &#40;5&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;208&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Enfermedad coronaria aguda&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13 &#40;2&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">26&#47; &#40;0&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;084&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Crisis de EPOC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10 &#40;2&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;305&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Neumon&#237;a&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#40;1&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6 &#40;2&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;293&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Infecci&#243;n de la herida quir&#250;rgica&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6 &#40;&#60;0&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;&#60;0&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;02&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Flebitis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#40;&#60;0&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;&#60;0&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Infecci&#243;n del tracto urinario&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;&#60;0&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#40;&#60;0&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Anemia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">377 &#40;78&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">215 &#40;90&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#44;01&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Ca&#237;da de hemoglobina<span class="elsevierStyleHsp" style=""></span>&#62;2 mg&#47;dl&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">330 &#40;87&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">192 &#40;91&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;144&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">P&#233;rdida de datos de anemizaci&#243;n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">17&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#44;01&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Transfusi&#243;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">105 &#40;22&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">84 &#40;36&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;011&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Transfusi&#243;n preoperatoria&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">20 &#40;19&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">20 &#40;23&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#44;01&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Transfusi&#243;n tras cirug&#237;a&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">85 &#40;81&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">64 &#40;76&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Creatinina en el ingreso&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;99 &#177; 0&#44;84&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;96 &#177; 0&#44;72&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">0&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Insuficiencia renal aguda&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">61 &#40;12&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">70 &#40;30&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#44;01&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">P&#233;rdida de datos de funci&#243;n renal &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">66&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#44;01&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Estre&#241;imiento&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">109 &#40;47&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#44;01&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Prescripci&#243;n de opioides&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">83 &#40;17&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">78 &#40;33&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
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                  \t\t\t\t\ttop\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">225 &#40;47&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9 &#40;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#60;0&#44;01&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">Morfina&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">166 &#40;72&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#44;01&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Fluido intravenoso&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">150 &#40;65&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;04&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Uso espor&#225;dico&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">216 &#40;45&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">45 &#40;19&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#44;01&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Prescrito&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">446 &#40;94&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">134 &#40;58&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#44;01&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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                  \t\t\t\t\ttable-head\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">HIST n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">COFRAC n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">p&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">Mortalidad global&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">9 &#40;3&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Mortalidad hospitalaria&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">3 &#40;1&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#44;028&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t">Mortalidad a los 30 d&#237;as&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">14 &#40;3&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">6 &#40;2&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#44;543&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Visitas a urgencias a los 30 d&#237;as&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">32 &#40;7&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">18 &#40;12&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#44;09&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Ingresos a los 30 d&#237;as&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">14 &#40;3&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">4 &#40;2&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#44;512&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">19 &#40;3&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">13 &#40;5&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#44;516&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>50&#37; del tiempo en cama&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">263 &#40;55&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">115 &#40;50&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Andador ortop&#233;dico&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">189 &#40;40&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">102 &#40;44&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Tratamiento de osteoporosis</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Suplementos de calcio&#47;vitamina D&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">31 &#40;6&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">196 &#40;85&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#60;0&#44;01&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Bisfosfonatos&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">110 &#40;47&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#60;0&#44;01&nbsp;\t\t\t\t\t\t\n
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          "es" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Impacto cl&#237;nico en el momento del alta hospitalaria y a los 30 d&#237;as desde el alta</p>"
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                      "titulo" => "Clinical pathway for hip fractures in the elderly&#58; The hospital for joint diseases experience"
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                      "titulo" => "Clinical pathway for fractured neck of femur&#58; A prospective&#44; controlled study"
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                            0 => "P&#46;F&#46; Choong"
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                    0 => array:1 [
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                        "tituloSerie" => "Med J Aust&#46;"
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                      "titulo" => "The effectiveness of implementing a care pathway for femoral neck fracture in older people&#58; A prospective controlled before and after study"
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                          "autores" => array:6 [
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                    0 => array:2 [
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                          "etal" => true
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                            3 => "C&#46;D&#46; Schleck"
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                            5 => "P&#46;M&#46; Huddleston"
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                      "titulo" => "ComanEdadment of geriatric patients with hip fractures&#58; A retrospective&#44; controlled&#44; cohort study"
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                        0 => array:2 [
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                          "autores" => array:6 [
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                            2 => "B&#46;D&#46; Crist"
                            3 => "D&#46;A&#46; Volgas"
                            4 => "J&#46;P&#46; Stannard"
                            5 => "D&#46;R&#46; Mehr"
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                    ]
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                0 => array:2 [
                  "contribucion" => array:1 [
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                        0 => array:2 [
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                            0 => "J&#46; Magaziner"
                            1 => "E&#46;M&#46; Simonsick"
                            2 => "T&#46;M&#46; Kashner"
                            3 => "J&#46;R&#46; Hebel"
                            4 => "J&#46;E&#46; Kenzora"
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                    0 => array:2 [
                      "doi" => "10.1093/geronj/45.3.m101"
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                        "tituloSerie" => "J Gerontol&#46;"
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                        "volumen" => "45"
                        "paginaInicial" => "M101"
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Mortality following hip fracture&#58; Trends and geographical variations over the last 40 years"
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                        0 => array:2 [
                          "etal" => false
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                            0 => "S&#46; Haleem"
                            1 => "L&#46; Lutchman"
                            2 => "R&#46; Mayahi"
                            3 => "J&#46;E&#46; Grice"
                            4 => "M&#46;J&#46; Parker"
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                    0 => array:2 [
                      "doi" => "10.1016/j.injury.2008.03.022"
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