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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Los progresos en los procedimientos y t&#233;cnicas quir&#250;rgicas&#44; anest&#233;sicas y analg&#233;sicas permiten operar a pacientes de mayor edad y comorbilidad<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">1</span></a> y realizar intervenciones quir&#250;rgicas en r&#233;gimen ambulatorio&#44; o con ingresos hospitalarios muy breves&#44; hasta hace poco impensables&#44; como artroplastias de cadera y rodilla<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">2</span></a>&#44; tiroidectom&#237;as<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">3</span></a> o extirpaci&#243;n de tumores cerebrales<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">4</span></a>&#46; Esta evoluci&#243;n de la asistencia condiciona que los enfermos que permanecen hospitalizados en los servicios quir&#250;rgicos son los que tienen m&#225;s comorbilidad o sufren complicaciones importantes&#44; y que sean dif&#237;ciles de manejar desde un punto de vista m&#233;dico y no solo quir&#250;rgico&#46; Todo ello ha provocado un incremento en la necesidad de apoyo de otros servicios hospitalarios&#44; en especial de Medicina Interna&#44; a los servicios quir&#250;rgicos<a class="elsevierStyleCrossRefs" href="#bib0135"><span class="elsevierStyleSup">1&#44;5</span></a>&#46; Este apoyo tradicionalmente se ha realizado mediante la interconsulta &#40;IC&#41; a demanda&#44; la cual presenta muchos problemas e inconvenientes<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">6</span></a>&#44; circunstancias que han facilitado el desarrollo de una forma distinta de colaboraci&#243;n&#44; la asistencia compartida<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">6</span></a> &#40;AC&#41; donde la responsabilidad sobre los problemas del paciente es compartida por un equipo multidisciplinar con participaci&#243;n de cl&#237;nicos durante todo el ingreso hospitalario&#46; Ambos modelos asistenciales persiguen un mismo fin&#44; ayudar al m&#233;dico responsable del enfermo en la atenci&#243;n m&#233;dica de sus pacientes&#44; pero con organizaci&#243;n y caracter&#237;sticas muy diferentes<a class="elsevierStyleCrossRefs" href="#bib0160"><span class="elsevierStyleSup">6&#44;7</span></a>&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">En los &#250;ltimos a&#241;os&#44; diversos estudios&#44; tanto nacionales<a class="elsevierStyleCrossRefs" href="#bib0170"><span class="elsevierStyleSup">8&#8211;10</span></a> como extranjeros<a class="elsevierStyleCrossRefs" href="#bib0185"><span class="elsevierStyleSup">11&#44;12</span></a>&#44; muestran mejores resultados de la AC frente al manejo habitual de los pacientes en diferentes servicios quir&#250;rgicos&#44; aunque todos son de car&#225;cter retrospectivo y circunscritos a un &#250;nico centro hospitalario&#46; No se han publicado trabajos multic&#233;ntricos que comparen directamente la AC con el modelo tradicional de IC&#46; Si bien la AC parece ser superior a las IC&#44; su implantaci&#243;n se enfrenta a una falta de confianza derivada de la ausencia de publicaciones metodol&#243;gicamente s&#243;lidas y&#44; adem&#225;s&#44; requiere de un profundo cambio tanto en la mentalidad asistencial como en la de gesti&#243;n&#44; al compartir 2 m&#233;dicos la responsabilidad sobre el enfermo&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">El objetivo de este estudio es comparar los resultados asistenciales alcanzados por los modelos de IC y AC en pacientes hospitalizados en Cirug&#237;a Ortop&#233;dica y Traumatolog&#237;a &#40;COT&#41;&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Material y m&#233;todos</span><p id="par0020" class="elsevierStylePara elsevierViewall">El Grupo de Trabajo de Asistencia Compartida e Interconsultas de la Sociedad Espa&#241;ola de Medicina Interna llev&#243; a cabo el &#171;Registro de Interconsultas y Asistencia Compartida de la Sociedad Espa&#241;ola de Medicina Interna&#46; Estudio REINA-SEMI&#187; entre el 15 de mayo y el 15 de junio de 2016&#46; Se trat&#243; de un registro multic&#233;ntrico observacional y prospectivo que reclut&#243; consecutivamente a todos los pacientes hospitalizados atendidos por Medicina Interna mediante IC a demanda o por medio de AC&#44; seg&#250;n definiciones previamente establecidas<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">13</span></a>&#46; El registro fue clasificado como investigaci&#243;n observacional no-postautorizaci&#243;n por la AEMPS y aprobado por el CEIC de Galicia &#40;c&#243;digo 2016-055&#41;&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">Para la realizaci&#243;n del presente trabajo se han seleccionado todos los pacientes incluidos en el registro REINA-SEMI ingresados en los servicios de COT&#44; ya que es habitual la implicaci&#243;n de los internistas con los servicios de COT en ambos modelos colaborativos&#44; AC e IC&#44; a nivel nacional<a class="elsevierStyleCrossRefs" href="#bib0170"><span class="elsevierStyleSup">8&#44;14</span></a>&#46; Con el fin de evitar el posible sesgo que supondr&#237;a la inclusi&#243;n de enfermos con menos comorbilidad en el grupo de AC&#44; al incluir un alto porcentaje de pacientes programados&#44; se decidi&#243; excluir a los pacientes con ingreso programado y considerar &#250;nicamente a los ingresados de urgencia&#46; Asimismo&#44; se excluyeron los pacientes menores de 18 a&#241;os y aquellos en los que no se obtuvo el consentimiento informado escrito aceptando su participaci&#243;n en el estudio&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">Se registraron las caracter&#237;sticas epidemiol&#243;gicas y de comorbilidad basales de los pacientes&#44; as&#237; como las relativas al momento de realizaci&#243;n de la IC y a los d&#237;as de seguimiento en ambos modelos de atenci&#243;n&#44; y el estado &#40;vivo o muerto&#41; al alta hospitalaria&#46; Tambi&#233;n se registraron todas las complicaciones m&#233;dicas desarrolladas durante el ingreso y otros diagn&#243;sticos no conocidos efectuados a ra&#237;z de la intervenci&#243;n &#40;p&#46; ej&#46;&#44; cirrosis&#41;&#46; No se recogieron las complicaciones directamente relacionadas con la cirug&#237;a&#46; Se cuantific&#243; la carga de trabajo midiendo el tiempo dedicado a la valoraci&#243;n cl&#237;nica del paciente por parte del internista&#44; incluyendo el tiempo de solicitud y gesti&#243;n de pruebas&#44; desplazamientos e informaci&#243;n a familiares&#46; Para efectos del c&#225;lculo del tiempo empleado en dicha valoraci&#243;n este se registr&#243; en m&#250;ltiplos de 10<span class="elsevierStyleHsp" style=""></span>min&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Se compararon las variables analizadas entre los grupos de AC e IC con el fin de valorar si alguno de los 2 modelos colaborativos se asociaba a alguna ventaja desde el punto de vista asistencial&#46; Se establecieron 2 grupos de estudio seg&#250;n su estancia hospitalaria&#44; &#60;<span class="elsevierStyleHsp" style=""></span>15 o &#8805;<span class="elsevierStyleHsp" style=""></span>15 d&#237;as&#44; teniendo en cuenta las &#250;ltimas estad&#237;sticas oficiales disponibles sobre la estancia media hospitalaria de los pacientes con fractura de cadera en Espa&#241;a &#40;16 d&#237;as&#41;<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">15</span></a>&#44; y se realiz&#243; un an&#225;lisis multivariante para determinar los factores independientes asociados a una estancia hospitalaria superior<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>15 d&#237;as&#46; Para comprobar qu&#233; variables se asociaron de forma independiente con una estancia hospitalaria prolongada se realiz&#243; un an&#225;lisis de regresi&#243;n log&#237;stica binaria&#46;</p><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">An&#225;lisis estad&#237;stico</span><p id="par0040" class="elsevierStylePara elsevierViewall">Las variables cuantitativas se describieron con la media y la desviaci&#243;n est&#225;ndar y las variables cualitativas con su valor absoluto y porcentaje&#46; En el an&#225;lisis univariante se realiz&#243; la comparaci&#243;n de 2 medias utilizando la prueba de la t de Student o la prueba de Mann Whitney seg&#250;n fueran apropiadas&#46; Para las variables cualitativas se us&#243; la prueba chi-cuadrado&#59; cuando las celdas conten&#237;an valores esperados inferiores a 5&#44; se utiliz&#243; la prueba exacta de Fisher&#46; La significaci&#243;n estad&#237;stica se estableci&#243; con un valor de p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#46; El an&#225;lisis multivariante se llev&#243; a cabo con un modelo de regresi&#243;n log&#237;stica&#44; introduciendo las variables con el m&#233;todo de inclusi&#243;n por pasos&#46; En el modelo final se incluyeron las variables significativas resultantes en el an&#225;lisis univariante&#44; y aquellas relevantes desde un punto de vista cl&#237;nico que pudiesen influir en el resultado final&#46; Se calcularon los valores de odds ratio ajustados y sus respectivos intervalos de confianza&#46; Para su realizaci&#243;n se utiliz&#243; el paquete estad&#237;stico SPSS&#174; v&#46;18&#46;0 &#40;SPSS Inc&#46; Chicago&#44; EE&#46; UU&#46;&#41;&#46;</p></span></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Resultados</span><p id="par0045" class="elsevierStylePara elsevierViewall">El registro REINA-SEMI incluy&#243; un total de 2&#46;234 pacientes&#44; de los que 697 fueron ingresos urgentes en los servicios de COT y participan en este estudio&#44; 415 en el grupo de AC y 282 en el de IC&#46; Los pacientes proven&#237;an de 41 hospitales de Asturias&#44; Andaluc&#237;a&#44; Arag&#243;n&#44; Catalu&#241;a&#44; Castilla-La Mancha&#44; Castilla y Le&#243;n&#44; Comunidad Valenciana&#44; Extremadura&#44; Galicia&#44; Islas Canarias&#44; La Rioja&#44; Madrid y Pa&#237;s Vasco&#44; adem&#225;s de un centro hospitalario de la ciudad de Buenos Aires &#40;Argentina&#41;&#46; Hospitales hasta 500 camas aportan 278 casos&#44; y los de m&#225;s de 500 camas 419 casos&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">En la <a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a> se describen las caracter&#237;sticas demogr&#225;ficas y asistenciales de los enfermos&#46; Los pacientes del grupo de AC fueron de m&#225;s edad &#40;4&#44;6 a&#241;os&#41;&#44; con un 50&#37; m&#225;s de pacientes con edad superior a 80 a&#241;os&#44; mayor n&#250;mero de mujeres&#44; fueron intervenidos quir&#250;rgicamente con m&#225;s frecuencia y tuvieron una estancia hospitalaria m&#225;s corta &#40;8 d&#237;as menos&#41; que el grupo de IC&#46; Se observ&#243; una tendencia no significativa hacia una menor mortalidad en el grupo de AC&#46; En el grupo de IC&#44; esta se solicit&#243; tras 7&#44;5 d&#237;as de ingreso &#40;desviaci&#243;n est&#225;ndar 13&#44;7&#41;&#44; mediana 3 d&#237;as&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0055" class="elsevierStylePara elsevierViewall">En la <a class="elsevierStyleCrossRef" href="#tbl0010">tabla 2</a> se muestran los diagn&#243;sticos m&#233;dicos registrados&#46; Hubo pocas diferencias entre ambos grupos en cuanto a la presencia de complicaciones individuales&#46; La anemia fue m&#225;s frecuente en el grupo de AC y la enfermedad pulmonar obstructiva cr&#243;nica agudizada en el de IC&#46; Otras&#44; como la infecci&#243;n urinaria&#44; las taquiarritmias y las neoplasias&#44; predominaron en el grupo de IC&#44; aunque sin alcanzar significaci&#243;n estad&#237;stica&#46; Sin embargo&#44; el grupo de AC tuvo menos complicaciones m&#233;dicas de forma global que el grupo de IC&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0060" class="elsevierStylePara elsevierViewall">En la <a class="elsevierStyleCrossRef" href="#tbl0015">tabla 3</a> se muestra el an&#225;lisis univariante de los factores relacionados con una estancia hospitalaria<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>15 d&#237;as&#46; La estancia prolongada se asoci&#243; a la demora en programar la intervenci&#243;n quir&#250;rgica desde el ingreso y al desarrollo de diversas complicaciones m&#233;dicas durante el ingreso&#44; como insuficiencia cardiaca&#44; infecci&#243;n respiratoria&#44; trastorno electrol&#237;tico o &#237;leo intestinal&#46; El tama&#241;o reducido del hospital&#44; el modelo de AC y el sexo &#40;mujer&#41; se relacionaron con estancias cortas&#44; mientras que la comorbilidad y la edad avanzada no se asociaron con estancias<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>15 d&#237;as&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0065" class="elsevierStylePara elsevierViewall">Se realiz&#243; una regresi&#243;n log&#237;stica binaria para evaluar el efecto de variables estad&#237;sticamente significativas en el an&#225;lisis univariante y las cl&#237;nicamente relevantes&#44; aunque no tuviesen significaci&#243;n&#46; El modelo de regresi&#243;n log&#237;stica fue estad&#237;sticamente significativo &#40;X<span class="elsevierStyleSup">2</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>153&#44;869&#44; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#44; explica el 34&#37; &#40;R<span class="elsevierStyleSup">2</span> de Nagelkerke&#41; de la varianza en estancia<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>15 d&#237;as y clasifica correctamente el 80&#44;5&#37; de los casos&#46; La sensibilidad fue del 76&#44;4&#37;&#44; la especificidad del 81&#44;2&#37;&#44; el valor predictivo negativo del <span class="elsevierStyleHsp" style=""></span>94&#44;9&#37; y el valor predictivo positivo del 42&#44;8&#37;&#46; Las variables independientes predictoras de una estancia prolongada se muestran en la <a class="elsevierStyleCrossRef" href="#tbl0020">tabla 4</a>&#58; modelo asistencial de interconsultas a demanda&#44; sexo &#40;hombre&#41;&#44; insuficiencia cardiaca&#44; infecci&#243;n respiratoria&#44; trastorno electrol&#237;tico y demora quir&#250;rgica&#46;</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Discusi&#243;n</span><p id="par0070" class="elsevierStylePara elsevierViewall">Nuestros resultados muestran que los pacientes ingresados de urgencia en COT atendidos mediante AC son operados en mayor proporci&#243;n y con menor demora hasta la intervenci&#243;n&#44; sufren menos complicaciones m&#233;dicas y tienen una menor estancia hospitalaria que los atendidos mediante IC&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">Observamos un mayor porcentaje de complicaciones m&#233;dicas en el grupo IC&#44; en especial de s&#237;ndrome coronario agudo y reagudizaci&#243;n de enfermedad pulmonar obstructiva cr&#243;nica&#46; Este hallazgo probablemente se explica porque los traumat&#243;logos no est&#225;n alertados para aplicar las medidas preventivas posibles en cada caso y detectar precozmente estas situaciones&#46; Este hallazgo es coherente con publicaciones previas&#44; las cuales comunican que los servicios quir&#250;rgicos solicitan la gran mayor&#237;a de las IC cuando ya se ha producido la complicaci&#243;n<a class="elsevierStyleCrossRefs" href="#bib0200"><span class="elsevierStyleSup">14&#44;16</span></a>&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">Desconocemos el motivo de la presencia de un mayor n&#250;mero de pacientes con anemia en el grupo de AC&#46; Podr&#237;a deberse a que se tratara de pacientes sometidos a cirug&#237;as m&#225;s sangrantes&#44; pero el dise&#241;o del estudio no permite establecer los motivos de este hallazgo&#46; Dicho hallazgo tiene importancia porque la anemia es un factor que empeora el pron&#243;stico quir&#250;rgico<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">17</span></a>&#46; A pesar de ello&#44; los resultados del grupo AC son mejores que los del grupo IC&#44; un dato m&#225;s a tener en consideraci&#243;n en la valoraci&#243;n final de este estudio&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">Respecto a la mayor proporci&#243;n de neoplasia en el grupo IC&#44; una posible explicaci&#243;n ser&#237;a que los traumat&#243;logos seleccionar&#237;an este tipo de pacientes en especial para ser seguidos por los internistas&#44; lo que aumentar&#237;a su proporci&#243;n en este grupo&#46; Sin embargo&#44; la mayor carga de morbilidad que supone este sesgo de selecci&#243;n parece que podr&#237;a estar compensada por otras comorbilidades de alguna forma&#44; ya que el &#237;ndice de comorbilidad de Charlson es similar en ambos grupos&#46; En cualquier caso&#44; el escaso n&#250;mero de neoplasias registrado no permite extraer explicaciones s&#243;lidas&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">Para intentar aclarar si el modelo asistencial por s&#237; mismo&#44; AC o IC&#44; ofrece resultados diferentes y para contrarrestar el posible sesgo de selecci&#243;n de pacientes en ambos modelos&#44; se complet&#243; el estudio mediante la creaci&#243;n de 2 grupos en funci&#243;n de su estancia hospitalaria<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>15 d&#237;as&#46; El estudio de la estancia hospitalaria tiene un inter&#233;s especial ya que&#44; entre otras razones&#44; es un buen indicador de padecer sucesos adversos<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">18</span></a> y del coste asistencial<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">19</span></a>&#46; Como era de esperar&#44; el grupo de estancia<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>15 d&#237;as mostr&#243; unos peores resultados y mayor cantidad de complicaciones m&#233;dicas&#44; as&#237; como una mayor demora hasta la intervenci&#243;n&#44; que podr&#237;a explicarse por su situaci&#243;n cl&#237;nica al ingreso y&#47;o aparici&#243;n de complicaciones&#44; hallazgos ya descritos por otros autores<a class="elsevierStyleCrossRefs" href="#bib0200"><span class="elsevierStyleSup">14&#44;16</span></a>&#46; En el an&#225;lisis multivariante&#44; el factor pron&#243;stico independiente m&#225;s importante fue el ser atendido mediante el sistema de interconsultas cl&#225;sico&#44; con 3 veces y media m&#225;s de posibilidades de permanecer ingresado<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>15 d&#237;as&#46; Conviene recordar que las IC se solicitan tard&#237;amente durante el ingreso o cuando ha aparecido una complicaci&#243;n<a class="elsevierStyleCrossRefs" href="#bib0200"><span class="elsevierStyleSup">14&#44;16</span></a>&#44; hallazgos que refuerzan la necesidad de realizar AC&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">Comparar directamente estos 2 modelos asistenciales puede ser problem&#225;tico porque&#44; mientras que en AC todos los pacientes son atendidos por los internistas de forma autom&#225;tica y reglada desde su ingreso&#44; en el modelo de IC lo son solo aquellos a petici&#243;n del traumat&#243;logo&#44; lo que introduce un importante sesgo de selecci&#243;n&#46; Sin embargo&#44; puesto que el objetivo del estudio es comparar ambos modelos colaborativos&#44; los resultados mostrados parecen pertinentes&#46; Uno de dichos modelos&#44; el de IC&#44; descansa en el traumat&#243;logo y su capacidad para detectar los problemas m&#233;dicos existentes o de nueva aparici&#243;n&#46; Es de esperar que ambos grupos de pacientes sean distintos&#46; Los traumat&#243;logos se ven forzados con mucha frecuencia&#44; por sus limitados conocimientos de la patolog&#237;a m&#233;dica&#44; a solicitar las interconsultas de manera incorrecta o tard&#237;a<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">16</span></a>&#46; Por ello&#44; creemos que la comparaci&#243;n directa de ambos grupos ofrece una visi&#243;n adecuada del problema&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">El menor n&#250;mero de problemas m&#233;dicos y los mejores resultados asistenciales mostrados por la AC frente a las IC pueden estar motivados por diversos factores&#46; La presencia desde el ingreso de los internistas en el modelo AC reduce la estancia&#44; los reingresos a 30 d&#237;as&#44; la mortalidad y los costes<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">20</span></a>&#46; Adem&#225;s&#44; no solo reduce la incidencia de complicaciones&#44; sino que tambi&#233;n disminuye su severidad al facilitar un diagn&#243;stico y tratamiento m&#225;s precoces&#44; reduciendo el &#171;fallo de rescate&#187;<a class="elsevierStyleCrossRefs" href="#bib0235"><span class="elsevierStyleSup">21&#44;22</span></a>&#46; Tambi&#233;n disminuye los errores&#44; facilita la coordinaci&#243;n entre los facultativos y permite una mejor conciliaci&#243;n de los tratamientos seguidos por el paciente&#46; Por el contrario&#44; las IC favorecen la realizaci&#243;n de un exceso de pruebas y su repetici&#243;n&#44; la polifarmacia&#44; el aislamiento del paciente y la complacencia o p&#233;rdida de inter&#233;s del m&#233;dico responsable&#44; entre otros muchos problemas<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">6</span></a>&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">Un factor importante es que nuestros resultados muestran que en el modelo de AC el internista emplea m&#225;s tiempo en cada paciente&#44; en especial en el seguimiento&#44; que en el modelo de IC&#44; lo que obviamente permite una mejor valoraci&#243;n&#44; control y seguimiento del enfermo&#46; El tiempo disponible para la contestaci&#243;n de una IC es un factor determinante para su resultado<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">23</span></a>&#46; Otro posible aspecto a tener en cuenta es que&#44; en nuestra experiencia&#44; la AC favorece un mayor contacto con la guardia m&#233;dica&#44; y esta tiene un efecto beneficioso sobre la mortalidad quir&#250;rgica<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">24</span></a>&#44; y tambi&#233;n facilita un mejor contacto y coordinaci&#243;n con Anestesia&#44; permitiendo discutir y prepara los casos adecuadamente&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">Adem&#225;s del ya comentado sesgo de selecci&#243;n de pacientes&#44; este trabajo presenta varias limitaciones&#46; No se registraron los motivos del ingreso&#44; por lo que podr&#237;an existir diferencias entre ambos grupos al solicitar IC con m&#225;s frecuencia a enfermos con determinados diagn&#243;sticos&#44; como la fractura de cadera&#46; Sin embargo&#44; y a pesar de ello&#44; el &#237;ndice de comorbilidad de Charlson es similar en ambos grupos&#44; mientras que la edad&#44; factor que empeora el pron&#243;stico<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">25</span></a>&#44; es mayor en el grupo AC&#46; Es posible que pacientes con problemas m&#233;dicos relevantes&#44; que son vistos siempre por internistas en el grupo AC&#44; no sean valorados por especialistas m&#233;dicos &#40;internistas u otros especialistas&#41; en el grupo IC al no ser solicitadas por los traumat&#243;logos&#46; Desconocer este dato es importante en la valoraci&#243;n de los resultados&#46; Por otra parte&#44; el registro no incluy&#243; las complicaciones directamente relacionadas con la cirug&#237;a &#40;infecciones de herida&#44; luxaciones&#8230;&#41;&#44; por lo que no se puede saber si este aspecto se modificar&#237;a en alguno de los modelos colaborativos analizados&#46; El periodo de reclutamiento de pacientes fue corto &#40;un mes&#41;&#44; por lo que es posible que existan diferencias con respecto a otras &#233;pocas del a&#241;o que podr&#237;an hacer variar los resultados&#44; ya que se han descrito variaciones estacionales en la solicitud de interconsultas<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">1</span></a>&#44; y tambi&#233;n en diversas patolog&#237;as quir&#250;rgicas urgentes<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">26</span></a>&#46; Al no ser un ensayo cl&#237;nico&#44; es posible la existencia de variables de confusi&#243;n no registradas que puedan influir en el grado de asociaci&#243;n encontrado&#46; Un problema a&#241;adido es que no hemos encontrado publicaciones similares a la nuestra&#44; ni en dise&#241;o ni en los pacientes incluidos en el estudio&#44; lo que impide poder comparar nuestros resultados con los de otros autores&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">Como conclusi&#243;n podemos decir que el modelo de AC ofrece mejores resultados asistenciales que el modelo tradicional de IC en pacientes ingresados de urgencia en el servicio de COT&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Conflicto de intereses</span><p id="par0120" 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">Antecedentes y objetivo</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Los enfermos quir&#250;rgicos hospitalizados est&#225;n aumentando su complejidad m&#233;dica&#44; incrementando la necesidad de apoyo por Medicina Interna&#46; Este apoyo se realiza mediante la interconsulta&#44; la cual presenta problemas que han inducido el desarrollo de la asistencia compartida &#40;AC&#41;&#46; Nuestro objetivo es comparar los resultados asistenciales alcanzados por los modelos de interconsulta y AC en Cirug&#237;a Ortop&#233;dica y Traumatolog&#237;a&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Material y m&#233;todo</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Estudio observacional&#44; prospectivo&#44; multic&#233;ntrico&#44; de los enfermos hospitalizados de urgencia en Cirug&#237;a Ortop&#233;dica y Traumatolog&#237;a recogidos en el registro REINA-SEMI&#44; atendidos por Medicina Interna mediante interconsulta o AC&#46; Se registraron las caracter&#237;sticas demogr&#225;ficas&#44; comorbilidad&#44; complicaciones m&#233;dicas&#44; estancia hospitalaria y mortalidad&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Se incluyeron 697 pacientes&#44; 415 con AC y 282 con interconsulta&#46; Los de AC ten&#237;an m&#225;s edad &#40;78&#44;9 vs&#46; 74&#44;3&#59; p &#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#44; se operaron m&#225;s &#40;89&#44;9 vs&#46; 78&#44;7&#37;&#59; p &#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#44; tuvieron menos complicaciones m&#233;dicas &#40;50&#44;4 vs&#46; 62&#44;8&#37;&#59; p &#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41; y su estancia hospitalaria fue menor &#40;10 vs&#46; 18 d&#237;as&#59; p &#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#44; sin diferencias en la comorbilidad ni mortalidad&#46; Los factores independientes asociados a estancia superior a 15 d&#237;as fueron&#58; insuficiencia cardiaca &#40;OR&#58; 3&#44;4&#59; IC 95&#37;&#58; 1&#44;8-6&#44;1&#59; p &#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#44; sexo &#40;hombre&#41; &#40;OR&#58; 1&#44;9&#59; IC 95&#37;&#58; 1&#44;2-3&#44;1&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;004&#41;&#44; trastorno electrol&#237;tico &#40;OR&#58; 2&#44;4&#59; IC 95&#37;&#58; 1&#44;3-4&#44;4&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;003&#41;&#44; infecci&#243;n respiratoria &#40;OR&#58; 1&#44;9&#59; IC 95&#37;&#58; 1&#44;04-3&#44;7&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;035&#41;&#44; demora quir&#250;rgica &#40;OR&#58; 1&#44;1&#59; IC 95&#37;&#58; 1&#44;08-1&#44;2&#59; p &#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41; y ser atendido mediante el modelo de interconsulta a demanda &#40;OR&#58; 3&#44;5&#59; IC 95&#37;&#58; 2&#44;3-5&#44;4&#59; p &#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">La AC ofrece mejores resultados asistenciales que las interconsultas en pacientes ingresados de urgencia en Cirug&#237;a Ortop&#233;dica y Traumatolog&#237;a&#46;</p></span>"
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        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Background and objectives</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Hospitalized surgical patients are increasing in medical complexity&#44; thereby increasing the need for support by internal medicine departments&#46; This support is provided through interconsultations&#44; which present problems that have resulted in the development of shared care &#40;SC&#41;&#46; Our objective was to compare the healthcare results achieved by the SC and interconsultation models in Orthopaedic Surgery and Trauma&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Materials and methods</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">We conducted an observational&#44; prospective&#44; multicentre study of patients hospitalized for emergency Orthopaedic Surgery and Trauma recorded in the REINA-SEMI registry&#44; treated by internal medicine departments through interconsultation or SC&#46; We recorded the demographic characteristics&#44; comorbidity&#44; medical complications&#44; hospital stay and mortality&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">The study included 697 patients&#44; 415 with SC and 282 with interconsultations&#46; The SC patients were older &#40;78&#46;9 vs&#46; 74&#46;3&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001&#41; underwent more operations &#40;89&#46;9 vs&#46; 78&#46;7&#37;&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001&#41;&#44; had fewer medical complications &#40;50&#46;4 vs&#46; 62&#46;8&#37;&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001&#41; and had shorter hospital stays &#40;10 vs&#46; 18 days&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001&#41;&#44; with no differences in comorbidity or mortality&#46; The following independent factors were associated with stays longer than 15 days&#58; heart failure &#40;OR 3&#46;4&#59; 95&#37; CI 1&#46;8-6&#46;1&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001&#41;&#44; the male sex &#40;OR 1&#46;9&#59; 95&#37; CI 1&#46;2-3&#46;1&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;004&#41;&#44; electrolyte disorder &#40;OR 2&#46;4&#59; 95&#37; CI 1&#46;3-4&#46;4&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;003&#41;&#44; respiratory infection &#40;OR 1&#46;9&#59; 95&#37; CI 1&#46;04-3&#46;7&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;035&#41;&#44; surgical delay &#40;OR 1&#46;1&#59; 95&#37; CI 1&#46;08-1&#46;2&#59; <span class="elsevierStyleItalic">P</span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001&#41; and treatment using the interconsultation on demand model &#40;OR 3&#46;5&#59; 95&#37; CI 2&#46;3-5&#46;4&#59; <span class="elsevierStyleItalic">P</span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001&#41;&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">SC offers better healthcare results than interconsultations for patients hospitalized for emergency Orthopaedic Surgery and Trauma&#46;</p></span>"
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            "apendice" => "<p id="par0125" class="elsevierStylePara elsevierViewall">J&#46; Feyjoo Casero&#44; M&#46; Gonz&#225;lez Anglada&#44; M&#46; Freire Romero&#44; A&#46; Gil D&#237;az&#44; A&#46; Granados Maturano&#44; D&#46; Rubal Bran&#44; R&#46; Rabu&#241;al Rey&#44; L&#46; Nevado Lopez-Alegr&#237;a&#44; H&#46; Meijide M&#237;guez&#44; C&#46; Cienfuegos Basanta&#44; D&#46; Brosio&#44; D&#46; Iglesias S&#225;enz&#44; J&#46; Rodr&#237;guez Ram&#237;rez&#44; A&#46; Baixauli Rubio&#44; M&#46;E&#46; Salguero C&#225;mara&#44; A&#46; Masabeu Urrutia&#44; J&#46;L&#46; Carrillo Linares&#44; A&#46; Gonz&#225;lez Garc&#237;a&#44; V&#46; Alfaro Lara&#44; B&#46; V&#225;zquez V&#225;zquez&#44; R&#46; Gonz&#225;lez Le&#243;n&#44; P&#46; Rubio Mar&#237;n&#44; D&#46; Moreno Ram&#237;rez-Cardenas&#44; I&#46; Selles Sirera&#44; M&#46; Espuelas Monge&#44; R&#46; Mart&#237;nez Guti&#233;rrez&#44; R&#46; Fern&#225;ndez Regueiro&#44; C&#46; Rodr&#237;guez Mart&#237;n&#44; J&#46; Castiella Herrero&#44; V&#46; Naranjo-Velasco&#44; I&#46; Jim&#233;nez P&#233;rez de Heredia&#44; J&#46; Carretero G&#243;mez&#44; J&#46;E&#46; Sol&#237;s Garc&#237;a del Pozo&#44; J&#46; Cueva Rubio&#44; P&#46; Arcos Pereda&#44; P&#46; Rom&#225;n S&#225;nchez&#44; S&#46; Crerar&#44; C&#46; Garmendia Fern&#225;ndez&#44; M&#46;J&#46; Soriano P&#233;rez&#46;</p>"
            "etiqueta" => "Anexo 1"
            "titulo" => "Investigadores del estudio REINA-SEMI"
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                  \t\t\t\t">79 &#40;15&#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">74&#44;4 &#40;16&#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">4&#44;6 &#40;2&#44;2-7&#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;<span class="elsevierStyleHsp" style=""></span>0&#44;001&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">Edad<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>80 a&#241;os &#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">266 &#40;65&#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">128 &#40;46&#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">OR 0&#44;5 &#40;0&#44;3-0&#44;6&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;<span class="elsevierStyleHsp" style=""></span>0&#44;001&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">Mujer &#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">305 &#40;73&#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">175 &#40;62&#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">OR 0&#44;6 &#40;0&#44;4-0&#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;001&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">ICh &#40;DE&#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&#44;2 &#40;2&#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">2&#44;2 &#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">&#8722;0&#44;03 &#40;&#8722;0&#44;4-0&#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;87&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">ICh<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>3 &#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">127 &#40;30&#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">103 &#40;36&#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">OR 1&#44;3 &#40;0&#44;9-1&#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;096&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">Operados &#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">365 &#40;89&#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">222 &#40;78&#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">OR 0&#44;4 &#40;0&#44;3-0&#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">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&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">DQ&#44; d&#237;as &#40;DE&#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&#44;7 &#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&#44;6 &#40;7&#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">-1&#44;90&#40;-2&#44;9--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">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&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">Hospital<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>500 camas &#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">245 &#40;59&#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">174 &#40;61&#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">OR 1&#44;1 &#40;0&#44;8-1&#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;481&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">Primera visita<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&#44; &#40;DE&#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&#44;5 &#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">3&#44;2 &#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">0&#44;3 &#40;0-0&#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">00&#44;025&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">Visitas sucesivas<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&#44; &#40;DE&#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;19&#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&#44;6 &#40;15&#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">2&#44;4 &#40;-0&#44;4-5&#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;09&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">Estancia&#44; d&#237;as &#40;DE&#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">10 &#40;8&#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">18&#44;1 &#40;17&#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">-8 &#40;-10-6&#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">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&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">Estancia<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>15 d&#237;as &#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">67 &#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
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                  \t\t\t\t">Infecci&#243;n respiratoria&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\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">Infecci&#243;n urinaria&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">28 &#40;6&#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">10 &#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">0&#44;5 &#40;0&#44;2-1&#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;068&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">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;14&#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">41 &#40;14&#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">1 &#40;0&#44;6-1&#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;953&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">Trastorno electrol&#237;tico&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">51 &#40;12&#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">43 &#40;15&#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">1&#44;3 &#40;0&#44;8-2&#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">0&#44;262&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">Diabetes descompensada&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">19 &#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">17 &#40;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">1&#44;3 &#40;0&#44;7-2&#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;396&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">Desnutrici&#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">27 &#40;6&#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">14 &#40;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;8 &#40;0&#44;4-1&#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;396&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">185 &#40;44&#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">98 &#40;34&#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;7 &#40;0&#44;5-0&#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;01&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">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">76 &#40;18&#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">42 &#40;14&#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;8 &#40;0&#44;5-1&#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">0&#44;237&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">SAA&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;0&#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">3 &#40;1&#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">4&#44;5 &#40;0&#44;5-43&#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;158&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">Neoplasia&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 &#40;1&#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">10 &#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">3 &#40;1-8&#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;037&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">Cirrosis&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&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;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;1-1&#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;129&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">&#205;leo intestinal&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;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">19 &#40;6&#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">1&#44;8 &#40;0&#44;9-3&#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;087&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">Hemorragia digestiva&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;0&#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">5 &#40;1&#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">3&#44;7 &#40;0&#44;7-19&#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">0&#44;093&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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                  """
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">EPOC agudizada&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">Taquiarritmia&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">36 &#40;7&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">9 &#40;4&#44;7&#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">0&#44;6 &#40;0&#44;3-1&#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;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="" 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">Trastorno electrol&#237;tico&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">47 &#40;9&#44;6&#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">46 &#40;24&#44;1&#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">3 &#40;1&#44;9-4&#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">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&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 respiratoria&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;8&#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">35 &#40;18&#44;3&#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">2&#44;6 &#40;1&#44;6-4&#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">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&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 urinaria&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;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">16 &#40;8&#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">2 &#40;1&#44;03-3&#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">0&#44;058&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">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">63 &#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">38 &#40;19&#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">1&#44;6 &#40;1&#44;02-2&#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;03&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">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">82 &#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">35 &#40;18&#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">1&#44;1 &#40;0&#44;7-1&#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">0&#44;6&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">&#205;leo intestinal&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">15 &#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">19 &#40;9&#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">3&#44;4 &#40;1&#44;7-6&#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;001&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">212 &#40;43&#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">67 &#40;35&#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;7 &#40;0&#44;5-0&#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;04&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">Desnutrici&#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">24 &#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">15 &#40;7&#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">1&#44;6 &#40;0&#44;8-3&#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">0&#44;1&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">Cualquier complicaci&#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">249 &#40;51&#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">125 &#40;65&#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">1&#44;8 &#40;1&#44;2-2&#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;001&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">Intervenci&#243;n 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">418 &#40;86&#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">159 &#40;83&#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">0&#44;8 &#40;0&#44;5-1&#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">0&#44;3&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">DQ &#40;d&#237;as&#41;&#44; media &#40;DE&#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&#44;1 &#40;4&#44;21&#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&#44;9 &#40;8&#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">4&#44;9 &#40;3&#44;8-5&#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">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&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">Modelo interconsultas&nbsp;\t\t\t\t\t\t\n
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Modelos colaborativos hospitalarios de asistencia compartida e interconsultas a demanda. ¿Cuál ofrece mejores resultados en Cirugía Ortopédica y Traumatología?
Collaborative hospital models for shared care and on-demand interconsultations. Which offer the best results for Orthopaedic Surgery and Trauma?
E. Montero Ruiza,
Autor para correspondencia
eduardo.montero@salud.madrid.org

Autor para correspondencia.
, R. Monte Secadesb, D.R. Padilla Lópezc, C. Palomo Antequerad, R.C. Gómez Fernándeze, J. Marco Martínezf, M. Vázquez Campog, F. Garrachón Valloh, A.B. Porto Pérezi, Grupo de Trabajo de Asistencia Compartida e Interconsultas de la Sociedad Española de Medicina Interna (SEMI)
a Servicio de Medicina Interna, Hospital Universitario Ramón y Cajal, Madrid, España
b Servicio de Medicina Interna, Hospital Lucus Augusti, Lugo, España
c Servicio de Medicina Interna, IMQ Clínica Zorrotzaurre, Bilbao, España
d Servicio de Medicina Interna, Hospital Universitario Central de Asturias, Oviedo, España
e Servicio de Medicina Interna, Complejo Hospitalario Universitario, Ourense, España
f Servicio de Medicina Interna, Hospital Clínico San Carlos, Madrid, España
g Servicio de Medicina Interna, Complejo Asistencial Universitario, León, España
h Servicio de Medicina Interna, Hospital Universitario Virgen Macarena, Sevilla, España
i Servicio de Medicina Interna, Complejo Universitario A Coruña, A Coruña, España
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        "titulo" => "Collaborative hospital models for shared care and on-demand interconsultations&#46; Which offer the best results for Orthopaedic Surgery and Trauma&#63;"
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Los progresos en los procedimientos y t&#233;cnicas quir&#250;rgicas&#44; anest&#233;sicas y analg&#233;sicas permiten operar a pacientes de mayor edad y comorbilidad<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">1</span></a> y realizar intervenciones quir&#250;rgicas en r&#233;gimen ambulatorio&#44; o con ingresos hospitalarios muy breves&#44; hasta hace poco impensables&#44; como artroplastias de cadera y rodilla<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">2</span></a>&#44; tiroidectom&#237;as<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">3</span></a> o extirpaci&#243;n de tumores cerebrales<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">4</span></a>&#46; Esta evoluci&#243;n de la asistencia condiciona que los enfermos que permanecen hospitalizados en los servicios quir&#250;rgicos son los que tienen m&#225;s comorbilidad o sufren complicaciones importantes&#44; y que sean dif&#237;ciles de manejar desde un punto de vista m&#233;dico y no solo quir&#250;rgico&#46; Todo ello ha provocado un incremento en la necesidad de apoyo de otros servicios hospitalarios&#44; en especial de Medicina Interna&#44; a los servicios quir&#250;rgicos<a class="elsevierStyleCrossRefs" href="#bib0135"><span class="elsevierStyleSup">1&#44;5</span></a>&#46; Este apoyo tradicionalmente se ha realizado mediante la interconsulta &#40;IC&#41; a demanda&#44; la cual presenta muchos problemas e inconvenientes<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">6</span></a>&#44; circunstancias que han facilitado el desarrollo de una forma distinta de colaboraci&#243;n&#44; la asistencia compartida<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">6</span></a> &#40;AC&#41; donde la responsabilidad sobre los problemas del paciente es compartida por un equipo multidisciplinar con participaci&#243;n de cl&#237;nicos durante todo el ingreso hospitalario&#46; Ambos modelos asistenciales persiguen un mismo fin&#44; ayudar al m&#233;dico responsable del enfermo en la atenci&#243;n m&#233;dica de sus pacientes&#44; pero con organizaci&#243;n y caracter&#237;sticas muy diferentes<a class="elsevierStyleCrossRefs" href="#bib0160"><span class="elsevierStyleSup">6&#44;7</span></a>&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">En los &#250;ltimos a&#241;os&#44; diversos estudios&#44; tanto nacionales<a class="elsevierStyleCrossRefs" href="#bib0170"><span class="elsevierStyleSup">8&#8211;10</span></a> como extranjeros<a class="elsevierStyleCrossRefs" href="#bib0185"><span class="elsevierStyleSup">11&#44;12</span></a>&#44; muestran mejores resultados de la AC frente al manejo habitual de los pacientes en diferentes servicios quir&#250;rgicos&#44; aunque todos son de car&#225;cter retrospectivo y circunscritos a un &#250;nico centro hospitalario&#46; No se han publicado trabajos multic&#233;ntricos que comparen directamente la AC con el modelo tradicional de IC&#46; Si bien la AC parece ser superior a las IC&#44; su implantaci&#243;n se enfrenta a una falta de confianza derivada de la ausencia de publicaciones metodol&#243;gicamente s&#243;lidas y&#44; adem&#225;s&#44; requiere de un profundo cambio tanto en la mentalidad asistencial como en la de gesti&#243;n&#44; al compartir 2 m&#233;dicos la responsabilidad sobre el enfermo&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">El objetivo de este estudio es comparar los resultados asistenciales alcanzados por los modelos de IC y AC en pacientes hospitalizados en Cirug&#237;a Ortop&#233;dica y Traumatolog&#237;a &#40;COT&#41;&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Material y m&#233;todos</span><p id="par0020" class="elsevierStylePara elsevierViewall">El Grupo de Trabajo de Asistencia Compartida e Interconsultas de la Sociedad Espa&#241;ola de Medicina Interna llev&#243; a cabo el &#171;Registro de Interconsultas y Asistencia Compartida de la Sociedad Espa&#241;ola de Medicina Interna&#46; Estudio REINA-SEMI&#187; entre el 15 de mayo y el 15 de junio de 2016&#46; Se trat&#243; de un registro multic&#233;ntrico observacional y prospectivo que reclut&#243; consecutivamente a todos los pacientes hospitalizados atendidos por Medicina Interna mediante IC a demanda o por medio de AC&#44; seg&#250;n definiciones previamente establecidas<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">13</span></a>&#46; El registro fue clasificado como investigaci&#243;n observacional no-postautorizaci&#243;n por la AEMPS y aprobado por el CEIC de Galicia &#40;c&#243;digo 2016-055&#41;&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">Para la realizaci&#243;n del presente trabajo se han seleccionado todos los pacientes incluidos en el registro REINA-SEMI ingresados en los servicios de COT&#44; ya que es habitual la implicaci&#243;n de los internistas con los servicios de COT en ambos modelos colaborativos&#44; AC e IC&#44; a nivel nacional<a class="elsevierStyleCrossRefs" href="#bib0170"><span class="elsevierStyleSup">8&#44;14</span></a>&#46; Con el fin de evitar el posible sesgo que supondr&#237;a la inclusi&#243;n de enfermos con menos comorbilidad en el grupo de AC&#44; al incluir un alto porcentaje de pacientes programados&#44; se decidi&#243; excluir a los pacientes con ingreso programado y considerar &#250;nicamente a los ingresados de urgencia&#46; Asimismo&#44; se excluyeron los pacientes menores de 18 a&#241;os y aquellos en los que no se obtuvo el consentimiento informado escrito aceptando su participaci&#243;n en el estudio&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">Se registraron las caracter&#237;sticas epidemiol&#243;gicas y de comorbilidad basales de los pacientes&#44; as&#237; como las relativas al momento de realizaci&#243;n de la IC y a los d&#237;as de seguimiento en ambos modelos de atenci&#243;n&#44; y el estado &#40;vivo o muerto&#41; al alta hospitalaria&#46; Tambi&#233;n se registraron todas las complicaciones m&#233;dicas desarrolladas durante el ingreso y otros diagn&#243;sticos no conocidos efectuados a ra&#237;z de la intervenci&#243;n &#40;p&#46; ej&#46;&#44; cirrosis&#41;&#46; No se recogieron las complicaciones directamente relacionadas con la cirug&#237;a&#46; Se cuantific&#243; la carga de trabajo midiendo el tiempo dedicado a la valoraci&#243;n cl&#237;nica del paciente por parte del internista&#44; incluyendo el tiempo de solicitud y gesti&#243;n de pruebas&#44; desplazamientos e informaci&#243;n a familiares&#46; Para efectos del c&#225;lculo del tiempo empleado en dicha valoraci&#243;n este se registr&#243; en m&#250;ltiplos de 10<span class="elsevierStyleHsp" style=""></span>min&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Se compararon las variables analizadas entre los grupos de AC e IC con el fin de valorar si alguno de los 2 modelos colaborativos se asociaba a alguna ventaja desde el punto de vista asistencial&#46; Se establecieron 2 grupos de estudio seg&#250;n su estancia hospitalaria&#44; &#60;<span class="elsevierStyleHsp" style=""></span>15 o &#8805;<span class="elsevierStyleHsp" style=""></span>15 d&#237;as&#44; teniendo en cuenta las &#250;ltimas estad&#237;sticas oficiales disponibles sobre la estancia media hospitalaria de los pacientes con fractura de cadera en Espa&#241;a &#40;16 d&#237;as&#41;<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">15</span></a>&#44; y se realiz&#243; un an&#225;lisis multivariante para determinar los factores independientes asociados a una estancia hospitalaria superior<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>15 d&#237;as&#46; Para comprobar qu&#233; variables se asociaron de forma independiente con una estancia hospitalaria prolongada se realiz&#243; un an&#225;lisis de regresi&#243;n log&#237;stica binaria&#46;</p><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">An&#225;lisis estad&#237;stico</span><p id="par0040" class="elsevierStylePara elsevierViewall">Las variables cuantitativas se describieron con la media y la desviaci&#243;n est&#225;ndar y las variables cualitativas con su valor absoluto y porcentaje&#46; En el an&#225;lisis univariante se realiz&#243; la comparaci&#243;n de 2 medias utilizando la prueba de la t de Student o la prueba de Mann Whitney seg&#250;n fueran apropiadas&#46; Para las variables cualitativas se us&#243; la prueba chi-cuadrado&#59; cuando las celdas conten&#237;an valores esperados inferiores a 5&#44; se utiliz&#243; la prueba exacta de Fisher&#46; La significaci&#243;n estad&#237;stica se estableci&#243; con un valor de p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#46; El an&#225;lisis multivariante se llev&#243; a cabo con un modelo de regresi&#243;n log&#237;stica&#44; introduciendo las variables con el m&#233;todo de inclusi&#243;n por pasos&#46; En el modelo final se incluyeron las variables significativas resultantes en el an&#225;lisis univariante&#44; y aquellas relevantes desde un punto de vista cl&#237;nico que pudiesen influir en el resultado final&#46; Se calcularon los valores de odds ratio ajustados y sus respectivos intervalos de confianza&#46; Para su realizaci&#243;n se utiliz&#243; el paquete estad&#237;stico SPSS&#174; v&#46;18&#46;0 &#40;SPSS Inc&#46; Chicago&#44; EE&#46; UU&#46;&#41;&#46;</p></span></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Resultados</span><p id="par0045" class="elsevierStylePara elsevierViewall">El registro REINA-SEMI incluy&#243; un total de 2&#46;234 pacientes&#44; de los que 697 fueron ingresos urgentes en los servicios de COT y participan en este estudio&#44; 415 en el grupo de AC y 282 en el de IC&#46; Los pacientes proven&#237;an de 41 hospitales de Asturias&#44; Andaluc&#237;a&#44; Arag&#243;n&#44; Catalu&#241;a&#44; Castilla-La Mancha&#44; Castilla y Le&#243;n&#44; Comunidad Valenciana&#44; Extremadura&#44; Galicia&#44; Islas Canarias&#44; La Rioja&#44; Madrid y Pa&#237;s Vasco&#44; adem&#225;s de un centro hospitalario de la ciudad de Buenos Aires &#40;Argentina&#41;&#46; Hospitales hasta 500 camas aportan 278 casos&#44; y los de m&#225;s de 500 camas 419 casos&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">En la <a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a> se describen las caracter&#237;sticas demogr&#225;ficas y asistenciales de los enfermos&#46; Los pacientes del grupo de AC fueron de m&#225;s edad &#40;4&#44;6 a&#241;os&#41;&#44; con un 50&#37; m&#225;s de pacientes con edad superior a 80 a&#241;os&#44; mayor n&#250;mero de mujeres&#44; fueron intervenidos quir&#250;rgicamente con m&#225;s frecuencia y tuvieron una estancia hospitalaria m&#225;s corta &#40;8 d&#237;as menos&#41; que el grupo de IC&#46; Se observ&#243; una tendencia no significativa hacia una menor mortalidad en el grupo de AC&#46; En el grupo de IC&#44; esta se solicit&#243; tras 7&#44;5 d&#237;as de ingreso &#40;desviaci&#243;n est&#225;ndar 13&#44;7&#41;&#44; mediana 3 d&#237;as&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0055" class="elsevierStylePara elsevierViewall">En la <a class="elsevierStyleCrossRef" href="#tbl0010">tabla 2</a> se muestran los diagn&#243;sticos m&#233;dicos registrados&#46; Hubo pocas diferencias entre ambos grupos en cuanto a la presencia de complicaciones individuales&#46; La anemia fue m&#225;s frecuente en el grupo de AC y la enfermedad pulmonar obstructiva cr&#243;nica agudizada en el de IC&#46; Otras&#44; como la infecci&#243;n urinaria&#44; las taquiarritmias y las neoplasias&#44; predominaron en el grupo de IC&#44; aunque sin alcanzar significaci&#243;n estad&#237;stica&#46; Sin embargo&#44; el grupo de AC tuvo menos complicaciones m&#233;dicas de forma global que el grupo de IC&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0060" class="elsevierStylePara elsevierViewall">En la <a class="elsevierStyleCrossRef" href="#tbl0015">tabla 3</a> se muestra el an&#225;lisis univariante de los factores relacionados con una estancia hospitalaria<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>15 d&#237;as&#46; La estancia prolongada se asoci&#243; a la demora en programar la intervenci&#243;n quir&#250;rgica desde el ingreso y al desarrollo de diversas complicaciones m&#233;dicas durante el ingreso&#44; como insuficiencia cardiaca&#44; infecci&#243;n respiratoria&#44; trastorno electrol&#237;tico o &#237;leo intestinal&#46; El tama&#241;o reducido del hospital&#44; el modelo de AC y el sexo &#40;mujer&#41; se relacionaron con estancias cortas&#44; mientras que la comorbilidad y la edad avanzada no se asociaron con estancias<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>15 d&#237;as&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0065" class="elsevierStylePara elsevierViewall">Se realiz&#243; una regresi&#243;n log&#237;stica binaria para evaluar el efecto de variables estad&#237;sticamente significativas en el an&#225;lisis univariante y las cl&#237;nicamente relevantes&#44; aunque no tuviesen significaci&#243;n&#46; El modelo de regresi&#243;n log&#237;stica fue estad&#237;sticamente significativo &#40;X<span class="elsevierStyleSup">2</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>153&#44;869&#44; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#44; explica el 34&#37; &#40;R<span class="elsevierStyleSup">2</span> de Nagelkerke&#41; de la varianza en estancia<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>15 d&#237;as y clasifica correctamente el 80&#44;5&#37; de los casos&#46; La sensibilidad fue del 76&#44;4&#37;&#44; la especificidad del 81&#44;2&#37;&#44; el valor predictivo negativo del <span class="elsevierStyleHsp" style=""></span>94&#44;9&#37; y el valor predictivo positivo del 42&#44;8&#37;&#46; Las variables independientes predictoras de una estancia prolongada se muestran en la <a class="elsevierStyleCrossRef" href="#tbl0020">tabla 4</a>&#58; modelo asistencial de interconsultas a demanda&#44; sexo &#40;hombre&#41;&#44; insuficiencia cardiaca&#44; infecci&#243;n respiratoria&#44; trastorno electrol&#237;tico y demora quir&#250;rgica&#46;</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Discusi&#243;n</span><p id="par0070" class="elsevierStylePara elsevierViewall">Nuestros resultados muestran que los pacientes ingresados de urgencia en COT atendidos mediante AC son operados en mayor proporci&#243;n y con menor demora hasta la intervenci&#243;n&#44; sufren menos complicaciones m&#233;dicas y tienen una menor estancia hospitalaria que los atendidos mediante IC&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">Observamos un mayor porcentaje de complicaciones m&#233;dicas en el grupo IC&#44; en especial de s&#237;ndrome coronario agudo y reagudizaci&#243;n de enfermedad pulmonar obstructiva cr&#243;nica&#46; Este hallazgo probablemente se explica porque los traumat&#243;logos no est&#225;n alertados para aplicar las medidas preventivas posibles en cada caso y detectar precozmente estas situaciones&#46; Este hallazgo es coherente con publicaciones previas&#44; las cuales comunican que los servicios quir&#250;rgicos solicitan la gran mayor&#237;a de las IC cuando ya se ha producido la complicaci&#243;n<a class="elsevierStyleCrossRefs" href="#bib0200"><span class="elsevierStyleSup">14&#44;16</span></a>&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">Desconocemos el motivo de la presencia de un mayor n&#250;mero de pacientes con anemia en el grupo de AC&#46; Podr&#237;a deberse a que se tratara de pacientes sometidos a cirug&#237;as m&#225;s sangrantes&#44; pero el dise&#241;o del estudio no permite establecer los motivos de este hallazgo&#46; Dicho hallazgo tiene importancia porque la anemia es un factor que empeora el pron&#243;stico quir&#250;rgico<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">17</span></a>&#46; A pesar de ello&#44; los resultados del grupo AC son mejores que los del grupo IC&#44; un dato m&#225;s a tener en consideraci&#243;n en la valoraci&#243;n final de este estudio&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">Respecto a la mayor proporci&#243;n de neoplasia en el grupo IC&#44; una posible explicaci&#243;n ser&#237;a que los traumat&#243;logos seleccionar&#237;an este tipo de pacientes en especial para ser seguidos por los internistas&#44; lo que aumentar&#237;a su proporci&#243;n en este grupo&#46; Sin embargo&#44; la mayor carga de morbilidad que supone este sesgo de selecci&#243;n parece que podr&#237;a estar compensada por otras comorbilidades de alguna forma&#44; ya que el &#237;ndice de comorbilidad de Charlson es similar en ambos grupos&#46; En cualquier caso&#44; el escaso n&#250;mero de neoplasias registrado no permite extraer explicaciones s&#243;lidas&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">Para intentar aclarar si el modelo asistencial por s&#237; mismo&#44; AC o IC&#44; ofrece resultados diferentes y para contrarrestar el posible sesgo de selecci&#243;n de pacientes en ambos modelos&#44; se complet&#243; el estudio mediante la creaci&#243;n de 2 grupos en funci&#243;n de su estancia hospitalaria<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>15 d&#237;as&#46; El estudio de la estancia hospitalaria tiene un inter&#233;s especial ya que&#44; entre otras razones&#44; es un buen indicador de padecer sucesos adversos<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">18</span></a> y del coste asistencial<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">19</span></a>&#46; Como era de esperar&#44; el grupo de estancia<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>15 d&#237;as mostr&#243; unos peores resultados y mayor cantidad de complicaciones m&#233;dicas&#44; as&#237; como una mayor demora hasta la intervenci&#243;n&#44; que podr&#237;a explicarse por su situaci&#243;n cl&#237;nica al ingreso y&#47;o aparici&#243;n de complicaciones&#44; hallazgos ya descritos por otros autores<a class="elsevierStyleCrossRefs" href="#bib0200"><span class="elsevierStyleSup">14&#44;16</span></a>&#46; En el an&#225;lisis multivariante&#44; el factor pron&#243;stico independiente m&#225;s importante fue el ser atendido mediante el sistema de interconsultas cl&#225;sico&#44; con 3 veces y media m&#225;s de posibilidades de permanecer ingresado<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>15 d&#237;as&#46; Conviene recordar que las IC se solicitan tard&#237;amente durante el ingreso o cuando ha aparecido una complicaci&#243;n<a class="elsevierStyleCrossRefs" href="#bib0200"><span class="elsevierStyleSup">14&#44;16</span></a>&#44; hallazgos que refuerzan la necesidad de realizar AC&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">Comparar directamente estos 2 modelos asistenciales puede ser problem&#225;tico porque&#44; mientras que en AC todos los pacientes son atendidos por los internistas de forma autom&#225;tica y reglada desde su ingreso&#44; en el modelo de IC lo son solo aquellos a petici&#243;n del traumat&#243;logo&#44; lo que introduce un importante sesgo de selecci&#243;n&#46; Sin embargo&#44; puesto que el objetivo del estudio es comparar ambos modelos colaborativos&#44; los resultados mostrados parecen pertinentes&#46; Uno de dichos modelos&#44; el de IC&#44; descansa en el traumat&#243;logo y su capacidad para detectar los problemas m&#233;dicos existentes o de nueva aparici&#243;n&#46; Es de esperar que ambos grupos de pacientes sean distintos&#46; Los traumat&#243;logos se ven forzados con mucha frecuencia&#44; por sus limitados conocimientos de la patolog&#237;a m&#233;dica&#44; a solicitar las interconsultas de manera incorrecta o tard&#237;a<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">16</span></a>&#46; Por ello&#44; creemos que la comparaci&#243;n directa de ambos grupos ofrece una visi&#243;n adecuada del problema&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">El menor n&#250;mero de problemas m&#233;dicos y los mejores resultados asistenciales mostrados por la AC frente a las IC pueden estar motivados por diversos factores&#46; La presencia desde el ingreso de los internistas en el modelo AC reduce la estancia&#44; los reingresos a 30 d&#237;as&#44; la mortalidad y los costes<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">20</span></a>&#46; Adem&#225;s&#44; no solo reduce la incidencia de complicaciones&#44; sino que tambi&#233;n disminuye su severidad al facilitar un diagn&#243;stico y tratamiento m&#225;s precoces&#44; reduciendo el &#171;fallo de rescate&#187;<a class="elsevierStyleCrossRefs" href="#bib0235"><span class="elsevierStyleSup">21&#44;22</span></a>&#46; Tambi&#233;n disminuye los errores&#44; facilita la coordinaci&#243;n entre los facultativos y permite una mejor conciliaci&#243;n de los tratamientos seguidos por el paciente&#46; Por el contrario&#44; las IC favorecen la realizaci&#243;n de un exceso de pruebas y su repetici&#243;n&#44; la polifarmacia&#44; el aislamiento del paciente y la complacencia o p&#233;rdida de inter&#233;s del m&#233;dico responsable&#44; entre otros muchos problemas<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">6</span></a>&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">Un factor importante es que nuestros resultados muestran que en el modelo de AC el internista emplea m&#225;s tiempo en cada paciente&#44; en especial en el seguimiento&#44; que en el modelo de IC&#44; lo que obviamente permite una mejor valoraci&#243;n&#44; control y seguimiento del enfermo&#46; El tiempo disponible para la contestaci&#243;n de una IC es un factor determinante para su resultado<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">23</span></a>&#46; Otro posible aspecto a tener en cuenta es que&#44; en nuestra experiencia&#44; la AC favorece un mayor contacto con la guardia m&#233;dica&#44; y esta tiene un efecto beneficioso sobre la mortalidad quir&#250;rgica<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">24</span></a>&#44; y tambi&#233;n facilita un mejor contacto y coordinaci&#243;n con Anestesia&#44; permitiendo discutir y prepara los casos adecuadamente&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">Adem&#225;s del ya comentado sesgo de selecci&#243;n de pacientes&#44; este trabajo presenta varias limitaciones&#46; No se registraron los motivos del ingreso&#44; por lo que podr&#237;an existir diferencias entre ambos grupos al solicitar IC con m&#225;s frecuencia a enfermos con determinados diagn&#243;sticos&#44; como la fractura de cadera&#46; Sin embargo&#44; y a pesar de ello&#44; el &#237;ndice de comorbilidad de Charlson es similar en ambos grupos&#44; mientras que la edad&#44; factor que empeora el pron&#243;stico<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">25</span></a>&#44; es mayor en el grupo AC&#46; Es posible que pacientes con problemas m&#233;dicos relevantes&#44; que son vistos siempre por internistas en el grupo AC&#44; no sean valorados por especialistas m&#233;dicos &#40;internistas u otros especialistas&#41; en el grupo IC al no ser solicitadas por los traumat&#243;logos&#46; Desconocer este dato es importante en la valoraci&#243;n de los resultados&#46; Por otra parte&#44; el registro no incluy&#243; las complicaciones directamente relacionadas con la cirug&#237;a &#40;infecciones de herida&#44; luxaciones&#8230;&#41;&#44; por lo que no se puede saber si este aspecto se modificar&#237;a en alguno de los modelos colaborativos analizados&#46; El periodo de reclutamiento de pacientes fue corto &#40;un mes&#41;&#44; por lo que es posible que existan diferencias con respecto a otras &#233;pocas del a&#241;o que podr&#237;an hacer variar los resultados&#44; ya que se han descrito variaciones estacionales en la solicitud de interconsultas<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">1</span></a>&#44; y tambi&#233;n en diversas patolog&#237;as quir&#250;rgicas urgentes<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">26</span></a>&#46; Al no ser un ensayo cl&#237;nico&#44; es posible la existencia de variables de confusi&#243;n no registradas que puedan influir en el grado de asociaci&#243;n encontrado&#46; Un problema a&#241;adido es que no hemos encontrado publicaciones similares a la nuestra&#44; ni en dise&#241;o ni en los pacientes incluidos en el estudio&#44; lo que impide poder comparar nuestros resultados con los de otros autores&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">Como conclusi&#243;n podemos decir que el modelo de AC ofrece mejores resultados asistenciales que el modelo tradicional de IC en pacientes ingresados de urgencia en el servicio de COT&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Conflicto de intereses</span><p id="par0120" 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">Antecedentes y objetivo</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Los enfermos quir&#250;rgicos hospitalizados est&#225;n aumentando su complejidad m&#233;dica&#44; incrementando la necesidad de apoyo por Medicina Interna&#46; Este apoyo se realiza mediante la interconsulta&#44; la cual presenta problemas que han inducido el desarrollo de la asistencia compartida &#40;AC&#41;&#46; Nuestro objetivo es comparar los resultados asistenciales alcanzados por los modelos de interconsulta y AC en Cirug&#237;a Ortop&#233;dica y Traumatolog&#237;a&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Material y m&#233;todo</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Estudio observacional&#44; prospectivo&#44; multic&#233;ntrico&#44; de los enfermos hospitalizados de urgencia en Cirug&#237;a Ortop&#233;dica y Traumatolog&#237;a recogidos en el registro REINA-SEMI&#44; atendidos por Medicina Interna mediante interconsulta o AC&#46; Se registraron las caracter&#237;sticas demogr&#225;ficas&#44; comorbilidad&#44; complicaciones m&#233;dicas&#44; estancia hospitalaria y mortalidad&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Se incluyeron 697 pacientes&#44; 415 con AC y 282 con interconsulta&#46; Los de AC ten&#237;an m&#225;s edad &#40;78&#44;9 vs&#46; 74&#44;3&#59; p &#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#44; se operaron m&#225;s &#40;89&#44;9 vs&#46; 78&#44;7&#37;&#59; p &#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#44; tuvieron menos complicaciones m&#233;dicas &#40;50&#44;4 vs&#46; 62&#44;8&#37;&#59; p &#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41; y su estancia hospitalaria fue menor &#40;10 vs&#46; 18 d&#237;as&#59; p &#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#44; sin diferencias en la comorbilidad ni mortalidad&#46; Los factores independientes asociados a estancia superior a 15 d&#237;as fueron&#58; insuficiencia cardiaca &#40;OR&#58; 3&#44;4&#59; IC 95&#37;&#58; 1&#44;8-6&#44;1&#59; p &#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#44; sexo &#40;hombre&#41; &#40;OR&#58; 1&#44;9&#59; IC 95&#37;&#58; 1&#44;2-3&#44;1&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;004&#41;&#44; trastorno electrol&#237;tico &#40;OR&#58; 2&#44;4&#59; IC 95&#37;&#58; 1&#44;3-4&#44;4&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;003&#41;&#44; infecci&#243;n respiratoria &#40;OR&#58; 1&#44;9&#59; IC 95&#37;&#58; 1&#44;04-3&#44;7&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;035&#41;&#44; demora quir&#250;rgica &#40;OR&#58; 1&#44;1&#59; IC 95&#37;&#58; 1&#44;08-1&#44;2&#59; p &#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41; y ser atendido mediante el modelo de interconsulta a demanda &#40;OR&#58; 3&#44;5&#59; IC 95&#37;&#58; 2&#44;3-5&#44;4&#59; p &#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">La AC ofrece mejores resultados asistenciales que las interconsultas en pacientes ingresados de urgencia en Cirug&#237;a Ortop&#233;dica y Traumatolog&#237;a&#46;</p></span>"
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        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Background and objectives</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Hospitalized surgical patients are increasing in medical complexity&#44; thereby increasing the need for support by internal medicine departments&#46; This support is provided through interconsultations&#44; which present problems that have resulted in the development of shared care &#40;SC&#41;&#46; Our objective was to compare the healthcare results achieved by the SC and interconsultation models in Orthopaedic Surgery and Trauma&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Materials and methods</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">We conducted an observational&#44; prospective&#44; multicentre study of patients hospitalized for emergency Orthopaedic Surgery and Trauma recorded in the REINA-SEMI registry&#44; treated by internal medicine departments through interconsultation or SC&#46; We recorded the demographic characteristics&#44; comorbidity&#44; medical complications&#44; hospital stay and mortality&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">The study included 697 patients&#44; 415 with SC and 282 with interconsultations&#46; The SC patients were older &#40;78&#46;9 vs&#46; 74&#46;3&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001&#41; underwent more operations &#40;89&#46;9 vs&#46; 78&#46;7&#37;&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001&#41;&#44; had fewer medical complications &#40;50&#46;4 vs&#46; 62&#46;8&#37;&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001&#41; and had shorter hospital stays &#40;10 vs&#46; 18 days&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001&#41;&#44; with no differences in comorbidity or mortality&#46; The following independent factors were associated with stays longer than 15 days&#58; heart failure &#40;OR 3&#46;4&#59; 95&#37; CI 1&#46;8-6&#46;1&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001&#41;&#44; the male sex &#40;OR 1&#46;9&#59; 95&#37; CI 1&#46;2-3&#46;1&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;004&#41;&#44; electrolyte disorder &#40;OR 2&#46;4&#59; 95&#37; CI 1&#46;3-4&#46;4&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;003&#41;&#44; respiratory infection &#40;OR 1&#46;9&#59; 95&#37; CI 1&#46;04-3&#46;7&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;035&#41;&#44; surgical delay &#40;OR 1&#46;1&#59; 95&#37; CI 1&#46;08-1&#46;2&#59; <span class="elsevierStyleItalic">P</span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001&#41; and treatment using the interconsultation on demand model &#40;OR 3&#46;5&#59; 95&#37; CI 2&#46;3-5&#46;4&#59; <span class="elsevierStyleItalic">P</span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001&#41;&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">SC offers better healthcare results than interconsultations for patients hospitalized for emergency Orthopaedic Surgery and Trauma&#46;</p></span>"
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            "apendice" => "<p id="par0125" class="elsevierStylePara elsevierViewall">J&#46; Feyjoo Casero&#44; M&#46; Gonz&#225;lez Anglada&#44; M&#46; Freire Romero&#44; A&#46; Gil D&#237;az&#44; A&#46; Granados Maturano&#44; D&#46; Rubal Bran&#44; R&#46; Rabu&#241;al Rey&#44; L&#46; Nevado Lopez-Alegr&#237;a&#44; H&#46; Meijide M&#237;guez&#44; C&#46; Cienfuegos Basanta&#44; D&#46; Brosio&#44; D&#46; Iglesias S&#225;enz&#44; J&#46; Rodr&#237;guez Ram&#237;rez&#44; A&#46; Baixauli Rubio&#44; M&#46;E&#46; Salguero C&#225;mara&#44; A&#46; Masabeu Urrutia&#44; J&#46;L&#46; Carrillo Linares&#44; A&#46; Gonz&#225;lez Garc&#237;a&#44; V&#46; Alfaro Lara&#44; B&#46; V&#225;zquez V&#225;zquez&#44; R&#46; Gonz&#225;lez Le&#243;n&#44; P&#46; Rubio Mar&#237;n&#44; D&#46; Moreno Ram&#237;rez-Cardenas&#44; I&#46; Selles Sirera&#44; M&#46; Espuelas Monge&#44; R&#46; Mart&#237;nez Guti&#233;rrez&#44; R&#46; Fern&#225;ndez Regueiro&#44; C&#46; Rodr&#237;guez Mart&#237;n&#44; J&#46; Castiella Herrero&#44; V&#46; Naranjo-Velasco&#44; I&#46; Jim&#233;nez P&#233;rez de Heredia&#44; J&#46; Carretero G&#243;mez&#44; J&#46;E&#46; Sol&#237;s Garc&#237;a del Pozo&#44; J&#46; Cueva Rubio&#44; P&#46; Arcos Pereda&#44; P&#46; Rom&#225;n S&#225;nchez&#44; S&#46; Crerar&#44; C&#46; Garmendia Fern&#225;ndez&#44; M&#46;J&#46; Soriano P&#233;rez&#46;</p>"
            "etiqueta" => "Anexo 1"
            "titulo" => "Investigadores del estudio REINA-SEMI"
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">AC&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">IC&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">Dif&#47;OR &#40;IC 95&#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">p&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="" 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
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><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">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">415&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">282&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><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><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">Edad&#44; a&#241;os &#40;DE&#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">79 &#40;15&#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">74&#44;4 &#40;16&#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">4&#44;6 &#40;2&#44;2-7&#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;<span class="elsevierStyleHsp" style=""></span>0&#44;001&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">Edad<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>80 a&#241;os &#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">266 &#40;65&#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">128 &#40;46&#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">OR 0&#44;5 &#40;0&#44;3-0&#44;6&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;<span class="elsevierStyleHsp" style=""></span>0&#44;001&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">Mujer &#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">305 &#40;73&#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">175 &#40;62&#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">OR 0&#44;6 &#40;0&#44;4-0&#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;001&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">ICh &#40;DE&#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&#44;2 &#40;2&#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">2&#44;2 &#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">&#8722;0&#44;03 &#40;&#8722;0&#44;4-0&#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;87&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">ICh<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>3 &#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">127 &#40;30&#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">103 &#40;36&#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">OR 1&#44;3 &#40;0&#44;9-1&#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;096&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">Operados &#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">365 &#40;89&#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">222 &#40;78&#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">OR 0&#44;4 &#40;0&#44;3-0&#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">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&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">DQ&#44; d&#237;as &#40;DE&#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&#44;7 &#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&#44;6 &#40;7&#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">-1&#44;90&#40;-2&#44;9--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">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&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">Hospital<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>500 camas &#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">245 &#40;59&#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">174 &#40;61&#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">OR 1&#44;1 &#40;0&#44;8-1&#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;481&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">Primera visita<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&#44; &#40;DE&#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&#44;5 &#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">3&#44;2 &#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">0&#44;3 &#40;0-0&#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">00&#44;025&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">Visitas sucesivas<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&#44; &#40;DE&#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;19&#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&#44;6 &#40;15&#44;7&#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
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                  \t\t\t\t">0&#44;354&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</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 respiratoria&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">41 &#40;9&#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">35 &#40;12&#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">1&#44;3 &#40;0&#44;8-2&#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">0&#44;293&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">EPOC reagudizada&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;3&#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">21 &#40;7&#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">2&#44;3 &#40;1&#44;2-4&#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;025&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 urinaria&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">28 &#40;6&#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">10 &#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">0&#44;5 &#40;0&#44;2-1&#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;068&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">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;14&#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">41 &#40;14&#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">1 &#40;0&#44;6-1&#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;953&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">Trastorno electrol&#237;tico&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">51 &#40;12&#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">43 &#40;15&#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">1&#44;3 &#40;0&#44;8-2&#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">0&#44;262&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">Diabetes descompensada&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">19 &#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">17 &#40;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">1&#44;3 &#40;0&#44;7-2&#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;396&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">Desnutrici&#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">27 &#40;6&#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">14 &#40;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;8 &#40;0&#44;4-1&#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;396&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">185 &#40;44&#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">98 &#40;34&#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;7 &#40;0&#44;5-0&#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;01&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">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">76 &#40;18&#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">42 &#40;14&#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;8 &#40;0&#44;5-1&#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">0&#44;237&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">SAA&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;0&#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">3 &#40;1&#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">4&#44;5 &#40;0&#44;5-43&#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;158&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">Neoplasia&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 &#40;1&#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">10 &#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">3 &#40;1-8&#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;037&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">Cirrosis&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&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;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;1-1&#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;129&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  """
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          "leyenda" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">DE&#58; desviaci&#243;n est&#225;ndar&#59; Dif&#47;OR&#58; diferencia&#47;odds ratio&#59; DQ&#58; demora quir&#250;rgica&#59; EPOC&#58; enfermedad pulmonar obstructiva cr&#243;nica&#59; IC 95&#37;&#58; intervalo de confianza del 95&#37;&#59; ICh&#58; &#205;ndice de comorbilidad de Charlson&#46;</p>"
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">EPOC agudizada&nbsp;\t\t\t\t\t\t\n
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                  \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&#44;4 &#40;0&#44;6-2&#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;3&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">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">45 &#40;9&#44;2&#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">47 &#40;24&#44;6&#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">3&#44;2 &#40;2-5&#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">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&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">Taquiarritmia&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;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">9 &#40;4&#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;6 &#40;0&#44;3-1&#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;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="" 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">Trastorno electrol&#237;tico&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">47 &#40;9&#44;6&#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">46 &#40;24&#44;1&#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">3 &#40;1&#44;9-4&#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">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&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 respiratoria&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;8&#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">35 &#40;18&#44;3&#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">2&#44;6 &#40;1&#44;6-4&#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">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&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 urinaria&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;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">16 &#40;8&#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">2 &#40;1&#44;03-3&#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">0&#44;058&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">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">63 &#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">38 &#40;19&#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">1&#44;6 &#40;1&#44;02-2&#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;03&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">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">82 &#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">35 &#40;18&#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">1&#44;1 &#40;0&#44;7-1&#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">0&#44;6&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">&#205;leo intestinal&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">15 &#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">19 &#40;9&#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">3&#44;4 &#40;1&#44;7-6&#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;001&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">212 &#40;43&#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">67 &#40;35&#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;7 &#40;0&#44;5-0&#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;04&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">Desnutrici&#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">24 &#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">15 &#40;7&#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">1&#44;6 &#40;0&#44;8-3&#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">0&#44;1&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">Cualquier complicaci&#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">249 &#40;51&#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">125 &#40;65&#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">1&#44;8 &#40;1&#44;2-2&#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;001&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">Intervenci&#243;n quir&#250;rgica&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">418 &#40;86&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#44;3&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">Hospital<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>500 camas&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">3&#44;5 &#40;2&#44;3-5&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">Sexo&#44; hombre&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">1&#44;9 &#40;1&#44;2-3&#44;1&#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
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                  \t\t\t\t">0&#44;004&nbsp;\t\t\t\t\t\t\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 ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">Insuficiencia cardiaca&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">3&#44;4 &#40;1&#44;8-6&#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">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&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
                  \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 ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">Infecci&#243;n respiratoria&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">1&#44;9 &#40;1&#44;04-3&#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">0&#44;035&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
                  \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 ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">Trastorno electrol&#237;tico&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">2&#44;4 &#40;1&#44;3-4&#44;4&#41;&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">0&#44;003&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">DQ &#40;d&#237;as&#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
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                  \t\t\t\t">1&#44;1 &#40;1&#44;08-1&#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
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                  \t\t\t\t">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
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                  \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>
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                      "titulo" => "Factores que influyen en la solicitud de interconsultas a medicina interna por los servicios quir&#250;rgicos"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "E&#46; Montero Ruiz"
                            1 => "L&#46; P&#233;rez S&#225;nchez"
                            2 => "C&#46; G&#243;mez Ayerbe"
                            3 => "J&#46;M&#46; Barbero Allende"
                            4 => "M&#46; Garc&#237;a S&#225;nchez"
                            5 => "J&#46; L&#243;pez &#193;lvarez"
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                      "doi" => "10.1016/j.ciresp.2010.12.008"
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                        "volumen" => "89"
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                            0 => "K&#46; Gromov"
                            1 => "P&#46; Kj&#230;rsgaard-Andersen"
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                            3 => "H&#46; Kehlet"
                            4 => "H&#46; Husted"
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                    0 => array:2 [
                      "doi" => "10.1080/17453674.2017.1314158"
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                        "tituloSerie" => "Acta Orthop&#46;"
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                        "volumen" => "88"
                        "paginaInicial" => "516"
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Safety of same-day thyroidectomy&#58; Meta-analysis and systematic review"
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                          "etal" => false
                          "autores" => array:6 [
                            0 => "H&#46; Khadra"
                            1 => "S&#46; Mohamed"
                            2 => "A&#46; Hauch"
                            3 => "J&#46; Carter"
                            4 => "T&#46; Hu"
                            5 => "E&#46; Kandil"
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Información del artículo
ISSN: 00142565
Idioma original: Español
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