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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introducci&#243;n</span><p id="par0005" class="elsevierStylePara elsevierViewall">La enfermedad tromboemb&#243;lica venosa &#40;ETV&#41; es una complicaci&#243;n com&#250;n en pacientes sometidos a cirug&#237;a articular mayor &#40;artroplastia electiva de cadera o rodilla o cirug&#237;a de fractura de cadera&#41;&#44; con una morbimortalidad significativa<a class="elsevierStyleCrossRefs" href="#bib0140"><span class="elsevierStyleSup">1&#8211;3</span></a>&#46; Sin embargo&#44; las evidencias sobre la frecuencia y la gravedad de los eventos de ETV desarrollados tanto tras una cirug&#237;a articular menor &#40;pacientes sin cirug&#237;a articular mayor&#41; como en pacientes que presentan lesiones no quir&#250;rgicas son escasas&#46; Entre estas &#250;ltimas figuran&#58; fracturas de hueso&#44; contusiones&#44; esguince de tobillo y roturas musculares o tendinosas&#44; y aquellas cuyas opciones terap&#233;uticas incluyen la inmovilizaci&#243;n con o sin yeso o f&#233;rula&#46; Son muy numerosos los art&#237;culos que demuestran la eficacia y la seguridad de la profilaxis de la ETV en pacientes sometidos a cirug&#237;a articular mayor&#46; Sin embargo&#44; son pocas las evidencias sobre la eficacia y la seguridad de estas medidas en pacientes con lesiones consideradas de bajo riesgo&#46; Bas&#225;ndose en los resultados obtenidos en 6 ensayos aleatorizados en pacientes que necesitaron inmovilizaci&#243;n de la pierna durante al menos una semana<a class="elsevierStyleCrossRefs" href="#bib0155"><span class="elsevierStyleSup">4&#8211;9</span></a>&#44; la gu&#237;a del American College of Chest Physicians propuso la no prescripci&#243;n de profilaxis farmacol&#243;gica de la ETV en pacientes con lesiones aisladas en la pierna<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">1</span></a>&#46; Otras gu&#237;as o recomendaciones de expertos s&#237; que aconsejaban su uso<a class="elsevierStyleCrossRefs" href="#bib0185"><span class="elsevierStyleSup">10&#8211;15</span></a>&#46; No obstante&#44; un ensayo reciente parece confirmar que la profilaxis puede no ser eficaz<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">16</span></a>&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">Debido a esta controversia&#44; utilizamos la base de datos del Registro Informatizado de pacientes con Enfermedad TromboEmb&#243;lica &#40;RIETE&#41; para comparar el desarrollo de la ETV despu&#233;s de&#58; 1&#41; artroplastia electiva de cadera o rodilla&#59; 2&#41; fractura de cadera&#59; 3&#41; cirug&#237;a ortop&#233;dica menor&#44; y 4&#41; traumatismo no quir&#250;rgico&#46; Tambi&#233;n evaluamos el cumplimiento de las directrices sobre el uso de la tromboprofilaxis&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">M&#233;todos</span><p id="par0015" class="elsevierStylePara elsevierViewall">El RIETE<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">17</span></a> es un registro prospectivo multic&#233;ntrico continuo&#44; observacional e internacional&#44; de pacientes sucesivos con ETV sintom&#225;tica aguda&#46; Se inici&#243; en Espa&#241;a en el 2011&#44; y a&#241;os m&#225;s tarde fue traducido al ingl&#233;s con el fin de extenderlo a otros pa&#237;ses y permitir&#44; en &#250;ltimo t&#233;rmino&#44; a los m&#233;dicos de todo el mundo el empleo de la base de datos para poder elegir el tratamiento m&#225;s apropiado para sus pacientes&#46; Los pa&#237;ses participantes incluidos fueron&#58; Espa&#241;a&#44; Andorra&#44; B&#233;lgica&#44; Francia&#44; Italia&#44; Grecia&#44; Portugal&#44; Israel&#44; Alemania&#44; Suiza&#44; Rep&#250;blica de Macedonia&#44; Letonia&#44; Rep&#250;blica Checa&#44; EE&#46; UU&#46;&#44; Canad&#225;&#44; Ecuador&#44; Argentina&#44; Nicaragua y Brasil&#46; Los datos del registro han sido utilizados para evaluar los eventos producidos tras la ETV&#44; como&#44; por ejemplo&#44; la frecuencia de ETV recurrente&#44; hemorragia mayor y mortalidad&#44; adem&#225;s de elementos predictores para cada uno de estos resultados<a class="elsevierStyleCrossRefs" href="#bib0225"><span class="elsevierStyleSup">18&#8211;20</span></a>&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Se inscribieron en el RIETE los pacientes ambulatorios consecutivos con embolia pulmonar sintom&#225;tica aguda &#40;EP&#41; o con trombosis venosa profunda &#40;TVP&#41; confirmados mediante pruebas objetivas &#40;gammagraf&#237;a pulmonar de ventilaci&#243;n-perfusi&#243;n&#44; tomograf&#237;a computarizada helicoidal o angiograf&#237;a en caso de sospecha de EP&#59; ecograf&#237;a compresiva o venograf&#237;a de contraste para los sospechosos de TVP&#41;&#46; Se excluyeron aquellos pacientes que en ese mismo momento participaran en un ensayo cl&#237;nico enmascarado&#46; Para su inclusi&#243;n en el registro&#44; de acuerdo con las exigencias de los comit&#233;s &#233;ticos locales&#44; todos los pacientes participantes &#40;o sus parientes&#41; proporcionaron su consentimiento oral o por escrito&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">En el registro en el RIETE&#44; los m&#233;dicos participantes se aseguraron en todo momento de que la inscripci&#243;n de los pacientes aptos fuera hecha de manera consecutiva&#46; Los datos se registraron en formato electr&#243;nico y se enviaron al centro de coordinaci&#243;n centralizada a trav&#233;s de un sitio web seguro&#46; El centro coordinador del estudio asign&#243; a cada paciente un &#250;nico n&#250;mero de identificaci&#243;n a fin de asegurar la confidencialidad de este&#44; al tiempo que asumi&#243; la responsabilidad de toda la gesti&#243;n de los datos&#46; De forma peri&#243;dica&#44; se monitorizaba electr&#243;nicamente la calidad de los datos registrados&#44; incorporando sistemas de verificaci&#243;n dise&#241;ados para detectar inconsistencias o errores&#44; que eran subsanados a continuaci&#243;n mediante informaci&#243;n al coordinador local&#46; La calidad de los datos tambi&#233;n se control&#243; a trav&#233;s de visitas peri&#243;dicas a los hospitales participantes&#44; que fueron llevadas a cabo por organizaciones de investigaci&#243;n contratadas&#44; las cuales compararon los registros m&#233;dicos con los datos presentados&#46;</p><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Pacientes</span><p id="par0030" class="elsevierStylePara elsevierViewall">Se incluyeron en el estudio aquellos pacientes que desarrollaron una ETV despu&#233;s de una cirug&#237;a ortop&#233;dica mayor &#40;artroplastia electiva de cadera o rodilla y cirug&#237;a de fractura de cadera&#41; o una cirug&#237;a ortop&#233;dica menor &#40;artroscopia de rodilla&#44; da&#241;os distales de cadera que requieren intervenci&#243;n quir&#250;rgica y cirug&#237;a electiva de columna&#41; o un traumatismo no quir&#250;rgico&#44; desde marzo de 2001 a marzo de 2015&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Variables basales</span><p id="par0035" class="elsevierStylePara elsevierViewall">Una vez diagnosticado el episodio de ETV que reun&#237;a las caracter&#237;sticas requeridas&#44; se recogieron los siguientes par&#225;metros&#58; sexo&#44; edad y peso corporal del paciente&#59; existencia de comorbilidades asociadas&#44; como enfermedad cardiaca o pulmonar cr&#243;nica&#59; hemorragia masiva reciente &#40;&#60;<span class="elsevierStyleHsp" style=""></span>30 d&#237;as antes del episodio de ETV&#41;&#59; presencia de factores de riesgo de ETV&#44; incluyendo c&#225;ncer activo&#44; inmovilizaci&#243;n reciente &#40;entendida como aquellos pacientes no quir&#250;rgicos encamados con privilegios de ba&#241;o durante<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>4 d&#237;as en los 2 meses previos al diagn&#243;stico de EP&#41;&#44; cirug&#237;a &#40;definida como aquellos pacientes que han sido intervenidos quir&#250;rgicamente en los 2 meses previos al episodio de EP&#41;&#59; y datos de laboratorio&#44; incluidos recuentos de sangre completa y niveles de aclaramiento de creatinina s&#233;rica al inicio del estudio&#46; Los niveles de aclaramiento de creatinina s&#233;rica se midieron de acuerdo con la f&#243;rmula de Cockcroft y Gault&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Tratamiento y seguimiento</span><p id="par0040" class="elsevierStylePara elsevierViewall">Se manej&#243; a los pacientes conforme a la pr&#225;ctica cl&#237;nica habitual de cada centro hospitalario participante &#40;por ejemplo&#44; no hubo estandarizaci&#243;n del tratamiento&#41;&#46; Se registr&#243; el tipo&#44; la dosis y la duraci&#243;n de la terapia anticoagulante&#46; La decisi&#243;n de tratar a los pacientes en el hospital o en casa fue tomada por los m&#233;dicos participantes&#46; Cada episodio de EP recurrente sintom&#225;tica se examin&#243; realizando un nuevo esc&#225;ner pulmonar&#44; TAC helicoidal o angiograf&#237;a pulmonar&#44; seg&#250;n correspondiera&#46; Se clasificaron la mayor&#237;a de los resultados seg&#250;n lo informado por los centros cl&#237;nicos&#46; No obstante&#44; si el personal del centro de coordinaci&#243;n dudaba sobre la clasificaci&#243;n de un informe de resultado&#44; este era revisado por un comit&#233; central de adjudicaci&#243;n&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Variables de resultado</span><p id="par0045" class="elsevierStylePara elsevierViewall">El resultado m&#225;s significativo fue la EP mortal &#40;tanto como evento inicial como recurrente&#44; esto es&#44; cuando la EP aparec&#237;a en los 3 primeros meses de la terapia anticoagulante&#41;&#46; La EP mortal&#44; en ausencia de autopsia&#44; se defini&#243; como cualquier muerte que ocurriera dentro de los 10 d&#237;as del diagn&#243;stico confirmado de EP&#44; en ausencia de otra causa alternativa de la muerte&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">An&#225;lisis estad&#237;stico</span><p id="par0050" class="elsevierStylePara elsevierViewall">El an&#225;lisis de las variables continuas y categ&#243;ricas se llev&#243; a cabo mediante la prueba t de Student y el test &#967;<span class="elsevierStyleSup">2</span> &#40;o prueba exacta de Fisher&#44; seg&#250;n corresponda&#41;&#46; Se utiliz&#243; el software SPSS &#40;versi&#243;n 20&#44; SPSS Inc&#46;&#44; Chicago&#44; Illinois&#41; y el Epidat 3&#46;1 &#40;Junta de Galicia&#44; OPS&#44; Coru&#241;a&#59; Washington DC&#44; 2006&#41; para el an&#225;lisis estad&#237;stico de los datos&#44; definiendo como significativo el valor p bilateral<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#46;</p></span></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Resultados</span><p id="par0055" class="elsevierStylePara elsevierViewall">Desde marzo de 2001 a marzo de 2015 se inscribieron 61&#46;789 en el RIETE&#46; De todos ellos&#44; 943 &#40;1&#44;52&#37;&#41; desarrollaron una ETV despu&#233;s de una artroplastia electiva &#40;cadera 460&#44; rodilla 483&#41;&#44; 445 &#40;0&#44;72&#37;&#41; tras una fractura de cadera&#44; 1&#46;045 &#40;1&#44;69&#37;&#41; a continuaci&#243;n de una cirug&#237;a ortop&#233;dica menor y 2&#46;136 &#40;3&#44;46&#37;&#41; posteriormente a un traumatismo no quir&#250;rgico&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">Las causas m&#225;s comunes de cirug&#237;a ortop&#233;dica menor y traumatismo no quir&#250;rgico se detallan en la <a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a>&#46; Se adoptaron medidas profil&#225;cticas frente a la ETV en m&#225;s del 90&#37; de los pacientes de cirug&#237;a ortop&#233;dica mayor&#44; en el 73&#37; de los de cirug&#237;a ortop&#233;dica menor y en el 32&#37; de los pacientes con trauma no quir&#250;rgico&#44; no observ&#225;ndose una reducci&#243;n significativa de la mortalidad en los 2 &#250;ltimos grupos&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0065" class="elsevierStylePara elsevierViewall">En general&#44; 2&#46;283 pacientes &#40;50&#37;&#41; presentaron de inicio EP &#40;con o sin TVP&#41; y 2&#46;285 TVP sola&#46; Durante los 90 primeros d&#237;as de tratamiento&#44; 30 pacientes &#40;0&#44;66&#37;&#59; IC 95&#37; 0&#44;45-0&#44;93&#41; murieron por EP&#58; 25 de ellos por un evento inicial de EP y los 5 restantes por EP recurrente durante el tratamiento anticoagulante&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">La tasa de EP mortal en pacientes con ETV tras una artroplastia electiva &#40;0&#44;53&#37;&#41; fue semejante a la del grupo de pacientes de cirug&#237;a ortop&#233;dica menor &#40;0&#44;48&#37;&#41; o traumatismo no quir&#250;rgico &#40;0&#44;51&#37;&#41;&#46; Sin embargo&#44; si tenemos en cuenta los valores absolutos&#44; la tasa es inferior&#58; 5 vs&#46; 16 casos de EP mortal&#44; respectivamente&#46; La tasa de EP mortal en pacientes con fractura de cadera con ETV fue 4 veces superior a la de los otros grupos &#40;2&#44;02 vs&#46; 0&#44;51&#37;&#59; odds ratio 4&#44;03&#59; IC 95&#37; 1&#44;75-9&#44;26&#41;&#46; En general&#44; uno de cada 3 pacientes muertos por EP hab&#237;a sufrido un traumatismo no quir&#250;rgico &#40;11 de 30&#59; 36&#44;7&#37;&#41;&#44; de los cuales &#250;nicamente el 40&#37; &#40;12 de 30&#41; recibieron tratamiento profil&#225;ctico de la ETV&#46; En la mayor&#237;a de los casos los pacientes hab&#237;an tenido fracturas &#243;seas&#44; si bien hubo 2 casos de contusiones en el miembro inferior y uno de esguince de tobillo&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">La media de edad&#44; as&#237; como la presencia de comorbilidades&#44; variaron entre los pacientes de los 4 subgrupos&#44; aunque la gravedad del evento de EP inicial &#40;en t&#233;rminos de hipotensi&#243;n&#44; bradicardia e hipoxemia&#41; fue similar &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">tabla 2</a>&#41;&#46; M&#225;s del 90&#37; de los pacientes&#44; tanto del subgrupo de artroplastia electiva como del de fractura de cadera&#44; recibieron profilaxis de ETV&#44; mientras que &#250;nicamente el 32&#37; de los pacientes con traumatismo no quir&#250;rgico recibieron profilaxis&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0080" class="elsevierStylePara elsevierViewall">La mayor&#237;a de los pacientes tratados en los 4 subgrupos &#40;86&#37;&#41; recibieron como tratamiento de inicio heparina de bajo peso molecular &#40;HBPM&#41;&#44; sin diferencia en la dosis media &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">tabla 3</a>&#41;&#46; Posteriormente&#44; la mayor&#237;a de ellos &#40;64&#37;&#41; pasaron a tratamiento con antagonistas de la vitamina K&#46; Los resultados a 90 d&#237;as fueron semejantes en todos los pacientes de todos los subgrupos&#44; con excepci&#243;n de los pacientes con fractura de cadera&#44; que manifestaron una mayor tasa de EP recurrente&#44; de hemorragia mayor&#44; de EP mortal y una mortalidad global m&#225;s alta &#40;<a class="elsevierStyleCrossRef" href="#tbl0020">tabla 4</a>&#41;&#46; Los principales factores de riesgo de hemorragia fueron &#40;OR &#91;IC 95&#37;&#93;&#41;&#58; EP vs&#46; TVP 3&#44;53 &#40;2&#44;02-6&#44;15&#41;&#44; insuficiencia cardiaca cr&#243;nica 2&#44;29 &#40;1&#44;19-4&#44;40&#41;&#44; niveles de aclaramiento de creatinina s&#233;rica<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>60<span class="elsevierStyleHsp" style=""></span>ml&#47;min&#47;1&#44;73<span class="elsevierStyleHsp" style=""></span>m<span class="elsevierStyleSup">2</span> 2&#44;63 &#40;1&#44;64-4&#44;21&#41; y c&#225;ncer 2&#44;26 &#40;1&#44;19-4&#44;29&#41;&#46; En cuanto a los factores de riesgo de muerte en general&#44; destacan &#40;OR &#91;IC 95&#37;&#93;&#41;&#58; cirug&#237;a de fractura de cadera 3&#44;13 &#40;1&#44;93-5&#44;09&#41;&#44; edad<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>80 a&#241;os 3&#44;07 &#40;2&#44;19-4&#44;29&#41;&#44; insuficiencia cardiaca cr&#243;nica 3&#44;54 &#40;2&#44;37-5&#44;31&#41; y c&#225;ncer 4&#44;98 &#40;3&#44;43-7&#44;23&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0025">tabla 5</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><elsevierMultimedia ident="tbl0020"></elsevierMultimedia><elsevierMultimedia ident="tbl0025"></elsevierMultimedia><p id="par0085" class="elsevierStylePara elsevierViewall">Cabe destacar que la EP fue la causa m&#225;s com&#250;n de muerte entre los paciente con ETV tras una artroplastia electiva &#40;5 de 30 muertes&#44; 17&#37;&#41;&#44; fractura de cadera &#40;9 de 65&#44; 14&#37;&#41;&#44; cirug&#237;a ortop&#233;dica menor &#40;5 de 20&#44; 25&#37;&#41; y traumatismo no quir&#250;rgico &#40;11 de 86&#44; 13&#37;&#41;&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Discusi&#243;n</span><p id="par0090" class="elsevierStylePara elsevierViewall">La 9&#46;<span class="elsevierStyleSup">a</span> gu&#237;a del American College of Chest Physicians &#40;2012&#41;&#44; para pacientes sometidos a cirug&#237;a ortop&#233;dica mayor&#44; recomienda la profilaxis antitromb&#243;tica&#44; en lugar de no profilaxis&#44; durante 10 a 14 d&#237;as como m&#237;nimo&#44; con una de las siguientes sustancias&#58; HBPM&#44; fondaparinux&#44; apixab&#225;n&#44; dabigatr&#225;n&#44; rivaroxab&#225;n&#44; heparina no fraccionada en baja dosis&#44; antagonistas de la vitamina K en dosis ajustada o aspirina &#40;todo&#44; Grado 1<span class="elsevierStyleHsp" style=""></span>B&#41;&#46; Para pacientes de artroscopia de rodilla sin antecedentes previos de ETV&#44; recomienda la no tromboprofilaxis frente a la profilaxis &#40;Grado 2<span class="elsevierStyleHsp" style=""></span>B&#41;&#44; y en pacientes con da&#241;os aislados de la pierna que necesiten inmovilizaci&#243;n propone no profilaxis en lugar de tromboprofilaxis farmacol&#243;gica &#40;Grado 2<span class="elsevierStyleHsp" style=""></span>C&#41;&#46; Estas 2 &#250;ltimas recomendaciones son muy gen&#233;ricas y carecen de evidencia s&#243;lida&#44; razones por las que es necesario acudir a otras gu&#237;as&#44; como la europea&#44; para complementarla<a class="elsevierStyleCrossRefs" href="#bib0185"><span class="elsevierStyleSup">10&#44;11&#44;21</span></a>&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">Nuestros datos revelan que en la vida real la mayor&#237;a de los pacientes que desarrollaron una ETV tras una artroplastia electiva &#40;94&#37;&#41;&#44; una fractura de cadera &#40;93&#37;&#41; o una cirug&#237;a ortop&#233;dica menor &#40;71&#37;&#41; hab&#237;an recibido profilaxis de ETV&#44; tal y como recomiendan las gu&#237;as actuales sobre terapia antitromb&#243;tica<a class="elsevierStyleCrossRefs" href="#bib0140"><span class="elsevierStyleSup">1&#44;21&#44;22</span></a>&#46; En la mayor&#237;a de los casos se emple&#243; HBPM como agente profil&#225;ctico tromboemb&#243;lico y carecemos de datos sobre el uso de aspirina&#44; ya que esta no ha sido recogida en nuestra base de datos&#46; Sin embargo&#44; solo uno de cada 3 pacientes &#40;32&#37;&#41; que desarroll&#243; ETV a continuaci&#243;n de un traumatismo no quir&#250;rgico recibi&#243; tratamiento profil&#225;ctico&#46; Curiosamente&#44; el n&#250;mero de pacientes que murieron por EP tras un traumatismo no quir&#250;rgico &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>11&#41; fue el doble que el de pacientes fallecidos por EP a continuaci&#243;n de una artroplastia electiva de cadera o rodilla &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>5&#41;&#44; por lo que no se debe subestimar su importancia cl&#237;nica&#46; Estos resultados son contrarios a los datos presentados en otros estudios&#44; en los que la mayor&#237;a de los pacientes ten&#237;an TVP distal en este contexto<a class="elsevierStyleCrossRefs" href="#bib0175"><span class="elsevierStyleSup">8&#44;13</span></a>&#46; Es m&#225;s&#44; &#250;nicamente el 40&#37; de los pacientes con EP mortal pertenecientes al grupo de traumatismo no quir&#250;rgico hab&#237;an recibido tratamiento profil&#225;ctico&#59; de los que ten&#237;an menor probabilidad de recibir tratamiento profil&#225;ctico&#44; entre los que figuraban los contusionados &#40;sin fractura &#243;sea&#41; o con esguince de tobillo&#44; murieron 3 pacientes por EP&#46; Casi el 100&#37; de los pacientes de los dem&#225;s grupos con EP mortal hab&#237;an recibido profilaxis&#46; Por tanto&#44; nuestros datos muestran la conveniencia de extender el uso de la terapia antitromb&#243;tica profil&#225;ctica de ETV a una poblaci&#243;n m&#225;s amplia de pacientes con traumatismo&#44; tal y como ha sido recomendado por algunas gu&#237;as europeas para pacientes ambulatorios con inmovilizaci&#243;n del miembro inferior y con alguno de los siguientes factores de riesgo&#58; inmovilizaci&#243;n r&#237;gida&#44; estado sin soporte de peso y da&#241;o grave agudo &#40;dislocaci&#243;n&#44; fractura o rotura tendinosa&#41;<a class="elsevierStyleCrossRefs" href="#bib0185"><span class="elsevierStyleSup">10&#44;11&#44;21</span></a>&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">Los pacientes sometidos a cirug&#237;a de fractura de cadera fueron los que presentaban mayor n&#250;mero de comorbilidades&#46; Eran los pacientes m&#225;s ancianos y&#44; por tanto&#44; los que ten&#237;an un peor pron&#243;stico&#44; mostrando las tasas m&#225;s altas de hemorragia mayor&#44; de EP recurrente y de mortalidad por EP&#46; La insuficiencia cardiaca cr&#243;nica y el c&#225;ncer son factores de riesgo frecuente de hemorragia mayor y muerte en general&#44; siendo la cirug&#237;a de fractura de cadera un factor independiente de riesgo de mortalidad &#40;<a class="elsevierStyleCrossRef" href="#tbl0025">tabla 5</a>&#41;&#46; Estos resultados son semejantes a los encontrados en otros estudios&#44; en los que los pacientes intervenidos quir&#250;rgicamente de fractura de cadera muestran las tasas m&#225;s elevadas de TVP &#40;46-50&#37;&#41; y de EP mortal &#40;2&#44;5-7&#44;5&#37;&#41;&#44; siendo el riesgo general de muerte a los 90 d&#237;as del 13&#37;<a class="elsevierStyleCrossRefs" href="#bib0240"><span class="elsevierStyleSup">21&#44;26</span></a>&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">En ausencia de ensayos cl&#237;nicos aleatorizados&#44; las ventajas de la profilaxis de ETV en pacientes con cirug&#237;a ortop&#233;dica menor o con traumatismo no quir&#250;rgico siguen siendo pol&#233;micas&#46; Un metaan&#225;lisis reciente<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">23</span></a> sobre la prevenci&#243;n de eventos de ETV con HBPM en pacientes con movilidad reducida en contextos ortop&#233;dicos menores &#40;inmovilizaci&#243;n de pierna por fractura o lesi&#243;n de tejidos blandos de la pierna o artroscopia de rodilla&#41; evidencia un cierto nivel de eficacia de la HBPM frente a placebo o no tratamiento&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">Recientemente&#44; en un ensayo aleatorizado que evaluaba el empleo de la profilaxis de ETV tras una artroscopia de rodilla &#40;POT-KAST&#41; o de enyesado del miembro inferior &#40;POT-CAST&#41;&#44; se lleg&#243; a la conclusi&#243;n de que la profilaxis de eventos ETV sintom&#225;ticos con HBPM durante 8 d&#237;as&#44; en el grupo POT-KAST&#44; no era eficaz<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">16</span></a>&#46; Al haber sido la duraci&#243;n media de las artroscopias inferior a los 30<span class="elsevierStyleHsp" style=""></span>min &#40;no hubo cirug&#237;a ligamentosa&#41;&#44; podr&#237;a considerarse&#44; seg&#250;n la estratificaci&#243;n del riesgo de Caprini<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">24</span></a>&#44; una cirug&#237;a menor con bajo riesgo de ETV&#46; Por otro lado&#44; algunas gu&#237;as europeas y la gu&#237;a del 2004 del American College of Chest Physicians aconsejaba la utilizaci&#243;n de HBPM en pacientes sometidos a procedimientos largos o complicados de artroscopia de rodilla<a class="elsevierStyleCrossRefs" href="#bib0190"><span class="elsevierStyleSup">11&#44;21&#44;25</span></a>&#46; Dichas gu&#237;as europeas tambi&#233;n recomendaban la profilaxis con HBPM en pacientes con inmovilizaci&#243;n del miembro inferior o sin soporte de peso completo&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">En cuanto al grupo de pacientes POT-CAST&#44; en el que el riesgo de ETV era bajo&#44; las dosis de antitromb&#243;ticos fueron bajas &#40;2&#46;850<span class="elsevierStyleHsp" style=""></span>UI de nadroparina o 2&#46;500<span class="elsevierStyleHsp" style=""></span>UI de dalteparina&#41; y casi el 40&#37; de los pacientes desarrollaron una ETV despu&#233;s de quitar la escayola&#46; En nuestro estudio&#44; no se registr&#243; el tiempo de ETV para el grupo de pacientes con traumatismo no quir&#250;rgico&#44; pero&#44; seg&#250;n nuestros datos&#44; ser&#237;a necesario prolongar la profilaxis en algunos pacientes&#44; una vez retirado el yeso&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">El presente estudio descriptivo tiene algunas limitaciones derivadas de la heterogeneidad de los subgrupos de pacientes y de la libertad de los m&#233;dicos para prescribir la profilaxis y el tratamiento&#44; lo que puede limitar claramente la interpretaci&#243;n de los resultados&#46; La principal limitaci&#243;n de este estudio epidemiol&#243;gico es la falta de un n&#250;mero total para la condici&#243;n de cada una las diferentes cirug&#237;as ortop&#233;dicas&#46; Al faltar este factor no se puede calcular la prevalencia real ni se pueden comparar las incidencias&#46; Nuestro estudio no mostr&#243; ning&#250;n beneficio en t&#233;rminos de mortalidad para los pacientes que recibieron tromboprofilaxis ni despu&#233;s de procedimientos ortop&#233;dicos menores ni despu&#233;s de un traumatismo no quir&#250;rgico&#46;</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Conclusiones</span><p id="par0125" class="elsevierStylePara elsevierViewall">Dada la inesperadamente elevada tasa de ETV en pacientes con cirug&#237;a ortop&#233;dica menor o traumatismo no quir&#250;rgico&#44; y teniendo en cuenta la semejanza de los resultados a 3 meses&#44; en t&#233;rminos de EP&#44; EP recurrente o hemorragia mayor&#44; con los otros subgrupos &#40;artroplastia electiva&#41; y la potencial eficacia de la profilaxis farmacol&#243;gica de ETV en esta poblaci&#243;n&#44; concluimos que se necesitan m&#225;s investigaciones para poder determinar con mayor precisi&#243;n qu&#233; pacientes deber&#237;an ser seleccionados para recibir tratamiento profil&#225;ctico&#46; Los pacientes sometidos a cirug&#237;a de fractura de cadera son los que tienen un peor pron&#243;stico&#46;</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Conflicto de intereses</span><p id="par0130" class="elsevierStylePara elsevierViewall">Los autores declaran que no tienen ning&#250;n conflicto de intereses&#46;</p></span></span>"
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          "titulo" => "Abstract"
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              "titulo" => "Background"
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    "fechaRecibido" => "2018-01-23"
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            0 => "Trombosis venosa profunda"
            1 => "Embolismo pulmonar"
            2 => "Sangrado mayor"
            3 => "Tromboembolismo recurrente"
            4 => "Cirug&#237;a ortop&#233;dica menor"
            5 => "Traumatismo sin cirug&#237;a"
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            0 => "Deep-vein thrombosis"
            1 => "Pulmonary embolism"
            2 => "Major bleeding"
            3 => "Recurrent thromboembolism"
            4 => "Non-major orthopaedic surgery"
            5 => "Trauma not requiring surgery"
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        "titulo" => "Resumen"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Antecedentes</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Hay escasa evidencia sobre el pron&#243;stico de la tromboembolia venosa en pacientes sometidos a cirug&#237;a ortop&#233;dica y en pacientes que sufren un trauma no quir&#250;rgico&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">M&#233;todos</span><p id="spar0115" class="elsevierStyleSimplePara elsevierViewall">Utilizamos la base de datos RIETE &#40;Registro Informatizado de pacientes con Enfermedad TromboEmb&#243;lica&#41; para comparar el pron&#243;stico del tromboembolismo venoso y el uso de tromboprofilaxis en pacientes sometidos a diferentes procedimientos ortop&#233;dicos y en pacientes con traumatismo que no requiere cirug&#237;a&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Resultados</span><p id="spar0120" class="elsevierStyleSimplePara elsevierViewall">Desde marzo de 2001 a marzo de 2015&#44; se inscribieron un total de 61&#46;789 pacientes en RIETE&#46; De estos&#44; 943 &#40;1&#46;52&#37;&#41; desarrollaron tromboembolismo venoso despu&#233;s de artroplastia electiva&#44; 445 &#40;0&#46;72&#37;&#41; despu&#233;s de fractura de cadera&#44; 1&#46;045 &#40;1&#46;69&#37;&#41; despu&#233;s de cirug&#237;a ortop&#233;dica no mayor y 2&#44;136 &#40;3&#46;46&#37;&#41; despu&#233;s de trauma no quir&#250;rgico&#46; En general&#44; 2&#46;283 pacientes &#40;50&#37;&#41; presentaron inicialmente embolia pulmonar&#46; En los primeros 90 d&#237;as de tratamiento&#44; 30 pacientes &#40;0&#46;66&#37;&#44; IC 95&#37; 0&#46;45-0&#46;93&#41; murieron por embolia pulmonar&#46; La tasa de embolia pulmonar fatal fue significativamente mayor despu&#233;s de cirug&#237;a de fractura de cadera &#40;n &#61; 9 &#91;2&#46;02&#37;&#93;&#41; que despu&#233;s de la artroplastia electiva &#40;n &#61; 5 &#91;0&#46;53&#37;&#93;&#41;&#44; cirug&#237;a ortop&#233;dica no mayor &#40;n &#61; 5 &#91;0&#46;48&#37;&#93;&#41; o traumatismo no quir&#250;rgico &#40;n &#61; 11 &#91;0&#44;48&#37;&#93;&#41;&#46; La tromboprofilaxis se utiliz&#243; con mayor frecuencia para la fractura de cadera &#40;93&#37;&#41; o la artroplastia electiva &#40;94&#37;&#41; que para la cirug&#237;a ortop&#233;dica no mayor &#40;71&#37;&#41; o traumatismo no quir&#250;rgico &#40;32&#37;&#41;&#46; La hemorragia mayor fue significativamente mayor despu&#233;s de la cirug&#237;a de fractura de cadera &#40;4&#37;&#41; que despu&#233;s de artroplastia electiva &#40;1&#44;6&#37;&#41;&#44; cirug&#237;a ortop&#233;dica no mayor &#40;1&#44;5&#37;&#41; o traumatismo no quir&#250;rgico &#40;1&#44;4&#37;&#41;&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusiones</span><p id="spar0125" class="elsevierStyleSimplePara elsevierViewall">La tromboprofilaxis se utiliz&#243; con menos frecuencia en los procedimientos de menor riesgo a pesar del n&#250;mero absoluto de embolia pulmonar fatal despu&#233;s de cirug&#237;a ortop&#233;dica no mayor o traumatismo no quir&#250;rgico&#44; excedieron los observados despu&#233;s de procedimientos de alto riesgo&#46;</p></span>"
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        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Background</span><p id="spar0130" class="elsevierStyleSimplePara elsevierViewall">There is scarce evidence about the prognosis of venous thromboembolism in patients undergoing orthopedic surgery and in patients suffering non-surgical trauma&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Methods</span><p id="spar0135" class="elsevierStyleSimplePara elsevierViewall">We used the RIETE database &#40;Registro Informatizado de pacientes con Enfermedad Trombo Emb&#243;lica&#41; to compare the prognosis of venous thromboembolism and the use of thromboprophylaxis in patients undergoing different orthopedic procedures and in trauma patients not requiring surgery&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Results</span><p id="spar0140" class="elsevierStyleSimplePara elsevierViewall">From March 2001 to March 2015&#44; a total of 61&#44;789 patients were enrolled in RIETE database&#46; Of these&#44; 943 &#40;1&#46;52&#37;&#41; developed venous thromboembolism after elective arthroplasty&#44; 445 &#40;0&#46;72&#37;&#41; after hip fracture&#44; 1&#44;045 &#40;1&#46;69&#37;&#41; after non-major orthopedic surgery and 2&#44;136 &#40;3&#46;46&#37;&#41; after non-surgical trauma&#46; Overall&#44; 2&#44;283 patients &#40;50&#37;&#41; initially presented with pulmonary embolism&#46; Within the first 90 days of therapy&#44; 30 patients &#40;0&#46;66&#37;&#59; 95&#37; CI 0&#46;45-0&#46;93&#41; died from pulmonary embolism&#46; The rate of fatal pulmonary embolism was significantly higher after hip fracture surgery &#40;n &#61; 9 &#91;2&#46;02&#37;&#93;&#41; than after elective arthroplasty &#40;n &#61; 5 &#91;0&#46;53&#37;&#93;&#41;&#44; non-major orthopedic surgery &#40;n &#61; 5 &#91;0&#46;48&#37;&#93;&#41; or non surgical trauma &#40;n &#61; 11 &#91;0&#46;48&#37;&#93;&#41;&#46; Thromboprophylaxis was more commonly used for hip fracture &#40;93&#37;&#41; or elective arthroplasty &#40;94&#37;&#41; than for non-major orthopedic surgery &#40;71&#37;&#41; or non-surgical trauma &#40;32&#37;&#41;&#46; Major bleeding was significantly higher after hip fracture surgery &#40;4&#37;&#41; than that observed after elective arthroplasty &#40;1&#46;6&#37;&#41;&#44; non-major orthopedic surgery &#40;1&#46;5&#37;&#41; or non-surgical trauma &#40;1&#46;4&#37;&#41;&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusions</span><p id="spar0145" class="elsevierStyleSimplePara elsevierViewall">Thromboprophylaxis was less frequently used in lower risk procedures despite the absolute number of fatal pulmonary embolism after non-major orthopedic surgery or non-surgical trauma&#44; exceeded that observed after high risk procedures&#46;</p></span>"
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            "apendice" => "<p id="par0145" class="elsevierStylePara elsevierViewall">Coordinador del Registro RIETE&#58;</p> <p id="par0150" class="elsevierStylePara elsevierViewall">Manuel Monreal &#40;Espa&#241;a&#41;</p> <p id="par0155" class="elsevierStylePara elsevierViewall">Miembros del Comit&#233; Directivo RIETE&#58;</p> <p id="par0160" class="elsevierStylePara elsevierViewall">Herv&#232; Decousus &#40;Francia&#41;&#44; Paolo Prandoni &#40;Italia&#41;&#44; Benjamin Brenner &#40;Israel&#41;</p> <p id="par0165" class="elsevierStylePara elsevierViewall">Coordinadores Nacionales RIETE&#58;</p> <p id="par0170" class="elsevierStylePara elsevierViewall">Raquel Barba &#40;Espa&#241;a&#41;&#44; Pierpaolo Di Micco &#40;Italia&#41;&#44; Laurent Bertoletti &#40;Francia&#41;&#44; Sebastian Schellong &#40;Alemania&#41;&#44; Manolis Papadakis &#40;Grecia&#41;&#44; Inna Tzoran &#40;Israel&#41;&#44; Abilio Reis &#40;Portugal&#41;&#44; Marijan Bosevski &#40;Rep&#250;blica de Macedonia&#41;&#44; Henri Bounameaux &#40;Suiza&#41;&#44; Radovan Mal&#253; &#40;Rep&#250;blica Checa&#41;</p> <p id="par0175" class="elsevierStylePara elsevierViewall">Centro de Coordinaci&#243;n de Registro RIETE&#58;</p> <p id="par0180" class="elsevierStylePara elsevierViewall">S &#38; H Medical Science Service</p> <p id="par0185" class="elsevierStylePara elsevierViewall">Miembros del grupo RIETE&#58;</p> <p id="par0190" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Espa&#241;a&#58;</span> And&#250;jar V&#44; Arcelus JI&#44; Arroyo-Cozar M&#44; Barba R&#44; Barr&#243;n M&#44; Barr&#243;n-Andr&#233;s B&#44; Bascu&#241;ana J&#44; Blanco-Molina A&#44; Casado I&#44; Conget F&#44; del Molino F&#44; del Toro J&#44; Falg&#225; C&#44; Fern&#225;ndez-Capit&#225;n C&#44; Font L&#44; Gallego P&#44; Garc&#237;a-Bragado F&#44; G&#243;mez V&#44; Gonz&#225;lez J&#44; Gonz&#225;lez-Bachs E&#44; Guijarro R&#44; Guil M&#44; Guti&#233;rrez J&#44; Hern&#225;ndez L&#44; Hern&#225;ndez-Huerta S&#44; Hernando E&#44; Jaras MJ&#44; Jim&#233;nez D&#44; Lecumberri R&#44; Lobo JL&#44; L&#243;pez-Jim&#233;nez L&#44; L&#243;pez-Montes L&#44; L&#243;pez-Reyes R&#44; L&#243;pez-S&#225;ez JB&#44; Lorenzo A&#44; Luque JM&#44; Madridano O&#44; Marchena PJ&#44; Mart&#237;n M&#44; Mart&#237;n-Antor&#225;n JM&#44; Mellado M&#44; Molla S&#44; Monreal M&#44; Nauffal D&#44; Nieto JA&#44; N&#250;&#241;ez MJ&#44; Ogea JL&#44; Pedrajas JM&#44; P&#233;rez G&#44; Peris ML&#44; Porras JA&#44; Riera-Mestre A&#44; Rivas A&#44; Rodr&#237;guez-D&#225;vila MA&#44; Rom&#225;n P&#44; Rosa V&#44; Ruiz J&#44; Ruiz-Gim&#233;nez N&#44; Sahuquillo JC&#44; S&#225;nchez R&#44; S&#225;nchez Mu&#241;oz-Torrero JF&#44; Soler S&#44; Suri&#241;ach JM&#44; Tiberio G&#44; Tolosa C&#44; Trujillo-Santos J&#44; Uresandi F&#44; Valero B&#44; Valle R&#44; Vela J&#44; Vidal G&#44; Villalobos A&#44; Villalta J&#46; <span class="elsevierStyleItalic">B&#233;lgica&#58;</span> Peerlinck K&#44; Verhamme P&#46; <span class="elsevierStyleItalic">Rep&#250;blica Checa&#58;</span> Mal&#253; R&#44; Kaletova M&#46; <span class="elsevierStyleItalic">Francia&#58;</span> Bertoletti L&#44; Bura-Riviere A&#44; Farge-Bancel D&#44; Grange C&#44; Hij A&#44; Mahe I&#44; Merah A&#46; <span class="elsevierStyleItalic">Alemania&#58;</span> Schellong S&#46; <span class="elsevierStyleItalic">Grecia&#58;</span> Babalis D&#44; Papadakis M&#44; Tzinieris I&#46; <span class="elsevierStyleItalic">Israel&#58;</span> Braester A&#44; Brenner B&#44; Tzoran I&#44; Zeltser D&#46; <span class="elsevierStyleItalic">Italia&#58;</span> Apollonio A&#44; Barillari G&#44; Ciammaichella M&#44; Dalla Valle F&#44; Di Micco P&#44; Duce R&#44; Guida A&#44; Maida R&#44; Pasca S&#44; Piovella C&#44; Poggio R&#44; Prandoni P&#44; Rota L&#44; Tonello D&#44; Tufano A&#44; Vison&#224; A&#44; Zalunardo B&#46; <span class="elsevierStyleItalic">Portugal&#58;</span> Barbosa AL&#44; Bastos M&#44; Sousa MS&#46; <span class="elsevierStyleItalic">Rep&#250;blica de Macedonia&#58;</span> Bosevski M&#44; Kovacevic D&#46; <span class="elsevierStyleItalic">Suiza&#58;</span> Alatri A&#44; Bounameaux H&#44; Calanca L&#44; Mazzolai L&#46;</p>"
            "etiqueta" => "Anexo"
            "titulo" => "Listado de investigadores del estudio RIETE"
            "identificador" => "sec0065"
          ]
        ]
      ]
    ]
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        "tipo" => "MULTIMEDIATABLA"
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          "leyenda" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">EP&#58; embolia pulmonar&#59; ETV&#58; tromboembolismo venoso&#59; TVP&#58; trombosis venosa profunda&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
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                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">N&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">TVP sola&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">EP no mortal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">EP mortal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Profilaxis de ETV&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Total pacientes&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&#46;569&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#46;285 &#40;50&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#46;254 &#40;49&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">30 &#40;0&#44;66&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#46;729 &#40;60&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="6" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Cirug&#237;a de elecci&#243;n&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">943&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">446 &#40;47&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">492 &#40;52&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5 &#40;0&#44;53&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">883 &#40;94&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Artroplastia de cadera&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">460&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">220 &#40;48&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">238 &#40;52&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3 &#40;0&#44;65&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">433 &#40;94&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Artroplastia de rodilla&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">483&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">226 &#40;47&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">256 &#40;53&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2 &#40;0&#44;41&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">451 &#40;93&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="6" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Fractura de cadera&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">445&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">188 &#40;42&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">248 &#40;56&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9 &#40;2&#44;02&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">412 &#40;93&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="6" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Cirug&#237;a ortop&#233;dica menor&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;045&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">485 &#40;46&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">555 &#40;53&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5 &#40;0&#44;48&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">745 &#40;71&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Fractura de la extremidad inferior&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">203&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">88 &#40;43&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">114 &#40;56&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1 &#40;0&#44;49&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">178 &#40;88&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Cirug&#237;a de menisco&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">151&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">78 &#40;52&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">73 &#40;48&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">115 &#40;76&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Fractura de la extremidad superior&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">80&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">24 &#40;31&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">54 &#40;69&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2 &#40;2&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">45 &#40;56&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Cirug&#237;a tendinosa&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">57&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">25 &#40;44&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">32 &#40;56&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">44 &#40;77&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Cirug&#237;a ligamentosa&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">55&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">29 &#40;53&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">26 &#40;47&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">43 &#40;78&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Hallux valgus&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">48&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">32 &#40;67&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">16 &#40;33&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">30 &#40;63&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Amputaci&#243;n de miembro&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">33&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9 &#40;27&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">23 &#40;70&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1 &#40;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">28 &#40;85&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Politraumatismos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">15&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6 &#40;40&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9 &#40;60&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10 &#40;67&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Otra&#47;desconocida&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">403&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">194 &#40;48&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">208 &#40;52&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1 &#40;0&#44;25&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">252 &#40;63&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="6" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Traumatismo no quir&#250;rgico&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#46;136&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;166 &#40;55&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">958 &#40;45&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">11 &#40;0&#44;51&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">689 &#40;32&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Fractura de la extremidad inferior&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">436&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">222 &#40;51&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">211 &#40;48&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3 &#40;0&#44;69&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">281 &#40;64&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Contusi&#243;n de la extremidad inferior&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">386&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">242 &#40;63&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">141 &#40;37&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2 &#40;0&#44;52&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">53 &#40;14&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Esguince de tobillo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">265&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">181 &#40;68&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">84 &#40;32&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1 &#40;0&#44;38&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">70 &#40;26&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Otras fracturas&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">189&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">75 &#40;40&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">112 &#40;59&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2 &#40;1&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">66 &#40;35&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Rotura fibrilar&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">178&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">112 &#40;63&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">66 &#40;37&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">36 &#40;20&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Fractura vertebral&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">89&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">39 &#40;44&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">49 &#40;55&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1 &#40;1&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">26 &#40;29&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Fractura de pelvis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">84&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">35 &#40;42&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">48 &#40;57&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1 &#40;1&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">58 &#40;69&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Tendinitis de la extremidad inferior&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">70&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">40 &#40;57&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">30 &#40;43&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">12 &#40;17&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Traumatismo craneoencef&#225;lico&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">68&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">30 &#40;44&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">38 &#40;56&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">19 &#40;28&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Lesi&#243;n de la extremidad superior&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">67&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">29 &#40;43&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">37 &#40;55&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7 &#40;10&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Otra&#47;desconocida&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">304&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">161 &#40;53&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">142 &#40;47&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1 &#40;0&#44;33&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">61 &#40;20&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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          "es" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Tipo de cirug&#237;a o traumatismo de acuerdo con la presentaci&#243;n inicial de la enfermedad tromboemb&#243;lica venosa y uso de profilaxis para esta</p>"
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          "leyenda" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">CrCl&#58; aclaramiento de creatinina&#59; DE&#58; desviaci&#243;n est&#225;ndar&#59; EP&#58; embolia pulmonar&#59; ETV&#58; enfermedad tromboemb&#243;lica venosa&#59; HBPM&#58; heparina de bajo peso molecular&#59; PSS&#58; presi&#243;n sangu&#237;nea sist&#243;lica&#59; SatO<span class="elsevierStyleInf">2</span>&#58; saturaci&#243;n de ox&#237;geno&#46;</p><p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Las comparaciones se realizaron empleando como referencia pacientes con artroplastia electiva&#58;</p>"
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                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Traumatismo no quir&#250;rgico&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">445&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;045&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#46;136&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleBold">Caracter&#237;sticas cl&#237;nicas</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Hombres&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">331 &#40;35&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">146 &#40;33&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">547 &#40;52&#41;<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">&#42;&#42;&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;011 &#40;47&#41;<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">&#42;&#42;&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Edad</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">&#60;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">50 a&#241;os&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">58 &#40;13&#41;<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">&#42;&#42;&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">409 &#40;39&#41;<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">&#42;&#42;&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">872 &#40;41&#41;<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">&#42;&#42;&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Edad</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">&#62;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">80 a&#241;os&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">176 &#40;19&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">224 &#40;50&#41;<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">&#42;&#42;&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">97 &#40;9&#44;3&#41;<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">&#42;&#42;&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">423 &#40;20&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Peso corporal &#40;kg&#41;&#44; media</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">&#177;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">DE</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">77<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>14&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">70<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>15<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">&#42;&#42;&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">79<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>16<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">77<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>16&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleBold">Enfermedades de base&#44; n &#40;&#37;&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Enfermedad pulmonar cr&#243;nica</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">73 &#40;7&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">48 &#40;11&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">51 &#40;4&#44;9&#41;<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">&#42;&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">161 &#40;7&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Insuficiencia cardiaca cr&#243;nica</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">51 &#40;5&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">38 &#40;8&#44;5&#41;<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">33 &#40;3&#44;2&#41;<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">101 &#40;4&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Niveles de CrCl</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">&#60;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">60</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">mL&#47;min</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">385 &#40;41&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">256 &#40;58&#41;<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">&#42;&#42;&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">178 &#40;17&#41;<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">&#42;&#42;&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">567 &#40;27&#41;<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">&#42;&#42;&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Anemia</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">678 &#40;72&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">309 &#40;69&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">358 &#40;34&#41;<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">&#42;&#42;&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">541 &#40;25&#41;<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">&#42;&#42;&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleBold">Factores de riesgo a&#241;adido para ETV&#44; n &#40;&#37;&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">C&#225;ncer</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">44 &#40;4&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">58 &#40;13&#41;<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">&#42;&#42;&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">52 &#40;5&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">127 &#40;5&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Terapia hormonal</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10 &#40;1&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4 &#40;0&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">69 &#40;6&#44;8&#41;<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">&#42;&#42;&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">175 &#40;8&#44;4&#41;<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">&#42;&#42;&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">ETV previa</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">82 &#40;8&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">36 &#40;8&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">84 &#40;8&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">173 &#40;8&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleBold">Presentaci&#243;n inicial de la ETV&#44; n &#40;&#37;&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Embolismo pulmonar</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">495 &#40;53&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">257 &#40;58&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">559 &#40;54&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">969 &#40;45&#41;<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">&#42;&#42;&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Para pacientes con EP</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>PSS<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>100<span class="elsevierStyleHsp" style=""></span>mmHg&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">41 &#40;8&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">25 &#40;9&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">40 &#40;7&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">85 &#40;8&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Ritmo cardiaco<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>100<span class="elsevierStyleHsp" style=""></span>lpm&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">167 &#40;34&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">97 &#40;38&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">206 &#40;37&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">356 &#40;37&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>SatO<span class="elsevierStyleInf">2</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>90&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">69 &#40;14&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">56 &#40;22&#41;<span class="elsevierStyleSup">&#42;&#42;&#42;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">65 &#40;12&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">157 &#40;16&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleBold">Profilaxis de la ETV</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">S&#237;&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">886 &#40;94&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">412 &#40;93&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">745 &#40;71&#41;<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">&#42;&#42;&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">689 &#40;32&#41;<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">&#42;&#42;&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Con heparina de bajo peso molecular&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">789 &#40;84&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">388 &#40;87&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">685 &#40;66&#41;<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">&#42;&#42;&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">628 &#40;29&#41;<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">&#42;&#42;&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Dosis de HBPM &#40;UI&#47;kg&#47;d&#237;a&#41;&#44; media</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">&#177;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">DE</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6&#46;053<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#44;406&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&#46;490<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;194&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6&#46;527<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>9&#44;027&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&#46;662<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&#44;253&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Duraci&#243;n &#40;d&#237;as&#41;&#44; media</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">&#177;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">DE</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">17<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">21<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>14&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">18<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>14&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">24<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>44<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">&#42;&#42;&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Tiempo hasta ETV &#40;d&#237;as&#41;&#44; media</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">&#177;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">DE</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">21<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>38&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">26<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>20&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">26<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>18<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">&#42;&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">22<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>73&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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          "leyenda" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">DE&#58; desviaci&#243;n est&#225;ndar&#59; HBPM&#58; heparina de bajo peso molecular&#46;</p><p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">Las comparaciones se realizaron empleando como referencia pacientes con artroplastia electiva&#58;</p>"
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                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Artroplastia electiva&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Fractura de cadera&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Cirug&#237;a ortop&#233;dica menor&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Traumatismo no quir&#250;rgico&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Pacientes&#44; n</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">445&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;045&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#46;136&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleItalic">Tratamiento inicial</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Heparina de bajo peso molecular&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">387 &#40;87&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">875 &#40;84&#41;<a class="elsevierStyleCrossRef" href="#tblfn0020"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Dosis de HBPM &#40;UI&#47;kg&#47;d&#237;a&#41;&#44; media<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>DE&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">180<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>41&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">178<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>39&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">177<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>43&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">80 &#40;7&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">105 &#40;4&#44;9&#41;<a class="elsevierStyleCrossRef" href="#tblfn0020"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">28 &#40;2&#44;7&#41;<span class="elsevierStyleSup">&#8224;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Rivaroxab&#225;n&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0<a class="elsevierStyleCrossRef" href="#tblfn0020"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">30 &#40;2&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">49 &#40;2&#44;3&#41;<a class="elsevierStyleCrossRef" href="#tblfn0020"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3 &#40;0&#44;67&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">18 &#40;1&#44;7&#41;<a class="elsevierStyleCrossRef" href="#tblfn0020"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">38 &#40;1&#44;8&#41;<a class="elsevierStyleCrossRef" href="#tblfn0020"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Filtro de vena cava inferior&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9 &#40;2&#44;0&#41;<a class="elsevierStyleCrossRef" href="#tblfn0020"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">18 &#40;1&#44;7&#41;<a class="elsevierStyleCrossRef" href="#tblfn0020"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">39 &#40;1&#44;8&#41;<a class="elsevierStyleCrossRef" href="#tblfn0020"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleItalic">Tratamiento a largo plazo</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Antagonistas de la vitamina K&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">251 &#40;60&#41;<a class="elsevierStyleCrossRef" href="#tblfn0025"><span class="elsevierStyleSup">&#42;&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">675 &#40;65&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;355 &#40;65&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Heparina de bajo peso molecular&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">140<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>51&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10 &#40;0&#44;47&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">TVP recurrente</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5 &#40;0&#44;53&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2 &#40;0&#44;45&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6 &#40;0&#44;57&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">13 &#40;0&#44;61&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">ETV recurrente</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8 &#40;0&#44;85&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8 &#40;1&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10 &#40;1&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">23 &#40;1&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Hemorragia mayor</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">15 &#40;1&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">18 &#40;4&#44;0&#41;<a class="elsevierStyleCrossRef" href="#tblfn0040"><span class="elsevierStyleSup">&#42;&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">16 &#40;1&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">29 &#40;1&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Localizaci&#243;n de las hemorragias</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Gastrointestinal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2 &#40;0&#44;21&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6 &#40;1&#44;3&#41;<a class="elsevierStyleCrossRef" href="#tblfn0040"><span class="elsevierStyleSup">&#42;&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3 &#40;0&#44;29&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7 &#40;0&#44;33&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Hematoma&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2 &#40;0&#44;21&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8 &#40;0&#44;77&#41;<a class="elsevierStyleCrossRef" href="#tblfn0035"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9 &#40;0&#44;42&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Retroperitoneal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1 &#40;0&#44;11&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1 &#40;0&#44;22&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3 &#40;0&#44;14&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Intraarticular&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3 &#40;0&#44;32&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1 &#40;0&#44;05&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Cerebral&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2 &#40;0&#44;21&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3 &#40;0&#44;14&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Muertes globales</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">30 &#40;3&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">65 &#40;15&#41;<a class="elsevierStyleCrossRef" href="#tblfn0045"><span class="elsevierStyleSup">&#42;&#42;&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">20 &#40;1&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">86 &#40;4&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Causas de la muerte</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>EP&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5 &#40;0&#44;53&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9 &#40;2&#44;0&#41;<a class="elsevierStyleCrossRef" href="#tblfn0040"><span class="elsevierStyleSup">&#42;&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5 &#40;0&#44;48&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">11 &#40;0&#44;51&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>EP inicial&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3 &#40;0&#44;32&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8 &#40;1&#44;8&#41;<a class="elsevierStyleCrossRef" href="#tblfn0035"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4 &#40;0&#44;38&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10 &#40;0&#44;47&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>EP recurrente&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2 &#40;0&#44;21&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1 &#40;0&#44;22&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1 &#40;0&#44;10&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1 &#40;0&#44;05&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Hemorragia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2 &#40;0&#44;21&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2 &#40;0&#44;45&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2 &#40;0&#44;09&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>C&#225;ncer diseminado&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1 &#40;0&#44;11&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6 &#40;1&#44;3&#41;<a class="elsevierStyleCrossRef" href="#tblfn0040"><span class="elsevierStyleSup">&#42;&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3 &#40;0&#44;29&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8 &#40;0&#44;37&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Insuficiencia cardiaca&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4 &#40;0&#44;90&#41;<a class="elsevierStyleCrossRef" href="#tblfn0040"><span class="elsevierStyleSup">&#42;&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1 &#40;0&#44;10&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2 &#40;0&#44;09&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Insuficiencia respiratoria&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4 &#40;0&#44;90&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9 &#40;0&#44;42&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Cirug&#237;a ortop&#233;dica menor&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Traumatismo no quir&#250;rgico&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="3" align="left" valign="top"><span class="elsevierStyleBold">Hemorragia mayor</span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="3" align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Tipo de cirug&#237;a o traumatismo</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Artroplastia electiva&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;18&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Fractura de cadera&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Cirug&#237;a ortop&#233;dica menor&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Traumatismo no quir&#250;rgico&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">EP &#40;vs&#46; TVP&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&#44;53 &#40;2&#44;02-6&#44;15&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Insuficiencia cardiaca cr&#243;nica</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#44;29 &#40;1&#44;19-4&#44;40&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;01&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Niveles de CrCl</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">&#60;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">60</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">mL&#47;min</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#44;63 &#40;1&#44;64-4&#44;21&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">C&#225;ncer</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#44;26 &#40;1&#44;19-4&#44;29&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;01&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="3" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="3" align="left" valign="top"><span class="elsevierStyleBold">Mortalidad global</span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="3" align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Tipo de cirug&#237;a o traumatismo</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Artroplastia electiva&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1 &#40;ref&#46;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Fractura de cadera&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&#44;13 &#40;1&#44;93-5&#44;09&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Cirug&#237;a ortop&#233;dica menor&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;79 &#40;0&#44;43-1&#44;44&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;44&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Traumatismo no quir&#250;rgico&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;37 &#40;0&#44;87-2&#44;15&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;18&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Niveles de PSS</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">&#60;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">100</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">mmHg</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#44;82 &#40;1&#44;78-4&#44;45&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Frecuencia cardiaca</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">&#62;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">100</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">lpm</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;88 &#40;1&#44;35-2&#44;61&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">SatO</span><span class="elsevierStyleInf"><span class="elsevierStyleItalic">2</span></span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">&#60;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">90&#37;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;72 &#40;1&#44;16-2&#44;54&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;007&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Edad</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">&#60;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">50 a&#241;os</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;35 &#40;0&#44;18-0&#44;68&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;002&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Edad</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">&#62;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">80 a&#241;os</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&#44;07 &#40;2&#44;19-4&#44;29&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Insuficiencia cardiaca cr&#243;nica</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&#44;54 &#40;2&#44;37-5&#44;31&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">C&#225;ncer</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&#44;98 &#40;3&#44;43-7&#44;23&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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          "es" => "<p id="spar0100" class="elsevierStyleSimplePara elsevierViewall">Odds ratio ajustada para cada resultado a 90 d&#237;as</p>"
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                    0 => array:2 [
                      "titulo" => "Prevention of VTE in orthopedic surgery patients&#58; Antithrombotic Therapy and Prevention of Thrombosis&#44; 9<span class="elsevierStyleHsp" style=""></span>th ed&#58; American College of Chest Physicians Evidence-Based Clinical Practice Guidelines"
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                            2 => "N&#46;A&#46; Johanson"
                            3 => "C&#46; Curley"
                            4 => "O&#46;E&#46; Dahl"
                            5 => "S&#46; Schulman"
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                    0 => array:2 [
                      "doi" => "10.1378/chest.11-2404"
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                        "numero" => "2 Suppl"
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                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22315265"
                            "web" => "Medline"
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Venous thromboembolism and bleeding after total knee and hip arthroplasty&#46; Findings from the Spanish National Discharge Database"
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                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "R&#46; Guijarro"
                            1 => "J&#46; Montes"
                            2 => "C&#46; San Rom&#225;n"
                            3 => "J&#46;I&#46; Arcelus"
                            4 => "G&#46; Barillari"
                            5 => "X&#46; Granero"
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                    ]
                  ]
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                    0 => array:2 [
                      "doi" => "10.1160/TH10-10-0645"
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                        "volumen" => "105"
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                      "titulo" => "Symptomatic in-hospital deep vein thrombosis and pulmonary embolism following hip and knee arthroplasty among patients receiving recommended prophylaxis&#58; A systematic review"
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                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46;M&#46; Januel"
                            1 => "G&#46; Chen"
                            2 => "C&#46; Ruffieux"
                            3 => "H&#46; Quan"
                            4 => "J&#46;D&#46; Douketis"
                            5 => "M&#46;A&#46; Crowther"
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                        ]
                      ]
                    ]
                  ]
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                    0 => array:2 [
                      "doi" => "10.1001/jama.2011.2029"
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                        "volumen" => "307"
                        "paginaInicial" => "294"
                        "paginaFinal" => "303"
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                          0 => array:2 [
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                0 => array:2 [
                  "contribucion" => array:1 [
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                      "titulo" => "Incidence and prophylaxis of deep venous thrombosis in outpatients with injury of the lower limb"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "P&#46; Kujath"
                            1 => "U&#46; Spannagel"
                            2 => "W&#46; Habscheid"
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                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1159/000216905"
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                        "tituloSerie" => "Haemostasis&#46;"
                        "fecha" => "1993"
                        "volumen" => "23"
                        "numero" => "Suppl 1"
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                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8388353"
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                0 => array:2 [
                  "contribucion" => array:1 [
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                      "titulo" => "Thromboprophylaxis with low-molecular-weight heparin in outpatients with plaster-cast immobilisation of the leg"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "H&#46;J&#46; Kock"
                            1 => "K&#46;P&#46; Schmit-Neuerburg"
                            2 => "J&#46; Hanke"
                            3 => "G&#46; Rudofsky"
                            4 => "H&#46; Hirche"
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                      "Revista" => array:6 [
                        "tituloSerie" => "Lancet&#46;"
                        "fecha" => "1995"
                        "volumen" => "346"
                        "paginaInicial" => "459"
                        "paginaFinal" => "461"
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                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7637478"
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                            2 => "K&#46; Hansen"
                            3 => "C&#46; Paltved"
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Vol. 218. Núm. 8.
Páginas 399-407 (noviembre 2018)
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174
Vol. 218. Núm. 8.
Páginas 399-407 (noviembre 2018)
ORIGINAL
Pronóstico de la enfermedad tromboembólica venosa en cirugía ortopédica o pacientes traumatológicos y uso de tromboprofilaxis
Prognosis of venous thromboembolism in orthopaedic surgery or trauma patients and use of thromboprophylaxis
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174
J. Gutiérrez Guisadoa,
Autor para correspondencia
jgutierrezguisado@asepeyo.es

Autor para correspondencia.
, J. Trujillo-Santosb, J.I. Arcelusc, L. Bertolettid, C. Fernandez-Capitáne, R. Vallef, J.A. Hernandez-Hermosog, A. Erice Calvo-Soteloa, J.A. Nietoh, M. Monreali, en nombre de los investigadores del estudio RIETE
a Departamento de Medicina Interna, Hospital ASEPEYO, Universidad Francisco de Vitoria, Coslada, Madrid, España
b Departamento de Medicina Interna, Hospital General Universitario Santa Lucía, Murcia, España
c Departamento de Cirugía General, Hospital Universitario Virgen de las Nieves, Granada, España
d Departamento de Medicina y Terapéutica, Hôpital Nord-CHU de Saint-Étienne, Saint Etienne, Francia
e Departamento de Medicina Interna, Hospital Universitario La Paz, Madrid, España
f Departamento de Medicina Interna, Hospital Sierrallana, Torrelavega, Cantabria, España
g Servicio de Cirugía Ortopédica, Hospital Universitario Germans Trias i Pujol, Badalona, Barcelona, España
h Departamento de Medicina Interna, Hospital General Virgen de la Luz, Cuenca, España
i Departamento de Medicina Interna, Hospital Universitario Germans Trias i Pujol, Badalona, Barcelona, España
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Tablas (5)
Tabla 1. Tipo de cirugía o traumatismo de acuerdo con la presentación inicial de la enfermedad tromboembólica venosa y uso de profilaxis para esta
Tabla 2. Características basales de los 4.569 pacientes que desarrollaron tromboembolismo venoso agudo tras cirugía ortopédica o traumatismo
Tabla 3. Estrategias terapéuticas
Tabla 4. Resultados a los 90 días
Tabla 5. Odds ratio ajustada para cada resultado a 90 días
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Resumen
Antecedentes

Hay escasa evidencia sobre el pronóstico de la tromboembolia venosa en pacientes sometidos a cirugía ortopédica y en pacientes que sufren un trauma no quirúrgico.

Métodos

Utilizamos la base de datos RIETE (Registro Informatizado de pacientes con Enfermedad TromboEmbólica) para comparar el pronóstico del tromboembolismo venoso y el uso de tromboprofilaxis en pacientes sometidos a diferentes procedimientos ortopédicos y en pacientes con traumatismo que no requiere cirugía.

Resultados

Desde marzo de 2001 a marzo de 2015, se inscribieron un total de 61.789 pacientes en RIETE. De estos, 943 (1.52%) desarrollaron tromboembolismo venoso después de artroplastia electiva, 445 (0.72%) después de fractura de cadera, 1.045 (1.69%) después de cirugía ortopédica no mayor y 2,136 (3.46%) después de trauma no quirúrgico. En general, 2.283 pacientes (50%) presentaron inicialmente embolia pulmonar. En los primeros 90 días de tratamiento, 30 pacientes (0.66%, IC 95% 0.45-0.93) murieron por embolia pulmonar. La tasa de embolia pulmonar fatal fue significativamente mayor después de cirugía de fractura de cadera (n = 9 [2.02%]) que después de la artroplastia electiva (n = 5 [0.53%]), cirugía ortopédica no mayor (n = 5 [0.48%]) o traumatismo no quirúrgico (n = 11 [0,48%]). La tromboprofilaxis se utilizó con mayor frecuencia para la fractura de cadera (93%) o la artroplastia electiva (94%) que para la cirugía ortopédica no mayor (71%) o traumatismo no quirúrgico (32%). La hemorragia mayor fue significativamente mayor después de la cirugía de fractura de cadera (4%) que después de artroplastia electiva (1,6%), cirugía ortopédica no mayor (1,5%) o traumatismo no quirúrgico (1,4%).

Conclusiones

La tromboprofilaxis se utilizó con menos frecuencia en los procedimientos de menor riesgo a pesar del número absoluto de embolia pulmonar fatal después de cirugía ortopédica no mayor o traumatismo no quirúrgico, excedieron los observados después de procedimientos de alto riesgo.

Palabras clave:
Trombosis venosa profunda
Embolismo pulmonar
Sangrado mayor
Tromboembolismo recurrente
Cirugía ortopédica menor
Traumatismo sin cirugía
Abstract
Background

There is scarce evidence about the prognosis of venous thromboembolism in patients undergoing orthopedic surgery and in patients suffering non-surgical trauma.

Methods

We used the RIETE database (Registro Informatizado de pacientes con Enfermedad Trombo Embólica) to compare the prognosis of venous thromboembolism and the use of thromboprophylaxis in patients undergoing different orthopedic procedures and in trauma patients not requiring surgery.

Results

From March 2001 to March 2015, a total of 61,789 patients were enrolled in RIETE database. Of these, 943 (1.52%) developed venous thromboembolism after elective arthroplasty, 445 (0.72%) after hip fracture, 1,045 (1.69%) after non-major orthopedic surgery and 2,136 (3.46%) after non-surgical trauma. Overall, 2,283 patients (50%) initially presented with pulmonary embolism. Within the first 90 days of therapy, 30 patients (0.66%; 95% CI 0.45-0.93) died from pulmonary embolism. The rate of fatal pulmonary embolism was significantly higher after hip fracture surgery (n = 9 [2.02%]) than after elective arthroplasty (n = 5 [0.53%]), non-major orthopedic surgery (n = 5 [0.48%]) or non surgical trauma (n = 11 [0.48%]). Thromboprophylaxis was more commonly used for hip fracture (93%) or elective arthroplasty (94%) than for non-major orthopedic surgery (71%) or non-surgical trauma (32%). Major bleeding was significantly higher after hip fracture surgery (4%) than that observed after elective arthroplasty (1.6%), non-major orthopedic surgery (1.5%) or non-surgical trauma (1.4%).

Conclusions

Thromboprophylaxis was less frequently used in lower risk procedures despite the absolute number of fatal pulmonary embolism after non-major orthopedic surgery or non-surgical trauma, exceeded that observed after high risk procedures.

Keywords:
Deep-vein thrombosis
Pulmonary embolism
Major bleeding
Recurrent thromboembolism
Non-major orthopaedic surgery
Trauma not requiring surgery

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