Association between use of enhanced recovery after surgery protocols and postoperative complications after gastric surgery for cancer (POWER 4): a nationwide, prospective multicentre study

array:24 ["pii" => "S217350772300100X" "issn" => "21735077" "doi" => "10.1016/j.cireng.2023.04.011" "estado" => "S300" "fechaPublicacion" => "2023-10-01" "aid" => "2881" "copyright" => "AEC" "copyrightAnyo" => "2023" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Cir Esp. 2023;101:665-77" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "Traduccion" => array:1 [ "en" => array:19 [ "pii" => "S0009739X23000799" "issn" => "0009739X" "doi" => "10.1016/j.ciresp.2023.02.009" "estado" => "S300" "fechaPublicacion" => "2023-10-01" "aid" => "2881" "copyright" => "AEC" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Cir Esp. 2023;101:665-77" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "en" => array:14 [ "idiomaDefecto" => true "cabecera" => "Original article" "titulo" => "Association between use of enhanced recovery after surgery protocols and postoperative complications after gastric surgery for cancer (POWER 4): a nationwide, prospective multicentre study" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:3 [ 0 => "en" 1 => "en" 2 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "665" "paginaFinal" => "677" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Asociación entre el uso de protocolos de recuperación intensificada y complicaciones postoperatorias tras cirugía gástrica por cáncer (POWER 4): estudio nacional, prospective multicéntrico" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 1 "multimedia" => array:5 [ "identificador" => "fig0020" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => false "mostrarDisplay" => true "figura" => array:1 [ 0 => array:4 [ "imagen" => "fx1.jpeg" "Alto" => 754 "Ancho" => 1333 "Tamanyo" => 89271 ] ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Javier Ripollés-Melchor, Ane Abad-Motos, Marcos Bruna-Esteban, María García-Nebreda, Isabel Otero-Martínez, Omar Abdel-lah Fernández, María P. Tormos-Pérez, Gloria Paseiro-Crespo, Raquel García-Álvarez, María A Mayo-Ossorio, Orreaga Zugasti-Echarte, Paula Nespereira-García, Lucia Gil-Gómez, Margarita Logroño-Ejea, Raquel Risco, Felipe C Parreño-Manchado, Silvia Gil-Trujillo, Carmen Benito, Carlos Jericó, María I De-Miguel-Cabrera, Bakarne Ugarte-Sierra, Cristina Barragán-Serrano, José A. García-Erce, Henar Muñoz-Hernández, Sabela del- Río-Fernández, María L. Herrero-Bogajo, Alma M. Espinosa-Moreno, Vanessa Concepción-Martín, Andrés Zorrilla-Vaca, Laura Vaquero-Pérez, Irene Mojarro, Manuel Llácer-Pérez, Leticia Gómez-Viana, María T. Fernández-Martín, Alfredo Abad-Gurumeta, Carlos Ferrando-Ortolà, José M. Ramírez-Rodríguez, César Aldecoa" "autores" => array:39 [ 0 => array:2 [ "nombre" => "Javier" "apellidos" => "Ripollés-Melchor" ] 1 => array:2 [ "nombre" => "Ane" "apellidos" => "Abad-Motos" ] 2 => array:2 [ "nombre" => "Marcos" "apellidos" => "Bruna-Esteban" ] 3 => array:2 [ "nombre" => "María" "apellidos" => "García-Nebreda" ] 4 => array:2 [ "nombre" => "Isabel" "apellidos" => "Otero-Martínez" ] 5 => array:2 [ "nombre" => "Omar" "apellidos" => "Abdel-lah Fernández" ] 6 => array:2 [ "nombre" => "María P." "apellidos" => "Tormos-Pérez" ] 7 => array:2 [ "nombre" => "Gloria" "apellidos" => "Paseiro-Crespo" ] 8 => array:2 [ "nombre" => "Raquel" "apellidos" => "García-Álvarez" ] 9 => array:2 [ "nombre" => "María" "apellidos" => "A Mayo-Ossorio" ] 10 => array:2 [ "nombre" => "Orreaga" "apellidos" => "Zugasti-Echarte" ] 11 => array:2 [ "nombre" => "Paula" "apellidos" => "Nespereira-García" ] 12 => array:2 [ "nombre" => "Lucia" "apellidos" => "Gil-Gómez" ] 13 => array:2 [ "nombre" => "Margarita" "apellidos" => "Logroño-Ejea" ] 14 => array:2 [ "nombre" => "Raquel" "apellidos" => "Risco" ] 15 => array:2 [ "nombre" => "Felipe C" "apellidos" => "Parreño-Manchado" ] 16 => array:2 [ "nombre" => "Silvia" "apellidos" => "Gil-Trujillo" ] 17 => array:2 [ "nombre" => "Carmen" "apellidos" => "Benito" ] 18 => array:2 [ "nombre" => "Carlos" "apellidos" => "Jericó" ] 19 => array:2 [ "nombre" => "María I" "apellidos" => "De-Miguel-Cabrera" ] 20 => array:2 [ "nombre" => "Bakarne" "apellidos" => "Ugarte-Sierra" ] 21 => array:2 [ "nombre" => "Cristina" "apellidos" => "Barragán-Serrano" ] 22 => array:2 [ "nombre" => "José A." "apellidos" => "García-Erce" ] 23 => array:2 [ "nombre" => "Henar" "apellidos" => "Muñoz-Hernández" ] 24 => array:2 [ "nombre" => "Sabela del-" "apellidos" => "Río-Fernández" ] 25 => array:2 [ "nombre" => "María L." "apellidos" => "Herrero-Bogajo" ] 26 => array:2 [ "nombre" => "Alma M." "apellidos" => "Espinosa-Moreno" ] 27 => array:2 [ "nombre" => "Vanessa" "apellidos" => "Concepción-Martín" ] 28 => array:2 [ "nombre" => "Andrés" "apellidos" => "Zorrilla-Vaca" ] 29 => array:2 [ "nombre" => "Laura" "apellidos" => "Vaquero-Pérez" ] 30 => array:2 [ "nombre" => "Irene" "apellidos" => "Mojarro" ] 31 => array:2 [ "nombre" => "Manuel" "apellidos" => "Llácer-Pérez" ] 32 => array:2 [ "nombre" => "Leticia" "apellidos" => "Gómez-Viana" ] 33 => array:2 [ "nombre" => "María T." "apellidos" => "Fernández-Martín" ] 34 => array:2 [ "nombre" => "Alfredo" "apellidos" => "Abad-Gurumeta" ] 35 => array:2 [ "nombre" => "Carlos" "apellidos" => "Ferrando-Ortolà" ] 36 => array:2 [ "nombre" => "José M." "apellidos" => "Ramírez-Rodríguez" ] 37 => array:2 [ "nombre" => "César" "apellidos" => "Aldecoa" ] 38 => array:1 [ "colaborador" => "on behalf of the POWER Study Investigators Group" ] ] ] ] "resumen" => array:1 [ 0 => array:3 [ "titulo" => "Graphical abstract" "clase" => "graphical" "resumen" => "<elsevierMultimedia ident="fig0020"></elsevierMultimedia>" ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S217350772300100X" "doi" => "10.1016/j.cireng.2023.04.011" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S217350772300100X?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0009739X23000799?idApp=UINPBA00004N" "url" => "/0009739X/0000010100000010/v1_202310100835/S0009739X23000799/v1_202310100835/en/main.assets" ] ] "itemSiguiente" => array:17 [ "pii" => "S2173507723000911" "issn" => "21735077" "doi" => "10.1016/j.cireng.2023.04.003" "estado" => "S300" "fechaPublicacion" => "2023-10-01" "aid" => "2882" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Cir Esp. 2023;101:678-83" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "en" => array:14 [ "idiomaDefecto" => true "cabecera" => "Original article" "titulo" => "Laparoscopic liver resections: What have we learned after more than 20 years of experience?" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:3 [ 0 => "en" 1 => "en" 2 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "678" "paginaFinal" => "683" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Resecciones hepáticas laparoscópicas: ¿qué hemos aprendido luego de más de 20 años de experiencia?" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 1 "multimedia" => array:5 [ "identificador" => "fig0030" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => false "mostrarDisplay" => true "figura" => array:1 [ 0 => array:4 [ "imagen" => "fx1.jpeg" "Alto" => 499 "Ancho" => 1333 "Tamanyo" => 66812 ] ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Catalina Poggi, Tomás Cifone, Luciana Peralta, Tomás d’Angelo, Oscar Mazza, Rodrigo Sánchez Clariá, Martín de Santibañes, Juan Pekolj" "autores" => array:8 [ 0 => array:2 [ "nombre" => "Catalina" "apellidos" => "Poggi" ] 1 => array:2 [ "nombre" => "Tomás" "apellidos" => "Cifone" ] 2 => array:2 [ "nombre" => "Luciana" "apellidos" => "Peralta" ] 3 => array:2 [ "nombre" => "Tomás" "apellidos" => "d’Angelo" ] 4 => array:2 [ "nombre" => "Oscar" "apellidos" => "Mazza" ] 5 => array:2 [ "nombre" => "Rodrigo" "apellidos" => "Sánchez Clariá" ] 6 => array:2 [ "nombre" => "Martín" "apellidos" => "de Santibañes" ] 7 => array:2 [ "nombre" => "Juan" "apellidos" => "Pekolj" ] ] ] ] "resumen" => array:1 [ 0 => array:3 [ "titulo" => "Graphical abstract" "clase" => "graphical" "resumen" => "<elsevierMultimedia ident="fig0030"></elsevierMultimedia>" ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173507723000911?idApp=UINPBA00004N" "url" => "/21735077/0000010100000010/v2_202406091334/S2173507723000911/v2_202406091334/en/main.assets" ] "itemAnterior" => array:18 [ "pii" => "S2173507723000157" "issn" => "21735077" "doi" => "10.1016/j.cireng.2023.01.003" "estado" => "S300" "fechaPublicacion" => "2023-10-01" "aid" => "2831" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Cir Esp. 2023;101:657-64" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "en" => array:13 [ "idiomaDefecto" => true "titulo" => "Study of risk factors for delayed gastric emptying after partial pancretoduodenectomy" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:3 [ 0 => "en" 1 => "en" 2 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "657" "paginaFinal" => "664" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Análisis de factores de riesgo de vaciamiento gástrico lento tras la duodenopancreatectomía cefálica" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 1 "multimedia" => array:5 [ "identificador" => "fig0010" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => false "mostrarDisplay" => true "figura" => array:1 [ 0 => array:4 [ "imagen" => "fx1.jpeg" "Alto" => 754 "Ancho" => 1333 "Tamanyo" => 87242 ] ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "S. Martín, Ll Secanella, M. Sorribas, N. Peláez, S. Salord, R. Lopez-Urdiales, J. Fabregat, J. Busquets" "autores" => array:8 [ 0 => array:2 [ "nombre" => "S." "apellidos" => "Martín" ] 1 => array:2 [ "nombre" => "Ll" "apellidos" => "Secanella" ] 2 => array:2 [ "nombre" => "M." "apellidos" => "Sorribas" ] 3 => array:2 [ "nombre" => "N." "apellidos" => "Peláez" ] 4 => array:2 [ "nombre" => "S." "apellidos" => "Salord" ] 5 => array:2 [ "nombre" => "R." "apellidos" => "Lopez-Urdiales" ] 6 => array:2 [ "nombre" => "J." "apellidos" => "Fabregat" ] 7 => array:2 [ "nombre" => "J." "apellidos" => "Busquets" ] ] ] ] "resumen" => array:1 [ 0 => array:3 [ "titulo" => "Graphical abstract" "clase" => "graphical" "resumen" => "<elsevierMultimedia ident="fig0010"></elsevierMultimedia>" ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0009739X22003499" "doi" => "10.1016/j.ciresp.2022.10.018" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0009739X22003499?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173507723000157?idApp=UINPBA00004N" "url" => "/21735077/0000010100000010/v2_202406091334/S2173507723000157/v2_202406091334/en/main.assets" ] "en" => array:22 [ "idiomaDefecto" => true "cabecera" => "Original article" "titulo" => "Association between use of enhanced recovery after surgery protocols and postoperative complications after gastric surgery for cancer (POWER 4): a nationwide, prospective multicentre study" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "665" "paginaFinal" => "677" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Javier Ripollés-Melchor, Ane Abad-Motos, Marcos Bruna-Esteban, María García-Nebreda, Isabel Otero-Martínez, Omar Abdel-lah Fernández, María P. Tormos-Pérez, Gloria Paseiro-Crespo, Raquel García-Álvarez, María A Mayo-Ossorio, Orreaga Zugasti-Echarte, Paula Nespereira-García, Lucia Gil-Gómez, Margarita Logroño-Ejea, Raquel Risco, Felipe C Parreño-Manchado, Silvia Gil-Trujillo, Carmen Benito, Carlos Jericó, María I De-Miguel-Cabrera, Bakarne Ugarte-Sierra, Cristina Barragán-Serrano, José A. García-Erce, Henar Muñoz-Hernández, Sabela del- Río-Fernández, María L. Herrero-Bogajo, Alma M. Espinosa-Moreno, Vanessa Concepción-Martín, Andrés Zorrilla-Vaca, Laura Vaquero-Pérez, Irene Mojarro, Manuel Llácer-Pérez, Leticia Gómez-Viana, María T. Fernández-Martín, Alfredo Abad-Gurumeta, Carlos Ferrando-Ortolà, José M. Ramírez-Rodríguez, César Aldecoa" "autores" => array:39 [ 0 => array:3 [ "nombre" => "Javier" "apellidos" => "Ripollés-Melchor" "referencia" => array:4 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:2 [ "etiqueta" => "c" "identificador" => "aff0015" ] 3 => array:2 [ "etiqueta" => "d" "identificador" => "aff0020" ] ] ] 1 => array:4 [ "nombre" => "Ane" "apellidos" => "Abad-Motos" "email" => array:1 [ 0 => "ane.abadmotos@osakidetza.eus" ] "referencia" => array:5 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:2 [ "etiqueta" => "c" "identificador" => "aff0015" ] 3 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] 4 => array:2 [ "etiqueta" => "1" "identificador" => "fn0005" ] ] ] 2 => array:3 [ "nombre" => "Marcos" "apellidos" => "Bruna-Esteban" "referencia" => array:3 [ 0 => array:2 [ "etiqueta" => "b" "identificador" => "aff0010" ] 1 => array:2 [ "etiqueta" => "c" "identificador" => "aff0015" ] 2 => array:2 [ "etiqueta" => "e" "identificador" => "aff0025" ] ] ] 3 => array:3 [ "nombre" => "María" "apellidos" => "García-Nebreda" "referencia" => array:3 [ 0 => array:2 [ "etiqueta" => "c" "identificador" => "aff0015" ] 1 => array:2 [ "etiqueta" => "d" "identificador" => "aff0020" ] 2 => array:2 [ "etiqueta" => "f" "identificador" => "aff0030" ] ] ] 4 => array:3 [ "nombre" => "Isabel" "apellidos" => "Otero-Martínez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "g" "identificador" => "aff0035" ] ] ] 5 => array:3 [ "nombre" => "Omar" "apellidos" => "Abdel-lah Fernández" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "h" "identificador" => "aff0040" ] ] ] 6 => array:3 [ "nombre" => "María P." "apellidos" => "Tormos-Pérez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "i" "identificador" => "aff0045" ] ] ] 7 => array:3 [ "nombre" => "Gloria" "apellidos" => "Paseiro-Crespo" "referencia" => array:3 [ 0 => array:2 [ "etiqueta" => "c" "identificador" => "aff0015" ] 1 => array:2 [ "etiqueta" => "d" "identificador" => "aff0020" ] 2 => array:2 [ "etiqueta" => "f" "identificador" => "aff0030" ] ] ] 8 => array:3 [ "nombre" => "Raquel" "apellidos" => "García-Álvarez" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "b" "identificador" => "aff0010" ] 1 => array:2 [ "etiqueta" => "j" "identificador" => "aff0050" ] ] ] 9 => array:3 [ "nombre" => "María" "apellidos" => "A Mayo-Ossorio" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "k" "identificador" => "aff0055" ] ] ] 10 => array:3 [ "nombre" => "Orreaga" "apellidos" => "Zugasti-Echarte" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "l" "identificador" => "aff0060" ] ] ] 11 => array:3 [ "nombre" => "Paula" "apellidos" => "Nespereira-García" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "m" "identificador" => "aff0065" ] ] ] 12 => array:3 [ "nombre" => "Lucia" "apellidos" => "Gil-Gómez" "referencia" => array:3 [ 0 => array:2 [ "etiqueta" => "b" "identificador" => "aff0010" ] 1 => array:2 [ "etiqueta" => "c" "identificador" => "aff0015" ] 2 => array:2 [ "etiqueta" => "n" "identificador" => "aff0070" ] ] ] 13 => array:3 [ "nombre" => "Margarita" "apellidos" => "Logroño-Ejea" "referencia" => array:3 [ 0 => array:2 [ "etiqueta" => "b" "identificador" => "aff0010" ] 1 => array:2 [ "etiqueta" => "c" "identificador" => "aff0015" ] 2 => array:2 [ "etiqueta" => "o" "identificador" => "aff0075" ] ] ] 14 => array:3 [ "nombre" => "Raquel" "apellidos" => "Risco" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "p" "identificador" => "aff0080" ] ] ] 15 => array:3 [ "nombre" => "Felipe C" "apellidos" => "Parreño-Manchado" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "h" "identificador" => "aff0040" ] ] ] 16 => array:3 [ "nombre" => "Silvia" "apellidos" => "Gil-Trujillo" "referencia" => array:3 [ 0 => array:2 [ "etiqueta" => "b" "identificador" => "aff0010" ] 1 => array:2 [ "etiqueta" => "c" "identificador" => "aff0015" ] 2 => array:2 [ "etiqueta" => "q" "identificador" => "aff0085" ] ] ] 17 => array:3 [ "nombre" => "Carmen" "apellidos" => "Benito" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "r" "identificador" => "aff0090" ] ] ] 18 => array:3 [ "nombre" => "Carlos" "apellidos" => "Jericó" "referencia" => array:3 [ 0 => array:2 [ "etiqueta" => "b" "identificador" => "aff0010" ] 1 => array:2 [ "etiqueta" => "c" "identificador" => "aff0015" ] 2 => array:2 [ "etiqueta" => "s" "identificador" => "aff0095" ] ] ] 19 => array:3 [ "nombre" => "María I" "apellidos" => "De-Miguel-Cabrera" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "t" "identificador" => "aff0100" ] ] ] 20 => array:3 [ "nombre" => "Bakarne" "apellidos" => "Ugarte-Sierra" "referencia" => array:3 [ 0 => array:2 [ "etiqueta" => "b" "identificador" => "aff0010" ] 1 => array:2 [ "etiqueta" => "c" "identificador" => "aff0015" ] 2 => array:2 [ "etiqueta" => "u" "identificador" => "aff0105" ] ] ] 21 => array:3 [ "nombre" => "Cristina" "apellidos" => "Barragán-Serrano" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "v" "identificador" => "aff0110" ] ] ] 22 => array:3 [ "nombre" => "José A." "apellidos" => "García-Erce" "referencia" => array:3 [ 0 => array:2 [ "etiqueta" => "b" "identificador" => "aff0010" ] 1 => array:2 [ "etiqueta" => "c" "identificador" => "aff0015" ] 2 => array:2 [ "etiqueta" => "w" "identificador" => "aff0115" ] ] ] 23 => array:3 [ "nombre" => "Henar" "apellidos" => "Muñoz-Hernández" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "x" "identificador" => "aff0120" ] ] ] 24 => array:3 [ "nombre" => "Sabela del-" "apellidos" => "Río-Fernández" "referencia" => array:3 [ 0 => array:2 [ "etiqueta" => "b" "identificador" => "aff0010" ] 1 => array:2 [ "etiqueta" => "c" "identificador" => "aff0015" ] 2 => array:2 [ "etiqueta" => "y" "identificador" => "aff0125" ] ] ] 25 => array:3 [ "nombre" => "María L." "apellidos" => "Herrero-Bogajo" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "c" "identificador" => "aff0015" ] 1 => array:2 [ "etiqueta" => "z" "identificador" => "aff0130" ] ] ] 26 => array:3 [ "nombre" => "Alma M." "apellidos" => "Espinosa-Moreno" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "c" "identificador" => "aff0015" ] 1 => array:2 [ "etiqueta" => "aa" "identificador" => "aff0135" ] ] ] 27 => array:3 [ "nombre" => "Vanessa" "apellidos" => "Concepción-Martín" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "c" "identificador" => "aff0015" ] 1 => array:2 [ "etiqueta" => "ab" "identificador" => "aff0140" ] ] ] 28 => array:3 [ "nombre" => "Andrés" "apellidos" => "Zorrilla-Vaca" "referencia" => array:3 [ 0 => array:2 [ "etiqueta" => "b" "identificador" => "aff0010" ] 1 => array:2 [ "etiqueta" => "ac" "identificador" => "aff0145" ] 2 => array:2 [ "etiqueta" => "ad" "identificador" => "aff0150" ] ] ] 29 => array:3 [ "nombre" => "Laura" "apellidos" => "Vaquero-Pérez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "ae" "identificador" => "aff0155" ] ] ] 30 => array:3 [ "nombre" => "Irene" "apellidos" => "Mojarro" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "af" "identificador" => "aff0160" ] ] ] 31 => array:3 [ "nombre" => "Manuel" "apellidos" => "Llácer-Pérez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "ag" "identificador" => "aff0165" ] ] ] 32 => array:3 [ "nombre" => "Leticia" "apellidos" => "Gómez-Viana" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "ah" "identificador" => "aff0170" ] ] ] 33 => array:3 [ "nombre" => "María T." "apellidos" => "Fernández-Martín" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "ai" "identificador" => "aff0175" ] ] ] 34 => array:3 [ "nombre" => "Alfredo" "apellidos" => "Abad-Gurumeta" "referencia" => array:4 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:2 [ "etiqueta" => "c" "identificador" => "aff0015" ] 3 => array:2 [ "etiqueta" => "d" "identificador" => "aff0020" ] ] ] 35 => array:3 [ "nombre" => "Carlos" "apellidos" => "Ferrando-Ortolà" "referencia" => array:4 [ 0 => array:2 [ "etiqueta" => "b" "identificador" => "aff0010" ] 1 => array:2 [ "etiqueta" => "c" "identificador" => "aff0015" ] 2 => array:2 [ "etiqueta" => "p" "identificador" => "aff0080" ] 3 => array:2 [ "etiqueta" => "aj" "identificador" => "aff0180" ] ] ] 36 => array:3 [ "nombre" => "José M." "apellidos" => "Ramírez-Rodríguez" "referencia" => array:3 [ 0 => array:2 [ "etiqueta" => "b" "identificador" => "aff0010" ] 1 => array:2 [ "etiqueta" => "c" "identificador" => "aff0015" ] 2 => array:2 [ "etiqueta" => "ak" "identificador" => "aff0185" ] ] ] 37 => array:3 [ "nombre" => "César" "apellidos" => "Aldecoa" "referencia" => array:3 [ 0 => array:2 [ "etiqueta" => "b" "identificador" => "aff0010" ] 1 => array:2 [ "etiqueta" => "c" "identificador" => "aff0015" ] 2 => array:2 [ "etiqueta" => "ah" "identificador" => "aff0170" ] ] ] 38 => array:2 [ "colaborador" => "POWER Study Investigators Group" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "d" "identificador" => "aff0020" ] 1 => array:2 [ "etiqueta" => "2" "identificador" => "fn2005" ] ] ] ] "afiliaciones" => array:37 [ 0 => array:3 [ "entidad" => "Department of Anaesthesia and Perioperative Medicine, Infanta Leonor University Hospital, Madrid, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Spanish Perioperative Audit and Research Network (REDGERM), Zaragoza, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Grupo Español de Rehabilitación Multimodal (GERM), Zaragoza, Spain" "etiqueta" => "c" "identificador" => "aff0015" ] 3 => array:3 [ "entidad" => "Universidad Complutense de Madrid, Madrid, Spain" "etiqueta" => "d" "identificador" => "aff0020" ] 4 => array:3 [ "entidad" => "Department of General Surgery, La Fe University Hospital, Valencia, Spain" "etiqueta" => "e" "identificador" => "aff0025" ] 5 => array:3 [ "entidad" => "Department of General Surgery, Infanta Leonor University Hospital, Madrid, Spain" "etiqueta" => "f" "identificador" => "aff0030" ] 6 => array:3 [ "entidad" => "Department of General Surgery, Hospital Álvaro Cunqueiro de Vigo (Complejo Hospitalario Universitario de Vigo), Vigo, Spain" "etiqueta" => "g" "identificador" => "aff0035" ] 7 => array:3 [ "entidad" => "Department of General Surgery, Complejo Asistencial Universitario de Salamanca, Salamanca, Spain" "etiqueta" => "h" "identificador" => "aff0040" ] 8 => array:3 [ "entidad" => "Department of Anaesthesia and Perioperative Medicine, Vall d’Hebrón University Hospital, Barcelona, Spain" "etiqueta" => "i" "identificador" => "aff0045" ] 9 => array:3 [ "entidad" => "Department of Anaesthesia and Perioperative Medicine, 12 de Octubre University Hospital, Madrid, Spain" "etiqueta" => "j" "identificador" => "aff0050" ] 10 => array:3 [ "entidad" => "Department of General Surgery, Hospital Universitario Puerta del Mar Cádiz, Cádiz, Spain" "etiqueta" => "k" "identificador" => "aff0055" ] 11 => array:3 [ "entidad" => "Department of Anaesthesia and Perioperative Medicine, Complejo Hospitalario Navarra, Pamplona, Spain" "etiqueta" => "l" "identificador" => "aff0060" ] 12 => array:3 [ "entidad" => "Department of Anaesthesia and Perioperative Medicine, Hospital POVISA Vigo, Vigo, Spain" "etiqueta" => "m" "identificador" => "aff0065" ] 13 => array:3 [ "entidad" => "Department of Anaesthesia and Perioperative Medicine, Hospital de Sant Joan Despí Moisès Broggi, Spain" "etiqueta" => "n" "identificador" => "aff0070" ] 14 => array:3 [ "entidad" => "Department of Anaesthesia and Perioperative Medicine, Hospital Universitario de Alava, Vitoria, Spain" "etiqueta" => "o" "identificador" => "aff0075" ] 15 => array:3 [ "entidad" => "Department of Anesthesiology and Critical Care, Hospital Clínic, Institut D'investigació August Pi i Sunyer, Barcelona, Spain" "etiqueta" => "p" "identificador" => "aff0080" ] 16 => array:3 [ "entidad" => "Department of Anaesthesia and Perioperative Medicine, Hospital General Universitario de Ciudad Real, Ciudad Real, Spain" "etiqueta" => "q" "identificador" => "aff0085" ] 17 => array:3 [ "entidad" => "Department of Anaesthesia and Perioperative Medicine, Hospital General Universitario Gregorio Marañón, Madrid, Spain" "etiqueta" => "r" "identificador" => "aff0090" ] 18 => array:3 [ "entidad" => "Department of Internal Medicine, Hospital Moisès Broggi, Consorci Sanitari Integral, Sant Joan Despí, Spain" "etiqueta" => "s" "identificador" => "aff0095" ] 19 => array:3 [ "entidad" => "Department of Anaesthesia and Perioperative Medicine, Hospital General Universitari Castelló, Castellón de La Plana, Spain" "etiqueta" => "t" "identificador" => "aff0100" ] 20 => array:3 [ "entidad" => "Department of General Surgery, Hospital Galdakao-Usansolo, Spain" "etiqueta" => "u" "identificador" => "aff0105" ] 21 => array:3 [ "entidad" => "Department of General Surgery, Fundación Jiménez Díaz University Hospital, Madrid, Spain" "etiqueta" => "v" "identificador" => "aff0110" ] 22 => array:3 [ "entidad" => "Banco de Sangre y Tejidos de Navarra, Pamplona, Spain" "etiqueta" => "w" "identificador" => "aff0115" ] 23 => array:3 [ "entidad" => "Department of Anaesthesia and Perioperative Medicine, Hospital Clínico de Valladolid, Spain" "etiqueta" => "x" "identificador" => "aff0120" ] 24 => array:3 [ "entidad" => "Department of Anaesthesia and Perioperative Medicine, Complexo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain" "etiqueta" => "y" "identificador" => "aff0125" ] 25 => array:3 [ "entidad" => "Department of General Surgery, Hospital General La Mancha Centro, Alcázar de San Juan, Spain" "etiqueta" => "z" "identificador" => "aff0130" ] 26 => array:3 [ "entidad" => "Department of Anaesthesia and Perioperative Medicine, Hospital Universitario Fundación Alcorcón, Alcorcón, Spain" "etiqueta" => "aa" "identificador" => "aff0135" ] 27 => array:3 [ "entidad" => "Department of General Surgery, Nuestra Señora de Candelaria Hospital Universitario, Spain" "etiqueta" => "ab" "identificador" => "aff0140" ] 28 => array:3 [ "entidad" => "Department of Anesthesiology and Perioperative Medicine, University of Texas MD Anderson Cancer Center, Houston, TX, USA" "etiqueta" => "ac" "identificador" => "aff0145" ] 29 => array:3 [ "entidad" => "Department of Anesthesiology, Perioperative, and Pain Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA" "etiqueta" => "ad" "identificador" => "aff0150" ] 30 => array:3 [ "entidad" => "Department of Anaesthesia and Perioperative Medicine, Hospital Universitario Río Hortega, Valladolid, Spain" "etiqueta" => "ae" "identificador" => "aff0155" ] 31 => array:3 [ "entidad" => "Department of Anaesthesia and Perioperative Medicine, Juan Ramón Jiménez University Hospital, Huelva, Spain" "etiqueta" => "af" "identificador" => "aff0160" ] 32 => array:3 [ "entidad" => "Department of Anaesthesia and Perioperative Medicine, Hospital Costa del Sol, Marbella, Spain" "etiqueta" => "ag" "identificador" => "aff0165" ] 33 => array:3 [ "entidad" => "Department of Anaesthesia and Perioperative Medicine, Complejo Hospitalario Universitario de Ourense, Ourense, Spain" "etiqueta" => "ah" "identificador" => "aff0170" ] 34 => array:3 [ "entidad" => "Department of Anaesthesia and Perioperative Medicine, Hospital Medina del Campo, Medina del Campo, Spain" "etiqueta" => "ai" "identificador" => "aff0175" ] 35 => array:3 [ "entidad" => "CIBER de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain" "etiqueta" => "aj" "identificador" => "aff0180" ] 36 => array:3 [ "entidad" => "Department of General Surgery, Lozano Blesa University Hospital, Universidad de Zaragoza, Zaragoza, Spain" "etiqueta" => "ak" "identificador" => "aff0185" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Asociación entre el uso de protocolos de recuperación intensificada y complicaciones postoperatorias tras cirugía gástrica por cáncer (POWER 4): estudio nacional, prospective multicéntrico" ] ] "resumenGrafico" => array:2 [ "original" => 1 "multimedia" => array:5 [ "identificador" => "fig0020" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => false "mostrarDisplay" => true "figura" => array:1 [ 0 => array:4 [ "imagen" => "fx1.jpeg" "Alto" => 754 "Ancho" => 1333 "Tamanyo" => 89271 ] ] ] ] "textoCompleto" => "IntroductionGastric cancer is the fifth most frequent malignant tumour worldwide, and accounts for 732,000 deaths per year, ranking it as the fourth leading cause of cancer-related death.<a class="elsevierStyleCrossRef" href="#bib0005">1</a> Gastrectomy for cancer is a technically challenging procedure, with postoperative complications occurring in 20 to 46 % of patients<a class="elsevierStyleCrossRefs" href="#bib0010">2,3</a>Enhanced Recovery After Surgery (ERAS) is a multidisciplinary perioperative approach that provides standardized evidence-based recommendations for the care of patients undergoing specific types of surgery.<a class="elsevierStyleCrossRef" href="#bib0020">4</a> ERAS began in patients undergoing colorectal surgery,<a class="elsevierStyleCrossRef" href="#bib0025">5</a> and resulted in a decrease in postoperative complications and length of hospital stay (LOS) when adequate adherence to the protocols was achieved.<a class="elsevierStyleCrossRefs" href="#bib0030">6,7</a> The ERAS model is well established for colorectal surgery as the optimal perioperative care. ERAS implementation in gastric surgery<a class="elsevierStyleCrossRef" href="#bib0040">8</a> has shown discrete decreases in LOS.<a class="elsevierStyleCrossRef" href="#bib0045">9</a> Moreover, despite the clinical reported benefits of ERAS, its implementation in clinical practice has been quite slow for a variety of reasons, such as lack of convincing data, low level of knowledge about ERAS, or expertise and institutional limitations,<a class="elsevierStyleCrossRefs" href="#bib0050">10,11</a> and lack of large studies assessing the association between ERAS adherence and postoperative outcomes.The aim of this study was to assess perioperative care in patients undergoing elective gastric surgery for cancer in Spain, and to analyse the association between the individual ERAS elements and postoperative complications.MethodsStudy design and participantsThe POWER 4study was a multicentre, prospective, three-month cohort study. The study was approved by the Ethics Committee of the Instituto Aragonés de Ciencias de la Salud, Zaragoza, Spain (C.P.-C.I. PI19/106, March 27, 2019) and was prospectively registered (NCT03865810). The study protocol was published,<a class="elsevierStyleCrossRef" href="#bib0060">12</a> and approved by the ethics committees or institutional review boards of each centre. All patients signed a written informed consent before inclusion. This study followed the STROBE reporting guideline for cohort studies,<a class="elsevierStyleCrossRef" href="#bib0065">13</a> and the Reporting on ERAS Compliance, Outcomes, and Elements Research Checklist.<a class="elsevierStyleCrossRef" href="#bib0070">14</a> The hospital and investigator involvement were provided through the Spanish Perioperative Audit and Research Network (RedGERM). All Spanish centres were invited to participate regardless of having or not an established ERAS pathway.ProceduresAll consecutive adult patients scheduled for elective gastric surgery for cancer were assessed for inclusion during a single period of three months of recruitment at each participating hospital between October 2019 and October 2020. Subtotal and total gastrectomies were included, both laparoscopic and open. Exclusion criteria were emergency surgery, endoscopic procedures, non-oncological gastric surgery and patient refusal. Each patient was followed up for 30 days after surgery. Patient information was acquired from hospital and primary care medical records.Data was collected using the Castor EDC platform<a class="elsevierStyleCrossRef" href="#bib0075">15</a> in a case record form designed specifically for POWER 4. Centres declared themselves as centres with or without an established multidisciplinary ERAS pathway for gastric surgery, regardless of the items that conformed the pathway and their current adherence.The definition of the individual ERAS components was based on the ERAS Society® Guidelines for gastric surgery.<a class="elsevierStyleCrossRef" href="#bib0040">8</a> For a simpler and more accurate data collection, some of the 25 items of these guidelines<a class="elsevierStyleCrossRef" href="#bib0040">8</a> were grouped and POWER4 included 22 elements of perioperative care<a class="elsevierStyleCrossRef" href="#bib0060">12</a>(Table S1 supplementary data).Data included patient characteristics, surgical procedure, surgical approach, duration of surgery, preoperative laboratory results, ERAS elements, and 30-day outcomes (postoperative complications, LOS, readmission, reoperation, and 30-day mortality). Thirty-day postoperative complications were predefined and graded as mild, moderate, or severe as described by the European Perioperative Clinical Outcome definitions (EPCO)<a class="elsevierStyleCrossRef" href="#bib0080">16</a> (Table S2, supplementary data).Data was censored at 30 days following surgery for patients who remained at the hospital. To ensure the validity of the data, they were validated and audited by another site investigator who was not involved in the initial data collection. Our aim was to recruit as many hospitals and patients in Spain as possible.OutcomesThe primary outcome measure was 30-day moderate-to-severe postoperative complications. Secondary outcomes were occurrence of overall postoperative complications, adherence to the ERAS pathway, 30 day-mortality and LOS.Adherence to the ERAS pathway was defined as the percentage of ERAS items that were applied to each patient over the total number of interventions recommended by the ERAS Society.Statistical analysisThe results were analysed according to whether the patient underwent surgery in a self-designed ERAS centre or in a non-ERAS centre. Discrete variables were described as absolute frequencies and percentages and their differences were analysed using Fisher's or Pearson's exact tests. Continuous variables were presented with medians with their corresponding interquartile ranges (IQR) and statistical differences were calculated using the Wilcoxon rank sum test. Adherence to the ERAS pathway was calculated for each individual patient according to the number of the ERAS items achieved over the 22 analysed items (ERAS adherence). Subsequently, the analysis was repeated, subdividing the entire sample into four quartiles according to the rate of adherence to the ERAS items (Q1: highest adherence, Q4: lowest adherence), regardless of whether or not the patients was treated at a self-designed ERAS centre. Highest and lowest adherence quartiles were compared, and linear adjustments of adherence were performed for each ERAS element. We then analysed the rate of moderate-to-severe complications for each ERAS element using Fisher's exact test, and we performed a multivariate analysis to study the association between the rate of each of the ERAS elements and the clinical and demographic variables. We also used the same model in a multilevel multivariable logistic regression model to explore independent factors associated with moderate-to-severe postoperative complications assessing the variability of each centre.In order to avoid errors in the multiple comparisons, the respective q value was calculated for each P value in order to maintain a false discovery rate of less than 5 %. Comparisons in which the P value and q value were less than 0.05 were considered statistically significant.ResultsParticipantsA total of 743 patients from 72 centres were included in the analysis (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>), of which 211 (28.4%) were included in self-declared ERAS centres; 444 (60 %) were men, and median age was 70 years [IQR 61 to 77]. Other characteristics are shown in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>. More patients in the ERAS group received preoperative neoadjuvant therapy and were treated in a centre with a Patient Blood Management (PBM) program. Duration of surgery was longer in the ERAS group. (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>).<elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="tbl0005"></elsevierMultimedia>Outcomes in self-declared ERAS vs. non-ERAS groupsA total of 172 patients (23.1%) suffered moderate-to-severe complications, and 245 patients (33 %) experienced overall postoperative complications. There were no differences in the incidence of moderate-to-severe complications (47 (22.3%) vs. 125 (23.5%); OR, 0.92 (95% CI, 0.59 to 1.41); P = 0.068) or overall postoperative complications (71 (33.6%) vs. 174 (32.7%); OR, 1.05, 95 % CI, 0.70 to 1.56; P = 0.825) between the self-declared ERAS and non-ERAS groups. Patients in the ERAS group had less bloodstream infection compared to the non-ERAS group. There were no differences in the rest of the predefined complications and there were no differences in readmissions, reoperations, mortality and LOS. (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>).<elsevierMultimedia ident="fig0010"></elsevierMultimedia>Adherence dataThe overall adherence rate to the ERAS individual items was 52% [IQR 45 to 60]. Adherence was significantly higher in self-declared ERAS centres compared to non-ERAS centres 60% [IQR 52 to 70] vs. 50% [IQR 43 to 57] (P < 0.001). Adherence to most of the individual ERAS elements was higher in the self-declared ERAS cohort. <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a> shows the adherence for each of the individual ERAS elements.<elsevierMultimedia ident="tbl0010"></elsevierMultimedia>Outcomes in higher versus lower ERAS adherence groupsAdherence to the ERAS elements in the highest adherence quartile (Q1) was > 60 %, while in the lowest adherence quartile (Q4) ≤ 45 %. There were no differences in the number of patients with moderate to severe complications, overall complications, readmissions, mortality or LOS. Patients in the Q1 had more anastomotic leak compared with those in the low adherence group (Q4). There were no other differences in any of the predefined complications between the highest and lowest adherence groups (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>). Linear adherence adjustment also showed that additional adherence to the ERAS pathway in the Q1 did not improve any of the outcomes compared to Q4.<elsevierMultimedia ident="fig0015"></elsevierMultimedia>Individual ERAS elements, patients characteristics and moderate-to-severe postoperative complicationsMultivariable and multilevel analyses of individual ERAS elements showed a statistically significant reduction of moderate-to-severe complications in those patients in which early mobilization was achieved while patients not receiving preoperative mechanical bowel preparation and postoperative nutritional care had more moderate-severe postoperative complications. No other associations were found for the other ERAS elements (Table S3, supplementary data.).Patients who received neoadjuvant therapy had a lower risk of moderate-severe postoperative complications. Frail patients, patients with cirrhosis, patients undergoing total gastrectomy, and patients with a longer lasting surgery had a higher risk of moderate-to-severe complications (Table S3, supplementary data).Individual ERAS elements and patients characteristics and LOSLOS was significantly lower in patients in whom nasogastric tube was not used, and in those who received early feeding. However, patients who underwent total gastrectomy and those who received postoperative nutritional support had a longer LOS. None of the other ERAS elements, neither being treated at a self-declared ERAS centre, were associated with shorter LOS (Table S4, supplementary data).DiscussionThe main finding of this study was that neither treatment at a self-declared ERAS centre nor high compliance (Q1) with ERAS measures were associated with improved outcomes after elective gastric cancer surgery.Given the success of ERAS in colorectal surgery, this multimodal perioperative care approach has emerged as an optimal perioperative strategy to improve clinical outcomes in gastric cancer surgery and in many other procedures. However, numerous controversies exist regarding the practice of ERAS in patients undergoing gastrectomy. A recent meta-analysis of randomized controlled trials which assessed the role of ERAS in radical gastrectomy showed that ERAS results in accelerated convalescence, improved nutritional status, and improved quality of life for gastric cancer patients.<a class="elsevierStyleCrossRef" href="#bib0085">17</a> Similarly to our findings, Blumenthaler et al did not find that the application of an ERAS pathway in gastric surgery resulted in fewer postoperative complications.<a class="elsevierStyleCrossRef" href="#bib0090">18</a> It has been reported that the efficacy of protocols that are incompletely or incipiently applied is markedly reduced.<a class="elsevierStyleCrossRefs" href="#bib0090">18,19</a> Although this has been mainly reported for colorectal surgery <a class="elsevierStyleCrossRefs" href="#bib0030">6,20</a> it was also recently shown that greater adherence to ERAS recommendations for gastric surgery resulted in improved postoperative outcomes.<a class="elsevierStyleCrossRef" href="#bib0105">21</a> However, we did not find that greater adherence to protocols was associated with better outcomes, although the adherence in our highest adherence quartile was lower than previously reported as required to improve postoperative outcomes<a class="elsevierStyleCrossRef" href="#bib0030">6</a>, so it is possible that our low overall adherence in Spain was one of the determinants of the ineffectiveness of the ERAS protocol in this cohort.Early mobilization was the only ERAS element that was associated with fewer moderate-severe complications. Several studies have shown that the application of this part of the ERAS program can significantly accelerate the recovery of postoperative intestinal function<a class="elsevierStyleCrossRefs" href="#bib0110">22,23</a> and improve postoperative outcomes.<a class="elsevierStyleCrossRefs" href="#bib0035">7,24,25</a> On the other hand, those who received postoperative nutritional support had more postoperative complications and higher LOS probably due to a previous poorer nutritional status or the presence of postoperative complications.. The length of stay was also shorter in patients who did not have a nasogastric tube and who received an early feeding. The number and relative combination of ERAS elements implemented, and the relative importance of individual items, especially those considered as "core elements'' of ERAS is currently a debated topic.<a class="elsevierStyleCrossRefs" href="#bib0130">26,27</a> It is accepted that early mobilization is a core element in most ERAS guidelines<a class="elsevierStyleCrossRef" href="#bib0020">4</a>, its fulfilment may be due to both a dedicated effort by the postoperative multidisciplinary team and a sign of favourable clinical outcome,<a class="elsevierStyleCrossRef" href="#bib0140">28</a> and conversely, the inability to mobilize early in the immediate postoperative period may be considered as a warning sign of poor clinical outcome.<a class="elsevierStyleCrossRef" href="#bib0145">29</a> Early deviation of postoperative ERAS elements appears to be the most significant in terms of association with ERAS failure and delayed discharge.<a class="elsevierStyleCrossRef" href="#bib0145">29</a> Early restoration of the oral feeding promotes early recovery of normal bowel function, so it seems logical that patients who achieve early tolerance will have a shorter LOS,<a class="elsevierStyleCrossRef" href="#bib0150">30</a> while those with impediments to achieving this, such as the presence of a nasogastric tube or the need for nutritional support, will have a longer LOS. Once again, this postoperative element could be considered as a success of the pathway, or as an early warning sign in those cases in which compliance is not achieved.<a class="elsevierStyleCrossRef" href="#bib0155">31</a>A recent study provided unique insight into changes in gastric cancer presentation, management and outcomes over a 30-year period and highlighted the importance of perioperative chemotherapy in long-term survival, as well as the reduction in the number of total gastrectomy as a milestone in the management of patients undergoing gastric cancer surgery to improve postoperative outcomes.<a class="elsevierStyleCrossRef" href="#bib0160">32</a> We found similar results, patients with neoadjuvant therapy presented fewer complications, but longer surgeries and total gastrectomy were associated with more postoperative complications. On the other hand, although the partial application of ERAS did not lead to better outcomes, it was not associated with more readmissions or more reoperations, so its practice seems safe, and efforts should be undertaken to achieve greater adherence to the protocol, since it is ultimately the standard of care in many cases.Most of the studies on gastric surgery were performed in the Asian population, and this study is the largest study to date on gastric surgery in the ERAS setting in a Western population; however, we must acknowledge some limitations of the study. First, in an optimally designed study, the groups would be blindly assigned to ERAS or non-ERAS for the same period of time to avoid allocation bias. However, we consider that a randomized clinical trial comparing an ERAS protocol versus a clinical practice in which none of the ERAS elements were used would be unethical. On the other hand, information bias may be inherent in the design of this study, and could have influenced an increase in adherence to the ERAS elements, so that the actual ERAS adherence could even be lower. The elements of ERAS themselves are interrelated. For example, conservative intraoperative fluid administration is arguably more applicable in patients who did not receive preoperative bowel preparation, and administration of carbohydrate drinks mandates adequate adherence to preoperative fasting time. In addition, the use of some of the ERAS elements are related to the severity of the patient, e.g., goal-directed fluid therapy, usually recommended for the high-risk patient.<a class="elsevierStyleCrossRefs" href="#bib0165">33,34</a> We tried to avoid selection bias by including a majority of Spanish centres that were performing gastrectomy, regardless of whether they self-designated as ERAS or not. The effect of these problems was partly offset by the large sample size and the number of institutions reporting data, but we also have to recognize that gastrectomy is not as frequent a procedure as, for example, colorectal surgery, and many centres recruited a low number of patients.The application of ERAS protocols for gastric surgery in our cohort was very low. Neither partial compliance with ERAS protocols nor treatment with self-designated ERAS centres improved postoperative outcomes in patients undergoing gastric surgery for cancer.FundingSupport was only provided by institutional sources. The POWER 4 study was supported by the Spanish Perioperative Audit and Research Network (RedGERM) and the Grupo Español de Rehabilitación Multimodal (GERM).RedGERM conducted and designed the study; provided collection and management of the data; but had no role in the analysis and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.COI/DisclosuresDr. Ripollés-Melchor reports personal fees from Edwards Lifesciences, Vifor Pharma, MSD and Fresenius Kabi outside the submitted work. Dr. Alfredo Abad-Gurumeta reports personal fees from Edwards Lifesciences, MSD, 3 M, Braun, Ferrer, Rovi and ALTAN outside the submitted work. Dr. Aldecoa reports personal fees from Fresenius Kabi and Octapharma outside the submitted work. Dr García-Erce declares no conflict of interest with this study. However, he has previously given talks, chaired tables at congresses and conferences and organized courses with scholarships or funding from Amgen, Jansen, Sandoz, Vifor Pharma and Zambon. Carlos Jericó has given talks and received consultancy fees from Viphor Pharma España SL, Bial and Zambon. Ane Abad-Motos, Marcos Bruna-Esteban, María García-Nebreda, Isabel Otero-Martínez, Omar Abdel-lah Fernández, María P. Tormos-Pérez, Gloria Paseiro-Crespo, Raquel García-Álvarez, María A Mayo-Ossorio, Orreaga Zugasti-Echarte, Paula Nespereira-García, Lucia Gil-Gómez, Margarita Logroño-Ejea, Raquel Risco, Felipe C Parreño-Manchado, Silvia Gil-Trujillo, Carmen Benito, María I De-Miguel-Cabrera, Bakarne Ugarte-Sierra, Cristina Barragán-Serrano, Henar Muñoz-Hernández, Sabela del- Río-Fernández, María L. Herrero-Bogajo, Alma M. Espinosa-Moreno, Vanessa Concepción-Martín, Andrés Zorrilla-Vaca, Laura Vaquero-Pérez, Irene Mojarro, Manuel Llácer-Pérez, Leticia Gómez-Viana, María T. Fernández-Martín, Carlos Ferrando-Ortolà, José M. Ramírez-Rodríguez report no potential conflicts of interest.Appendix 1: POWER 4 Investigators GroupAlthaia. Xarxa Assistencial i Universitària de ManresaMercè Güell Farré1,2, Roser Farré Font, Rafael Diaz del Gobbo, Raquel Sánchez Jimenez (Surgery Department) Isabel Pérez Reche, Belen Gil Calvo, Jordi Llorca García, Laura Carrasco Sánchez, Cristina Prat llimargas (Anesthesia Department).Complejo Asistencial de ZamoraAna María García-Sánchez1, Gema Martínez-Ragüés1, María Gómez-Fernández (Anesthesia Department); Álvaro del-Castillo-Criado2, Ruth Martínez-Díaz, Sara Alegría-Rebollo (Surgery Department)Complejo Asistencial Universitario de LeónJavier Ferrero-de-Paz1,2, Cristina García-Pérez, Sergio Marcos-Contreras, Diana Fernández-García, Maeva Torío-Marcos (Anesthesia Department)Complejo Asistencial Universitario de SalamancaOmar Abdel-lah Fernández1,2, Felipe Carlos Parreño-Manchado1 (Surgery Department); María Ángeles Martín (Anesthesia Department)Complejo Hospitalario de MéridaJosé María Tena-Guerrero1,2, Estefanía Palma-González (Anesthesia Department); Gustavo Flores-Flores1 (Surgery Department)Complejo Hospitalario de NavarraOrreaga Zugasti-Echarte1,2, Elena Pérez-Bergara, Susana Hernández-García, Marta Martín-Vizcaíno, Francisco Javier Yoldi-Murillo, Maider Valencia-Alzueta (Anesthesia Department); Carlos Chaveli-Díaz, Coro Miranda-Murua, Concepción Yárnoz-Irazábal (Surgery Department); Sonsoles Botella-Martínez (Nutrition Department)Complejo Hospitalario de ToledoRafael López-Pardo1,2 (Surgery Department); Marta Torres-Montalvo (Anesthesia Department)Complejo Hospitalario Don Benito Villanueva de la SerenaIsabel Pinilla-Pico, Enrique del-Cojo-Peces1,2, María del Pilar Rodríguez-Chaparro (Anesthesia Department)Complejo Hospitalario Universitario A CoruñaManuel Ángel Gómez-Ríos1,2, Sara del-Río-Regueira, Eva Mosquera-Rodríguez (Anesthesia Department)Complejo Hospitalario Universitario de CanariasJessica Hernández-Beslmeisl1,2, María Alejandra Perozo-Medina1, Beneharo Darias-Delbey, María del Carmen Martín- Lorenzo, Vanessa González-Fariña, Montserrat Rodríguez-Domínguez, Jaime Fernández-de-la-Vega-Medina, Pilar Berrotarán-Ayub (Anesthesia Department)Complejo Hospitalario Universitario Insular Materno Infantil de Gran CanariaJosé Valín-Martínez1,2, Laura Concepción-Santana, Raúl Cruz-Zorio, Dolores Betancort-Gutiérrez Rodríguez (Anesthesia Department)Complexo Hospitalario Universitario de OurenseLeticia Gómez-Viana1,2, Olalla Figueiredo, Ariadna Rodríguez, Manuel González (Anesthesia Department); David Iglesias, José Manuel Domínguez-Carrera (Surgery Department); Jorge do Olmo (Adminisitrative support)Complexo Hospitalario Universitario de SantiagoSabela Del-Río-Fernández1,2, Laura Dos-Santos-Carregal, María Jesús Rodríguez-Forja, Olga Campaña-Figueira, Julián Álvarez-Escudero (Anesthesia Department); Lucía Lesquereux-Martínez, Purificación Parada-González, Ricardo Montenegro-Romero, Manuel Bustamante-Montalvo (Surgery Department); Ana Rosa García-Placín, Carmen Carpintero-Rama, Sergio Brea-Bahamonde (Nursing Department)Fundación Jímenez DíazJosé Ramón Torres-Alfonso1, Cristina Barragán-Serrano1,2, María Posada-González, Gabriel Salcedo-Cabañas, Peter Vorwald-Wolfgang (Surgery Department)Hospital Álvaro Cunqueiro de Vigo (Complejo Hospitalario Universitario de Vigo)Isabel Otero-Martínez1,2, Patricia Jove-Alborés, Marta López-Otero, Hermelinda Pardellas-Rivera, Ignacio Maruri-Chimeno, Sonia González-Fernández, Raquel Sánchez-Santos (Surgery Department); Luis Luna-Mendoza (Anesthesia Department)Hospital Arnau de Vilanova, ValenciaEnrique Lloria-Pons1,2, Francisco Gramuntell-Marco (Anesthesia Department) ; Raúl Cánovas-de-Lucas, Cristina Sancho-Moya (Surgery Department)Hospital Clínic de BarcelonaRaquel Risco1,2, Anna Fernández-Esmerats, Josep Martí Sanahuja-Blasco, Manuel López-Baamonde, Marta Ubré, Graciela Martínez-Pallí (Anesthesia Department); Dulce Momblán (Surgery Department); Nuria Rivas-Gallardo (Nurse)Hospital Clínico San CarlosRubén Sánchez-Martín1,2, Pedro Moral, Rosalía Navarro, Luis Santé (Anesthesia Department); Esther Almenta (Surgery Department)Hospital Clínico Universitario de ValladolidHenar Muñoz-Hernández1,2, Rita Pilar Rodríguez-Jiménez, Nuria Ruiz, María Teresa Peláez, Juan José Rojo, Carlota Gordaliza (Anesthesia Department); Carlos Jezieniecki (Surgery Department)Hospital Comarcal de IncaCarlos Jimenez-Viñas1,2, Carlo Brugiotti, Ulices Onchalos-Lopez (Surgery Department)Hospital Costa del Sol, Marbella (Málaga)Manuel Llácer-Pérez1,2 (Anesthesia Department)Hospital de la Santa Creu i Sant PauAstrid Batalla1,2, Gonzalo Azparren, Micaela Bastitta, Luisa Cueva, Mar Felipe, Marta Giné, Ana M. Gómez, Inmaculada India, Santiago Piñol (Anesthesia Department)Hospital de SaguntoMaria José Gimeno-Campos1,2, Aurora Moreno-Gázquez1, Julio Llorens-Herrerías, Gema Del-Castillo-Rodrigo (Anesthesia Department)Hospital General La Mancha CentroMaría Luz Herrero-Bogajo (Surgery Department)Hospital General Universitario de CastellonMaría Isabel De Miguel-Cabrera1,2, José Miguel España-Pamplona, María Gellida-Vilarroig, Laura Jordá-Sanz (Anesthesia Department)Hospital General Universitario de Ciudad RealSilvia Gil-Trujillo1,2, Laura Calatayud-Gómez, Juan David Valencia-Echeverri, Víctor Baladrón-González (Anesthesia Department); Aurora Gil-Rendo1,2, Susana Sanchez-García, Esther García-Santos (Surgery Department)Hospital General Universitario Gregorio Marañón de MadridCarmen Benito1,2, Cristina Lisbona, Pilar Benito (Anesthesia Department)Hospital General Universitario Santa LuciaOlga Cecilia Correa-Chacón1,2, Alejandro Alcázar-Urrea, Ana Belén Fernández-López, Ramiro Betancourt-Bastidas (Anesthesia Department); Inmaculada Navarro-García, Elena Romera-Barba (Surgery Department)Hospital Joan XXIII de TarragonaNuria Mira-Jovells1,2, Liz Karime Estevez-Perez, Judit Saludes-Serra (Anesthesia Department); Carles Olona-Casas2, Jordi Vadillo-Bargalló. Rosa Jorba-Martín (Surgery Department)Hospital Juan Ramon Jimenez, HuelvaIrene Mojarro1,2, Juan Victor Lorente, Pablo Longo-Guridi, Ana Maria Quintero-Moreno, David Soriano-López, Maria de la Peña Gómez-Dominguez, Cecilia Prieto-Candau, Marisol Hernández-Castillo, Irene Jarana, Francisco García-Andreu, Jose González-González, María Dolores Díaz-Lara (Anesthesia Department)Hospital Lluís AlcanyísElena Añón-Iranzo, Javier Aguiló-Lucia (Surgery Department)Hospital Medina del CampoMaria Teresa Fernandez-Martin1,2, Yessica Guerra (Anesthesia Department)Hospital Nuestra Señora del Prado. Talavera de la ReinaPablo Gimeno-Fernández1,2, Carla Iglesias-Morales, Ana María Ríos Villalba (Anesthesia Department)Hospital Povisa, VigoPaula Nespereira-García1,2, María José Castro-Neira, María Ochoa-Díez (Anesthesia Department)Hospital Sierrallana, TorrelavegaSilvia García-Orallo (Anesthesia Department); Maialen Mozo-Segurado, Jose Manuel Gutiérrez-Cabezas1,2, Ruben Gonzalo-González (Surgery Department)Hospital Universitario 12 de OctubreRaquel García-Álvarez1,2, Álvaro Ramiro-Ruíz1,2, María González-Cofrade, Estefanía Carvajal-Revuelta, Ana Bellido-López, Guillermo Redondo-Cristóbal (Anesthesia Department);Hospital Universitario Central de AsturiasSonia Amoza-Pais1,2, Tamara Díaz-Vico, María Moreno-Gijón, Sandra Sanz-Navarro, Lourdes M Sanz-Álvarez, Estrella Olga Turienzo-Santos, Jose Luis Rodicio-Miravalles, Amaya Rizzo-Ramos (Surgery Department); Ana Cuéllar-Martínez, Rosa Ana Álvarez-Fernández, Carmen Fernández-Seijo, Amelia Álvarez-Barrial, Carmen Gónzalez-Ortea, Silvia Fernández-Rodriguez, Nerea García-González, Lorena Varela-Rodriguez, Elena Berzal-Canga, Ángela García-Díaz-Negrete, Helena García-Sánchez, Javier Saenz-Abos, Beatriz Ayuso-Iñigo, María Vega-Colón (Anesthesia Department)Hospital Universitario Clínico San Cecilio, GranadaÁngela Catalina Palacios-Córdoba1, María Teresa Quel-Collado2, Mercedes Olvera-García, Agustina Martinez-Sánchez, Carmen Serrano-Alvarez (Anesthesia Department)Hospital Universitario CrucesEunate Ganuza-Martínez, María Jesús Maroño-Boedo2, Alberto Sánchez-Campos, Blanca Anuncia Escontrela-Rodríguez, Alberto Martínez-Ruiz1 (Anesthesia Department); Gaizka Errazti-Olartecoechea, Iratxe Rodeño-Esteban, Tamara Moreno-Allende, Oihane Gutierrez-Grijalba, Yanina Kataryniuk-Di-Costanzo, Irene Alvarez-Abad, Patricia Sendino-Cañizares, Patricia Mifsut-Porcel, Aingeru Sarriugarte-Lasarte1, Mikel Guerra-Lerma (Surgery Department)Hospital Universitario de ÁlavaMargarita Logroño-Ejea1,2, María Del Carmen Iturricastillo-Pérez, María Gastaca-AbasoloMaría José Muñoz-Sanz, Ibai Iriarte-Zaranton, Erika Olea-De-La-Fuente, Ana Mendiguren-Murua (Anesthesia Department); Lorena Reka-Mediavilla, Alberto Gastón-Moreno, Gabriel Jesús Martínez-De-Aragón-Remirez-De-Esparza, Valentín Sierra-Esteban (Surgery Department)Hospital Universitario de BadajozGema Montero-Mejías, Claudia Pardo-Martínez, Teresa Valadés-Periañez, Ana Marín-Moreno, Juan Ricardo Caro-González, María José Rodríguez- Pérez1,2 (Anesthesia Department)Hospital Universitario de BasurtoJosé Carlos Herrero-Herrero1,2, Pablo Renedo-Corcóstegui, Alejandro Martín-Oliva, Ana Isabel Fernández-Herrero, Nerea Andrieu-Estefanía (Anesthesia Department)Hospital Universitario de CabueñesJavier Albaladejo-Magdalena, María Álvarez-Rodriguez (Anesthesia Department); Valentina Sosa-Rodríguez, Raquel María Fresnedo-Pérez (Surgery Department)Hospital Universitario de FuenlabradaCristina Gil-Lapetra1,2, Beatriz Bolzoni-Marciel, Maria Isabel Herrera-López, Fernando Setién-Moreno, Ana Zulema Castro-Costoya, José Olarra-Nuel (Anesthesia Department); Marta De-Vega-Irañeta (Surgery Department)Hospital Universitario de GaldakaoBakarne Ugarte-Sierra1,2, Irune Vicente-Rodríguez, Francisco Javier Fernández-Pablos, Rafael Alberto Abad-Alonso, Roberto Maniega-Alba, Francisco Javier Ibáñez-Aguirre (Surgery Department); Susana Postigo-Morales, Karmelo Intxaurraga-Fernández, Sorkunde Telletxea-Benguria (Anesthesia Department); Ángela Outón-Guerrero (Nurse)Hospital Universitario de Gran Canaria Dr. NegrínMaría Asunción Acosta-Mérida1,2 (Surgery Department)Hospital Universitario de GuadalajaraRoberto de la Plaza-Llamas1,2, José Manuel García-Gil, Ignacio Antonio Gemio-del-Rey (Surgery Department); Mercedes Cabellos-Olivares (Anesthesia Department)Hospital Universitario de MóstolesRaquel Fernández-García1,2, Lidia Castro Freitas, Beatriz Nacarino Alcorta, María Martín Ayuso (Anesthesia Department); María Moral González, David García Teruel (Surgery Department)Hospital Universitario de VicJordi Serrat-Puyol1,2 (Anesthesia Department), Joan Molinas-Bruguera, Sara Fernández (Surgery Department)Hospital Universitario Doctor PesetNuria Peris-Tomás1,2, Jose Ángel Díez-Ares, Dolores Periáñez-Gómez, Paula Gonzálvez-Guardiola, Ramón Trullenque-Juan, Ezequiel Martínez-Mas (Surgery Department); Estefanía Martínez, Julia Martín, Raquel Higueras, Sara Cuenca (Anesthesia Department)Hospital Universitario Fundación de AlcorcónBeatriz Martín-Vaquerizo1, Alma M. Espinosa-Moreno1,2, Miriam Sánchez-Merchante, Rebeca Alcañiz-Sobrino, Guillermo Egea-Hita, Santiago García-del-Valle-y-Manzano (Anesthesia Department)Hospital Universitari i Politècnic La FeVirginia Moreno-Blanco1 (Research Nurse); Marcos Bruna-Esteban2, Fernando Mingol-Navarro, Javier Vaqué-Urbaneja (Surgery Department); Óscar Díaz-Cambronero (Anesthesia Department); Beatriz Luján-Sandemetrio, Bisila Copariate-Piqueras, Sonia Giménez-Salcedo (OR Nurse)Hospital Universitario Infanta LeonorJavier Ripolles-Melchor1, Ane Abad-Motos1,2, Alfredo Abad-Gurumeta, Norma Aracil-Escoda, Elena Saez-Ruiz, Rut Salvachua-Fernandez (Anesthesia Department); Gloria Paseiro-Crespo, María García-Nebreda (Surgery Department) ; Begoña Toribio (OR Nurse)Hospital Universitario Infanta SofíaEsther Ferrero-Celemin1,2, Luis García-Sancho-Téllez, José Daniel Sánchez-López, Sara Núñez-O'Sullivan, Mariana García-Virosta, Carmen Rodriguez-Haro, María Hernández-O'Reilly (Surgery Department)Hospital Universitario La PazAlejandro Suarez-de-la-Rica1,2, Mercedes Lopez-Martinez, Bryant Croes, Jaime Mujica, Emilio Maseda (Anesthesia Department);Hospital Universitario La PrincesaEnrique Alday-Muñoz1,2, Esperanza Mata-Mena (Anesthesia Department); Iñigo García-Sanz,Cristina Marín (Surgery Department)Hospital Universitario La ZarzuelaAntonio Pedraza Muñoz, Jorge Puertas Dominguez (Anesthesia Department)Hospital Universitario Lucus AugustiRocío González-López1,2, Gisela Navarro-Quirós1,2, M. Isabel Pérez-Moreiras, María Conde-Rodriguez, Manuel Muinelo-Lorenzo (Surgery Department)Hospital Universitario Marqués de ValdecillaMiren Jasone Díez-Zapirain1,2, Guillermo Tejón-Pérez1, María Asunción Álvarez-Cebrián, Eva Barrero-Ruiz, Eva Capa-Fuertes, Mariana Carrillo-Rivas, Isabel Hernandez-Sanchez, Valvanuz Monteagudo-Cimiano, Ángela Pascual-Casado, Jose Luis Rábago-Morillón (Anesthesia Department)Hospital Universitario Miguel Servet de ZaragozaJavier Martinez-Ubieto1, Ana Pascual-Bellosta1, Sonia Ortega-Lucea, Berta Perez-Otal2, Lucia Tardos-Ascaso2 (Anesthesia Department); Luis Antonio Ligorred-Padilla (Surgery Department)Hospital Universitari Mútua TerrassaJaume Tur-Martínez1,2, Joaquin Rodríguez-Santiago, Noelia Pérez-Romero, Noelia Puértolas-Rico, Laura Hernández-Giménez (Surgery Department)Hospital Universitario Nuestra Señora de CandelariaVanessa Concepción-Martín1,2 (Surgery Department)Hospital Universitario Puerta de Hierro, MajadahondaViktoria Molnar1,2, Macarena Barbero, Belén San-Antonio (Anesthesia Department); Alberto Pueyo (Surgery Department)Hospital Universitario Puerta del MarM de los Angeles Mayo-Ossorio1,2, Ander Bengoechea-Trujillo, José Manuel Pacheco-Garcia (Surgery Department)Hospital Universitario Ramón y CajalYolanda Diez-Remesal1,2, Alba Gonzalo-Millán, Alberto Berruezo-Camacho, Azucena Alaez-Cortés, Begoña Ortolá-Rocher, Berta Iglesias-Gallego, Eduardo Martín-Montero, Gerardo Arias-Cuesta, Inés de la Hoz-Polo, Isabel Recuero-Torrijos, Lucia Pereira-Torres, Maria Cañamas-Catalá, Maria C. Martin-González, Paloma Zambrana-García, Sergio Llorente -DamasHospital Universitario Rio HortegaCesar Aldecoa1,2, Alba Perez-Gonzalez, Clara Bolaño-Perez, Delia Velasco-Andres, Esther Aguado-Saster, Irene Arranz, Itziar Mendez-Torrubiano, Laura Vaquero-Perez, Maria Jesus Sanz-de-Leon, Pablo Rodicio, Silvia Martin-Alfonso, David Martin-TappiMario Madrid-Tribano, Rocio Rioja-Garrido, Borja Morales-Jaquete (Dept. of Anesthesia)Hospital Universitario Severo OchoaMarta Vicente-Orgaz1,2, Adriana Carolina Orozco-Vinasco, Gema Fraga-Casais; Any Minerva Miyagi-Yonamine, Raquel Ramos-de-Castro, Rossel Alina Mejía-Arnaud, Rubén Saz-Castro (Anesthesia Department); Patricia Díaz-Peña (Surgery Department)Hospital Universitario Vall d’HebrónAngels Camps-Cervantes1, M Pilar Tormos-Perez, Patricia Galan-Menendez1,2, Elena Esclapez-Sampere, Laura Villarino-Villa, Yuri Loaiza-Aldeán, Ivette Chocron-Dapratt, Olga Martinez-Silva, Silvia Matarin-Olmo (Surgery Department)Hospital Universitario Virgen MacarenaHéctor Berges-Gutiérrez1,2, Macarena Pérez-Serrano, Juan Javier Diaz-Castillo, Álvaro Sancho-Muñoz-de-Verger, Jesús Alejandro Villanueva-Mena-Bernal (Anesthesia Department)Hospital Sant Joan Despi Moises BroggiMaria Lucia Gil-Gómez1,2, Jesús Fernanz-Anton2, Sandra Marmaña-Mezquita (Anesthesia Department); Gonzalo Galofré-Pujol (Surgery Department); Carlos Jericó (Internal Medicine Department.)Hospital Virgen de los Lirios de AlcoyJosé Jacob Motos-Micó1,2, Francisco José Orts-Micó1, Carlos Serra-Díaz, Francisco Arlandis-Félix, Nieves Pérez-Climent (Surgery Department); Lorena Blanes-Pastor, Jose Luis Jover-Pinillos (Anesthesia Department)MD Anderson Cancer Center MadridDavid Salvaterra1,2, Manuel Linero, Javier Galipienzo (Anesthesia Department);Óscar Alonso, Gloria Ortega, Santiago Gonzalez, Irene Lopez-Rojo (Surgery Department);" "textoCompletoSecciones" => array:1 [ "secciones" => array:14 [ 0 => array:3 [ "identificador" => "xres2162345" "titulo" => "Graphical abstract" "secciones" => array:1 [ 0 => array:1 [ "identificador" => "abst0005" ] ] ] 1 => array:3 [ "identificador" => "xres2162344" "titulo" => "Abstract" "secciones" => array:5 [ 0 => array:2 [ "identificador" => "abst0010" "titulo" => "Introduction" ] 1 => array:2 [ "identificador" => "abst0015" "titulo" => "Methods" ] 2 => array:2 [ "identificador" => "abst0020" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0025" "titulo" => "Conclusions" ] 4 => array:2 [ "identificador" => "abst0030" "titulo" => "Trial Registration" ] ] ] 2 => array:2 [ "identificador" => "xpalclavsec1834461" "titulo" => "Keywords" ] 3 => array:3 [ "identificador" => "xres2162346" "titulo" => "Resumen" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0035" "titulo" => "Introducción" ] 1 => array:2 [ "identificador" => "abst0040" "titulo" => "Métodos" ] 2 => array:2 [ "identificador" => "abst0045" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0050" "titulo" => "Conclusiones" ] ] ] 4 => array:2 [ "identificador" => "xpalclavsec1834462" "titulo" => "Palabras clave" ] 5 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 6 => array:3 [ "identificador" => "sec0010" "titulo" => "Methods" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "sec0015" "titulo" => "Study design and participants" ] 1 => array:2 [ "identificador" => "sec0020" "titulo" => "Procedures" ] 2 => array:2 [ "identificador" => "sec0025" "titulo" => "Outcomes" ] 3 => array:2 [ "identificador" => "sec0030" "titulo" => "Statistical analysis" ] ] ] 7 => array:3 [ "identificador" => "sec0035" "titulo" => "Results" "secciones" => array:6 [ 0 => array:2 [ "identificador" => "sec0040" "titulo" => "Participants" ] 1 => array:2 [ "identificador" => "sec0045" "titulo" => "Outcomes in self-declared ERAS vs. non-ERAS groups" ] 2 => array:2 [ "identificador" => "sec0050" "titulo" => "Adherence data" ] 3 => array:2 [ "identificador" => "sec0055" "titulo" => "Outcomes in higher versus lower ERAS adherence groups" ] 4 => array:2 [ "identificador" => "sec0060" "titulo" => "Individual ERAS elements, patients characteristics and moderate-to-severe postoperative complications" ] 5 => array:2 [ "identificador" => "sec0065" "titulo" => "Individual ERAS elements and patients characteristics and LOS" ] ] ] 8 => array:2 [ "identificador" => "sec0070" "titulo" => "Discussion" ] 9 => array:2 [ "identificador" => "sec0075" "titulo" => "Funding" ] 10 => array:2 [ "identificador" => "sec0080" "titulo" => "COI/Disclosures" ] 11 => array:2 [ "identificador" => "sec1080" "titulo" => "Appendix 1: POWER 4 Investigators Group" ] 12 => array:2 [ "identificador" => "xack750440" "titulo" => "Acknowledgments" ] 13 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2022-12-27" "fechaAceptado" => "2023-02-21" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec1834461" "palabras" => array:6 [ 0 => "ERAS" 1 => "gastric surgery" 2 => "postoperative complications" 3 => "perioperative management" 4 => "optimization" 5 => "enhanced recovery" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec1834462" "palabras" => array:5 [ 0 => "ERAS" 1 => "cirugía gástrica" 2 => "complicaciones postoperatorias" 3 => "manejo perioperatorio" 4 => "recuperación intensificada" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "IntroductionThe effectiveness of the Enhanced Recovery After Surgery (ERAS) protocols in gastric cancer surgery remains controversial. MethodsMulticentre prospective cohort study of adult patients undergoing surgery for gastric cancer. Adherence with 22 individual components of ERAS pathways were assessed in all patients, regardless of whether they were treated in a self-designed ERAS centre. Each centre had a three-month recruitment period between October 2019 and September 2020. The primary outcome was moderate-to-severe postoperative complications within 30 days after surgery. Secondary outcomes were overall postoperative complications, adherence to the ERAS pathway, 30 day-mortality and hospital length of stay (LOS). ResultsA total of 743 patients in 72 Spanish hospitals were included, 211 of them (28.4 %) from self-declared ERAS centres. A total of 245 patients (33 %) experienced postoperative complications, graded as moderate-to-severe complications in 172 patients (23.1 %). There were no differences in the incidence of moderate-to-severe complications (22.3% vs. 23.5%; OR, 0.92 (95% CI, 0.59 to 1.41); P = 0.068), or overall postoperative complications between the self-declared ERAS and non-ERAS groups (33.6% vs. 32.7%; OR, 1.05 (95 % CI, 0.70 to 1.56); P = 0.825). The overall rate of adherence to the ERAS pathway was 52% [IQR 45 to 60]. There were no differences in postoperative outcomes between higher (Q1, > 60 %) and lower (Q4, ≤ 45 %) ERAS adherence quartiles. ConclusionsNeither the partial application of perioperative ERAS measures nor treatment in self-designated ERAS centres improved postoperative outcomes in patients undergoing gastric surgery for cancer. Trial RegistrationClinicalTrials.gov Identifier NCT03865810" "secciones" => array:5 [ 0 => array:2 [ "identificador" => "abst0010" "titulo" => "Introduction" ] 1 => array:2 [ "identificador" => "abst0015" "titulo" => "Methods" ] 2 => array:2 [ "identificador" => "abst0020" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0025" "titulo" => "Conclusions" ] 4 => array:2 [ "identificador" => "abst0030" "titulo" => "Trial Registration" ] ] ] "es" => array:3 [ "titulo" => "Resumen" "resumen" => "IntroducciónLa efectividad de los protocolos de recuperación intensificada o ERAS en la cirugía del cáncer gástrico sigue siendo controvertida. MétodosEstudio de cohortes prospectivo multicéntrico de pacientes intervenidos de cáncer gástrico. Se evaluó la adherencia a 22 elementos ERAS en todos los pacientes, independientemente de la existencia de un protocolo ERAS. Cada centro tuvo un período de reclutamiento de tres meses, con un seguimiento de 30 días. La medida de resultado primario fue el numero de complicaciones posoperatorias moderadas a graves. Las medidas de resultado secundarias fueron el número total de complicaciones, la adherencia a los elementos ERAS, la mortalidad y la estancia. ResultadosSe incluyeron 743 pacientes en 72 hospitales, 211 (28,4 %) en centros ERAS. 245 pacientes (33 %) experimentaron complicaciones posoperatorias, moderadas o graves en 172 (23,1 %). No hubo diferencias en la incidencia de complicaciones moderadas a graves (22,3 % vs. 23,5 %; OR, 0,92 (IC 95 %, 0,59 a 1,41); P = 0,068), o complicaciones posoperatorias totales entre los centros ERAS y no ERAS (33,6 % vs. 32,7 %; OR, 1,05 (IC 95 %, 0,70 a 1,56); P = 0,825). La adherencia a los elementos ERAS fue del 52% [IQR 45 a 60]. No hubo diferencias entre los cuartiles de cumplimiento ERAS más alto (Q1, > 60 %) y más bajo (Q4, ≤ 45 %). ConclusionesNi la aplicación parcial de medidas ERAS ni el tratamiento en centros ERAS mejoraron los resultados en pacientes sometidos a cirugía gástrica por cáncer." "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0035" "titulo" => "Introducción" ] 1 => array:2 [ "identificador" => "abst0040" "titulo" => "Métodos" ] 2 => array:2 [ "identificador" => "abst0045" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0050" "titulo" => "Conclusiones" ] ] ] ] "NotaPie" => array:2 [ 0 => array:3 [ "etiqueta" => "1" "nota" => "Current address: Hospital Universitario Donostia, Paseo Doctor Beguiristain s/n. 20014. Donostia-San Sebastián. Spain" "identificador" => "fn0005" ] 1 => array:3 [ "etiqueta" => "2" "nota" => "<a class="elsevierStyleCrossRef" href="#sec1080">Appendix 1</a>: POWER 4 Investigators Group." "identificador" => "fn2005" ] ] "apendice" => array:1 [ 0 => array:1 [ "seccion" => array:1 [ 0 => array:4 [ "apendice" => "The following is Supplementary data to this article:<elsevierMultimedia ident="upi0005"></elsevierMultimedia>" "etiqueta" => "Appendix A" "titulo" => "Supplementary data" "identificador" => "sec0090" ] ] ] ] "multimedia" => array:7 [ 0 => array:8 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1690 "Ancho" => 1667 "Tamanyo" => 115722 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "STROBE flow diagram for included patients." ] ] 1 => array:8 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1843 "Ancho" => 3341 "Tamanyo" => 586566 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0010" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "Title: Postoperative outcomes. Complications in all included patients and in patients who did or did not receive the Enhanced Recovery After Surgery (ERAS) protocol. Note. Data are expressed as number (%) or median (Q1-Q3)." ] ] 2 => array:8 [ "identificador" => "fig0015" "etiqueta" => "Fig. 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 2377 "Ancho" => 3341 "Tamanyo" => 686615 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0015" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "Title: Postoperative outcomes and Enhanced Recovery After Surgery (ERAS) adherence. Postoperative complications in all included patients depending on the quartile (Q) of adherence to the ERAS protocol. Note. Data are expressed as number (%) or median (Q1-Q3)." ] ] 3 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0020" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "ASA: American Society of Anesthesiology; ERAS: Enhanced recovery after surgery; PBM: Patient Blood Management.Percentage reflects over non-missing sample size. Discrete variables n (%). Continuous variables Median[Q1-Q3]." "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">All patients (N = 743) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Self-declared ERAS (N = 211) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Non-ERAS (N = 532) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">P overall \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Age, years \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">70 [61-77] \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">69 [59-77] \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">70 [61-77] \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.379 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Sex: male \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">444 (60%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">136 (65%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">308 (58%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.118 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">BMI, kg/m<a class="elsevierStyleCrossRef" href="#bib0010">2</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">25.6 [23 - 28.7] \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">26 [23.1 - 29.2] \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">25.6 [22.9 - 28.6] \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.366 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">ASA physical status \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">I \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">27 (4%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8 (4%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">19 (4%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.111 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">II \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">353 (48%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">110 (52%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">243 (46%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">. \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">III \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">336 (45%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">82 (39%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">254 (48%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">. \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">IV \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">27 (4%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">11 (5%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">16 (3%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">. \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Smoking status \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Smoker \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">107 (14%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">33 (16%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">74 (14%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.188 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Ex-smoker > 1 year \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">207 (28%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">61 (29%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">146 (27%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">. \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Ex-smoker < 1 year \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">30 (4%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">13 (6%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">17 (3%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">. \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Rockwood Clinical Frailty Scale \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Score ≤ 4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">656 (88%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">190 (90%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">466 (88%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.417 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Score > 4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">87 (12%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">21 (10%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">66 (12%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">. \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Hypertension \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">369 (50%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">102 (48%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">267 (50%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.709 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Diabetes Mellitus \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">178 (24%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">46 (22%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">132 (25%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.440 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Ischaemic heart disease \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">88 (12%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">22 (10%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">66 (12%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.531 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Heart Failure \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">46 (6%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">13 (6%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">33 (6%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.000 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Stroke \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 (0.3%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 (0%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 (0.4%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.000 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Chronic obstructive pulmonary disease \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">103 (14%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">31 (15%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">72 (14%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.769 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Chronic kidney disease \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">64 (9%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">14 (7%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">50 (9%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.287 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Liver cirrhosis \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">11 (2%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 (1%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">9 (2%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.737 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Preoperative laboratory tests \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Haemoglobin (g/dl) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12.4 [11.1- 13.6] \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12.6 [11.2 -13.7] \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12.4 [11- 13.5] \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.264 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Creatinine (mg/dl) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.8 [0.7 - 0.9] \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.8 [0.7- 0.9] \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.8 [0.7- 1] \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.872 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Albumin (g/dl) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3.9 [3.5 - 4.3] \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3.9 [3.4 - 4.3] \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3.9 [3.5 - 4.3] \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.672 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">TNM staging \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">I A \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">120 (16.5%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">32 (15.5%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">88 (16.9%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.130 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">I B \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">102 (14.1%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">21 (10.2%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">81 (15.6%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">. \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">II A \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">128 (17.6%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">38 (18.5%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">90 (17.3%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">. \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">II B \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">112 (15.4%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">30 (14.6%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">82 (15.8%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">. \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">III A \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">114 (15.7%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">30 (14.6%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">84 (16.2%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">. \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">III B \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">73 (10.1%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">28 (13.6%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">45 (8.7%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">. \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">III C \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">21 (2.9%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">10 (4.9%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">11 (2.1%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">. \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">IV \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">56 (7.7%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">17 (8.3%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">39 (7.5%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">. \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Preoperative neoadjuvancy \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">292 (39%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">106 (50%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">186 (36%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Surgical Procedure \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Subtotal Gastrectomy \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">472 (64%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">123 (58%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">349 (66%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.065 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Total Gastrectomy \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">269 (36%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">88 (42%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">181 (34%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">. \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Duration of surgery, minutes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">235 [180 - 300] \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">245 [188 - 300] \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">215 [170 - 270] \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Intraoperative fluid balance, ml \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">850 [493 -1394] \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">851 [490 - 1369] \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">850 [495 -1437] \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.777 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Centre with an established PBM protocol \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">444 (60%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">171 (81%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">273 (51%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab3563201.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Patient characteristics." ] ] 4 => array:8 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0025" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "Percentage reflects over non-missing sample size. Discrete variables n (%).Continuous variables Median [Q1-Q3]." "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">All patients (N = 743) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Self-declared ERAS (N = 211) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Non-ERAS (N = 532) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">P value \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">ERAS overall adherence \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">52 [45 - 60] \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">60 [52 - 70] \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">50 [43 - 57] \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Preadmission information, education and counselling \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">145 (19.5%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">114 (54%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">31 (5.8%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Preoperative exercise and prehabilitation \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">115 (16%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">90 (43.9%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">25 (4.9%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Preoperative optimisation \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">15 (14%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5 (15.2%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">10 (13.5%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.773 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Preoperative nutrition \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">217 (65.4%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">79 (79%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">138 (59.5%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Avoid bowel preparation \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">632 (85.3%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">188 (89.5%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">444 (83.6%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.053 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Preoperative fasting \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">281 (37.9%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">135 (64%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">146 (27.5%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Preoperative carbohydrate loading \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">129 (17.4%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">86 (40.8%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">43 (8.1%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Avoid preoperative administration of immediate or long-acting sedatives \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">604 (81.4%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">162 (76.8%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">442 (83.3%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.053 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Perioperative fluid management \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">202 (27.3%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">64 (30.3%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">138 (26%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.274 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Deep neuromuscular block \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">361 (48.9%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">88 (41.7%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">273 (51.7%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.018 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Anesthetic depth monitoring \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">699 (94.5%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">197 (93.4%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">502 (94.9%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.520 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Laparoscopic approach \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">415 (55.85%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">116 (54.98%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">299 (56.20%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.731 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Avoid nasogastric tube \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">446 (60%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">160 (75.8%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">286 (53.8%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Avoid surgical drains \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">132 (17.8%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">38 (18%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">94 (17.7%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.998 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Analgesia \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">458 (61.6%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">179 (84.8%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">279 (52.4%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Antithrombotic prophylaxis \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">713 (96.1%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">210 (99.5%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">503 (94.7%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.005 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Prevention of nausea and vomiting \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">717 (96.6%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">206 (97.6%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">511 (96.2%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.468 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Prevention of intraoperative hypothermia \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">720 (97.3%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">208 (98.6%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">512 (96.8%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.269 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Postoperative nutrition \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">419 (56.4%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">113 (53.6%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">306 (57.5%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.368 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Postoperative glycaemic control \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">642 (86.4%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">185 (87.7%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">457 (85.9%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.604 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Early mobilization n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">439 (60.2%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">143 (69.8%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">296 (56.5%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Early feeding n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">51 (7%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">22 (10.7%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">29 (5.6%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.022 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Time to oral intake (hours) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">48 [24 - 96] \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">30 [24 -72] \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">72 [25 - 120] \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Time to mobilization (hours) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">24 [22 - 48] \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">24 <a class="elsevierStyleCrossRefs" href="#bib0105">21–30</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">24 [23 - 48] \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab3563200.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Adherence to ERAS elements in self-declared ERAS and non-ERAS centres." ] ] 5 => array:5 [ "identificador" => "upi0005" "tipo" => "MULTIMEDIAECOMPONENTE" "mostrarFloat" => false "mostrarDisplay" => true "Ecomponente" => array:2 [ "fichero" => "mmc1.docx" "ficheroTamanyo" => 46053 ] ] 6 => array:5 [ "identificador" => "fig0020" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => false "mostrarDisplay" => true "figura" => array:1 [ 0 => array:4 [ "imagen" => "fx1.jpeg" "Alto" => 754 "Ancho" => 1333 "Tamanyo" => 89271 ] ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:34 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "H. Sung" 1 => "J. Ferlay" 2 => "R.L. Siegel" 3 => "M. Laversanne" 4 => "I. Soerjomataram" 5 => "A. Jemal" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3322/caac.21660" "Revista" => array:6 [ "tituloSerie" => "CA Cancer J Clin." "fecha" => "2021" "volumen" => "71" "paginaInicial" => "209" "paginaFinal" => "249" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/33538338" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Morbidity and mortality associated with gastrectomy for gastric cancer" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "W.A. Papenfuss" 1 => "M. Kukar" 2 => "J. Oxenberg" 3 => "K. Attwood" 4 => "S. Nurkin" 5 => "U. Malhotra" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1245/s10434-014-3664-z" "Revista" => array:6 [ "tituloSerie" => "Ann Surg Oncol." "fecha" => "2014" "volumen" => "21" "paginaInicial" => "3008" "paginaFinal" => "3014" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24700300" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Post-operative complications of gastric cancer surgery: female gender at high risk" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "B.K. Sah" 1 => "Z.G. Zhu" 2 => "X.Y. Wang" 3 => "Q.M. Yang" 4 => "M.M. Chen" 5 => "M. Xiang" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1365-2354.2008.01036.x" "Revista" => array:6 [ "tituloSerie" => "Eur J Cancer Care (Engl)." "fecha" => "2009" "volumen" => "18" "paginaInicial" => "202" "paginaFinal" => "208" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19267738" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Enhanced recovery after surgery a review" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "O. Ljungqvist" 1 => "M. Scott" 2 => "K.C. Fearon" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "JAMA Surg." "fecha" => "2017" "volumen" => "1" "numero" => "152" "paginaInicial" => "292" "paginaFinal" => "298" ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The History of Enhanced Recovery After Surgery and the ERAS Society" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "O. Ljungqvist" 1 => "T. Young-Fadok" 2 => "N. Demartines" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1089/lap.2017.0350" "Revista" => array:6 [ "tituloSerie" => "J Laparoendosc Adv Surg Tech A." "fecha" => "2017" "volumen" => "27" "paginaInicial" => "860" "paginaFinal" => "862" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28795858" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0030" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Adherence to the enhanced recovery after surgery protocol and outcomes after colorectal cancer surgery" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "U.O. Gustafsson" 1 => "J. Hausel" 2 => "A. Thorell" 3 => "O. Ljungqvist" 4 => "M. Soop" 5 => "J. Nygren" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1001/archsurg.2010.309" "Revista" => array:6 [ "tituloSerie" => "Arch Surg." "fecha" => "2011" "volumen" => "146" "paginaInicial" => "571" "paginaFinal" => "577" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21242424" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0035" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Association between Use of Enhanced Recovery after Surgery Protocol and Postoperative Complications in Colorectal Surgery: The Postoperative Outcomes Within Enhanced Recovery after Surgery Protocol (POWER) Study" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J. Ripollés-Melchor" 1 => "J.M. Ramírez-Rodríguez" 2 => "R. Casans-Francés" 3 => "C. Aldecoa" 4 => "A. Abad-Motos" 5 => "M. Logroño-Egea" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:4 [ "tituloSerie" => "JAMA Surg." "fecha" => "2019" "paginaInicial" => "1" "paginaFinal" => "11" ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0040" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Consensus guidelines for enhanced recovery after gastrectomy: Enhanced Recovery After Surgery (ERAS®) Society recommendations" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "K. Mortensen" 1 => "M. Nilsson" 2 => "K. Slim" 3 => "M. Schäfer" 4 => "C. Mariette" 5 => "M. Braga" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/bjs.9582" "Revista" => array:6 [ "tituloSerie" => "Br J Surg." "fecha" => "2014" "volumen" => "101" "paginaInicial" => "1209" "paginaFinal" => "1229" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25047143" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0045" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The benefits of enhanced recovery after surgery for gastric cancer: A large before-and-after propensity score matching study" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "O. Jeong" 1 => "A. Jang" 2 => "M.R. Jung" 3 => "J.H. Kang" 4 => "S.Y. Ryu" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.clnu.2020.09.042" "Revista" => array:6 [ "tituloSerie" => "Clin Nutr." "fecha" => "2021" "volumen" => "40" "paginaInicial" => "2162" "paginaFinal" => "2168" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/33069509" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0050" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Implementation of a fast-track perioperative care program: what are the difficulties?" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "S.W. Polle" 1 => "J. Wind" 2 => "J.W. Fuhring" 3 => "J. Hofland" 4 => "D.J. Gouma" 5 => "W.A. Bemelman" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1159/000108327" "Revista" => array:6 [ "tituloSerie" => "Dig Surg." "fecha" => "2007" "volumen" => "24" "paginaInicial" => "441" "paginaFinal" => "449" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17851238" "web" => "Medline" ] ] ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib0055" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Risk factors for acute kidney injury in an enhanced recovery pathway for colorectal surgery" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "A. Zorrilla-Vaca" 1 => "G.E. Mena" 2 => "J. Ripolles-Melchor" 3 => "J.V. Lorente" 4 => "J.J.M. Ramirez-Rodriguez" 5 => "M.C. Grant" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s00595-020-02107-2" "Revista" => array:6 [ "tituloSerie" => "Surg Today" "fecha" => "2021" "volumen" => "51" "paginaInicial" => "537" "paginaFinal" => "544" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32785846" "web" => "Medline" ] ] ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib0060" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Postoperative Outcomes Within an Enhanced Recovery after surgery protocol in gastric surgery for cancer (POWER.4): Study protocol for a prospective, multicentre, observational cohort study" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A. Abad-Motos" 1 => "J. Ripollés-Melchor" 2 => "M. Bruna-Esteban" 3 => "C. Ferrando-Ortolá" 4 => "G. Paseiro-Crespo" 5 => "A. Abad-Gurumeta" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.redar.2019.10.004" "Revista" => array:6 [ "tituloSerie" => "Rev Esp Anestesiol Reanim (Engl Ed)" "fecha" => "2020" "volumen" => "67" "paginaInicial" => "130" "paginaFinal" => "138" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31767197" "web" => "Medline" ] ] ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib0065" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: guidelines for reporting observational studies" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "E. von Elm" 1 => "D.G. Altman" 2 => "M. Egger" 3 => "S.J. Pocock" 4 => "P.C. Gotzsche" 5 => "J.P. Vandenbroucke" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.ijsu.2014.07.013" "Revista" => array:6 [ "tituloSerie" => "Int J Surg." "fecha" => "2014" "volumen" => "12" "paginaInicial" => "1495" "paginaFinal" => "1499" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25046131" "web" => "Medline" ] ] ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib0070" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The Reporting on ERAS Compliance, Outcomes, and Elements Research (RECOvER) Checklist: A Joint Statement by the ERAS® and ERAS® USA Societies" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "K.M. Elias" 1 => "A.B. Stone" 2 => "K. McGinigle" 3 => "J.A.I. Tankou" 4 => "M.J. Scott" 5 => "W.J. Fawcett" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:3 [ "tituloSerie" => "World J Surg." "fecha" => "2019" "volumen" => "43" ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib0075" "etiqueta" => "15" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Castor Electronic Data Capture. Ciwit BV. Amsterdam, the Netherlands; 2018." ] ] ] 15 => array:3 [ "identificador" => "bib0080" "etiqueta" => "16" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Standards for definitions and use of outcome measures for clinical effectiveness research in perioperative medicine: European Perioperative Clinical Outcome (EPCO) definitions: A statement from the ESA-ESICM joint taskforce on perioperative outcome measures" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "I. Jammer" 1 => "N. Wickboldt" 2 => "M. Sander" 3 => "A. Smith" 4 => "M.J. Schultz" 5 => "P. Pelosi" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/EJA.0000000000000118" "Revista" => array:6 [ "tituloSerie" => "Eur J Anaesthesiol." "fecha" => "2015" "volumen" => "32" "paginaInicial" => "88" "paginaFinal" => "105" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25058504" "web" => "Medline" ] ] ] ] ] ] ] ] 16 => array:3 [ "identificador" => "bib0085" "etiqueta" => "17" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Application of enhanced recovery after gastric cancer surgery: An updated meta-analysis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "L.-H. Wang" 1 => "R.-F. Zhu" 2 => "C. Gao" 3 => "S.-L. Wang" 4 => "L.-Z. Shen" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3748/wjg.v24.i14.1562" "Revista" => array:6 [ "tituloSerie" => "World J Gastroenterol." "fecha" => "2018" "volumen" => "24" "paginaInicial" => "1562" "paginaFinal" => "1578" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29662294" "web" => "Medline" ] ] ] ] ] ] ] ] 17 => array:3 [ "identificador" => "bib0090" "etiqueta" => "18" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Implementation of a perioperative-enhanced recovery protocol in patients undergoing open gastrectomy for gastric cancer" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A.N. Blumenthaler" 1 => "K.A. Robinson" 2 => "B.C. Kruse" 3 => "K. Munder" 4 => "N. Ikoma" 5 => "P.F. Mansfield" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/jso.26591" "Revista" => array:2 [ "tituloSerie" => "J Surg Oncol" "fecha" => "2021" ] ] ] ] ] ] 18 => array:3 [ "identificador" => "bib0095" "etiqueta" => "19" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "ERAS protocol compliance impact on functional recovery in colorectal surgery" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M. Barbero" 1 => "J. García" 2 => "I. Alonso" 3 => "L. Alonso" 4 => "B San Antonio-San Román" 5 => "V Molnar" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.ciresp.2020.05.010" "Revista" => array:6 [ "tituloSerie" => "Cir Esp." "fecha" => "2021" "volumen" => "99" "paginaInicial" => "108" "paginaFinal" => "114" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32564875" "web" => "Medline" ] ] ] ] ] ] ] ] 19 => array:3 [ "identificador" => "bib0100" "etiqueta" => "20" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "ERAS guidelines adherence and outcome correlation in colorectal surgery: 100 patients experience" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "G. Pernazza" 1 => "R. Mancini" 2 => "P. Marino" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Clinical Nutrition ESPEN" "fecha" => "2019" "volumen" => "31" "paginaInicial" => "143" "paginaFinal" => "144" ] ] ] ] ] ] 20 => array:3 [ "identificador" => "bib0105" "etiqueta" => "21" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Short- and long-term outcomes associated with enhanced recovery after surgery protocol vs conventional management in patients undergoing laparoscopic gastrectomy" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "Y.-L. Tian" 1 => "S.-G. Cao" 2 => "X.-D. Liu" 3 => "Z.-Q. Li" 4 => "G. Liu" 5 => "X.-Q. Zhang" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3748/wjg.v26.i37.5646" "Revista" => array:6 [ "tituloSerie" => "World J Gastroenterol." "fecha" => "2020" "volumen" => "26" "paginaInicial" => "5646" "paginaFinal" => "5660" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/33088158" "web" => "Medline" ] ] ] ] ] ] ] ] 21 => array:3 [ "identificador" => "bib0110" "etiqueta" => "22" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Usefulness of enhanced recovery after surgery protocol as compared with conventional perioperative care in gastric surgery" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "T. Yamada" 1 => "T. Hayashi" 2 => "H. Cho" 3 => "T. Yoshikawa" 4 => "H. Taniguchi" 5 => "R. Fukushima" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Gastric cancer Off J Int Gastric Cancer Assoc Japanese Gastric Cancer Assoc." "fecha" => "2012" "volumen" => "15" "paginaInicial" => "34" "paginaFinal" => "41" ] ] ] ] ] ] 22 => array:3 [ "identificador" => "bib0115" "etiqueta" => "23" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Enhanced Recovery after Surgery for Gastric Cancer Patients Improves Clinical Outcomes at a US Cancer Center" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J. Desiderio" 1 => "C.L. Stewart" 2 => "V. Sun" 3 => "L. Melstrom" 4 => "S. Warner" 5 => "B. Lee" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.5230/jgc.2018.18.e24" "Revista" => array:6 [ "tituloSerie" => "J Gastric Cancer." "fecha" => "2018" "volumen" => "18" "paginaInicial" => "230" "paginaFinal" => "241" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30276000" "web" => "Medline" ] ] ] ] ] ] ] ] 23 => array:3 [ "identificador" => "bib0120" "etiqueta" => "24" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Association Between Use of Enhanced Recovery After Surgery Protocol and Postoperative Complications in Total Hip and Knee Arthroplasty in the Postoperative Outcomes Within Enhanced Recovery After Surgery Protocol in Elective Total Hip and Knee Arthroplasty Study (POWER2)" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J. Ripollés-Melchor" 1 => "A. Abad-Motos" 2 => "Y. Díez-Remesal" 3 => "M. Aseguinolaza-Pagola" 4 => "L. Padin-Barreiro" 5 => "R. Sánchez-Martín" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:4 [ "tituloSerie" => "JAMA Surg." "fecha" => "2020" "volumen" => "1" "paginaInicial" => "155" ] ] ] ] ] ] 24 => array:3 [ "identificador" => "bib0125" "etiqueta" => "25" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "[Enhanced recovery after surgery protocol versus conventional perioperative care in colorectal surgery. A single center cohort study]" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J Ripollés-Melchor" 1 => "Fuenmayor-Varela ML de" 2 => "SC Camargo" 3 => "PJ Fernández" 4 => "Barrio ÁC Del" 5 => "E Martínez-Hurtado" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Brazilian J Anesthesiol" "fecha" => "2018" "volumen" => "68" "paginaInicial" => "358" "paginaFinal" => "368" ] ] ] ] ] ] 25 => array:3 [ "identificador" => "bib0130" "etiqueta" => "26" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Modern perioperative medicine - past, present, and future" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "H.F. Dean" 1 => "F. Carter" 2 => "N.K. Francis" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Innov Surg Sci." "fecha" => "2019" "volumen" => "5" "numero" => "4" "paginaInicial" => "123" "paginaFinal" => "131" ] ] ] ] ] ] 26 => array:3 [ "identificador" => "bib0135" "etiqueta" => "27" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Enhanced Recovery after Surgery in the United States: From Evidence-Based Practice to Uncertain Science?" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "S.G. Memtsoudis" 1 => "J. Poeran" 2 => "H. Kehlet" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "JAMA - J Am Med Assoc." "fecha" => "2019" "volumen" => "321" "paginaInicial" => "1049" "paginaFinal" => "1050" ] ] ] ] ] ] 27 => array:3 [ "identificador" => "bib0140" "etiqueta" => "28" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Studying Enhanced Recovery After Surgery (ERAS®) Core Items in Colorectal Surgery: A Causal Model with Latent Variables" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "M. Gemma" 1 => "F. Pennoni" 2 => "M. Braga" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s00268-020-05940-1" "Revista" => array:6 [ "tituloSerie" => "World J Surg." "fecha" => "2021" "volumen" => "45" "paginaInicial" => "928" "paginaFinal" => "939" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/33575826" "web" => "Medline" ] ] ] ] ] ] ] ] 28 => array:3 [ "identificador" => "bib0145" "etiqueta" => "29" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Deviation and failure of enhanced recovery after surgery following laparoscopic colorectal surgery: early prediction model" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "N.J. Smart" 1 => "P. White" 2 => "A.S. Allison" 3 => "J.B. Ockrim" 4 => "R.H. Kennedy" 5 => "N.K. Francis" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Color Dis Off J Assoc Coloproctology Gt Britain Irel." "fecha" => "2012" "volumen" => "14" "paginaInicial" => "e727" "paginaFinal" => "34" ] ] ] ] ] ] 29 => array:3 [ "identificador" => "bib0150" "etiqueta" => "30" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Effects of early oral feeding after radical total gastrectomy in gastric cancer patients" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "Y.-X. Lu" 1 => "Y.-J. Wang" 2 => "T.-Y. Xie" 3 => "S. Li" 4 => "D. Wu" 5 => "X.-G. Li" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3748/wjg.v26.i36.5508" "Revista" => array:6 [ "tituloSerie" => "World J Gastroenterol." "fecha" => "2020" "volumen" => "26" "paginaInicial" => "5508" "paginaFinal" => "5519" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/33024401" "web" => "Medline" ] ] ] ] ] ] ] ] 30 => array:3 [ "identificador" => "bib0155" "etiqueta" => "31" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Intolerance to early oral feeding in enhanced recovery after colorectal surgery: an early red flag?" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "K. Slim" 1 => "T. Reymond" 2 => "J. Joris" 3 => "S. Paul" 4 => "B. Pereira" 5 => "E. Cotte" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Color Dis Off J Assoc Coloproctology Gt Britain Irel." "fecha" => "2020" "volumen" => "22" "paginaInicial" => "95" "paginaFinal" => "101" ] ] ] ] ] ] 31 => array:3 [ "identificador" => "bib0160" "etiqueta" => "32" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Evolution of gastrectomy for cancer over 30-years: Changes in presentation, management, and outcomes" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "S.M. Griffin" 1 => "S.K. Kamarajah" 2 => "M. Navidi" 3 => "S. Wahed" 4 => "A. Immanuel" 5 => "N. Hayes" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.surg.2021.01.040" "Revista" => array:6 [ "tituloSerie" => "Surgery." "fecha" => "2021" "volumen" => "170" "paginaInicial" => "2" "paginaFinal" => "10" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/33674126" "web" => "Medline" ] ] ] ] ] ] ] ] 32 => array:3 [ "identificador" => "bib0165" "etiqueta" => "33" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Goal directed hemodynamic therapy based in esophageal Doppler flow parameters: A systematic review, meta-analysis and trial sequential analysis" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J. Ripolles-Melchor" 1 => "R. Casans-Frances" 2 => "A. Espinosa" 3 => "A. Abad-Gurumeta" 4 => "A. Feldheiser" 5 => "F. Lopez-Timoneda" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.redar.2015.07.009" "Revista" => array:6 [ "tituloSerie" => "Rev Esp Anestesiol Reanim." "fecha" => "2016" "volumen" => "63" "paginaInicial" => "384" "paginaFinal" => "405" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26873025" "web" => "Medline" ] ] ] ] ] ] ] ] 33 => array:3 [ "identificador" => "bib0170" "etiqueta" => "34" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Perioperative goal-directed hemodynamic therapy in noncardiac surgery: a systematic review and meta-analysis" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J. Ripolles-Melchor" 1 => "A. Espinosa" 2 => "E. Martinez-Hurtado" 3 => "A. Abad-Gurumeta" 4 => "R. Casans-Frances" 5 => "C. Fernandez-Perez" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jclinane.2015.08.004" "Revista" => array:6 [ "tituloSerie" => "J Clin Anesth." "fecha" => "2016" "volumen" => "28" "paginaInicial" => "105" "paginaFinal" => "115" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26440438" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] "agradecimientos" => array:1 [ 0 => array:4 [ "identificador" => "xack750440" "titulo" => "Acknowledgments" "texto" => "Javier García-Fernández as President Elect of the Spanish Society of Anesthesiology and Critical Care (SEDAR); the Spanish Surgeons Association (AEC), and the European Society of Regional Anaesthesia and Pain Management-Spain (ESRA Spain) provided non compensated pre recruitment announcement of the study on their websites and social networks. Alejandro Bona-Enguita (GERM Secretary) was the POWER 4 website webmaster. Alberto Cebollada-Solanas provided statistical analysis. No financial compensation was provided." "vista" => "all" ] ] ] "idiomaDefecto" => "en" "url" => "/21735077/0000010100000010/v2_202406091334/S217350772300100X/v2_202406091334/en/main.assets" "Apartado" => array:4 [ "identificador" => "7443" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Original Article" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/21735077/0000010100000010/v2_202406091334/S217350772300100X/v2_202406091334/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S217350772300100X?idApp=UINPBA00004N"]

Statistics

Original article

Association between use of enhanced recovery after surgery protocols and postoperative complications after gastric surgery for cancer (POWER 4): a nationwide, prospective multicentre study

Asociación entre el uso de protocolos de recuperación intensificada y complicaciones postoperatorias tras cirugía gástrica por cáncer (POWER 4): estudio nacional, prospective multicéntrico

Javier Ripollés-Melchora,b,c,d, Ane Abad-Motosa,b,c,

,1, Marcos Bruna-Estebanb,c,e, María García-Nebredac,d,f, Isabel Otero-Martínezg, Omar Abdel-lah Fernándezh, María P. Tormos-Pérezi, Gloria Paseiro-Crespoc,d,f, Raquel García-Álvarezb,j, María A Mayo-Ossoriok, Orreaga Zugasti-Echartel, Paula Nespereira-Garcíam, Lucia Gil-Gómezb,c,n, Margarita Logroño-Ejeab,c,o, Raquel Riscop, Felipe C Parreño-Manchadoh, Silvia Gil-Trujillob,c,q, Carmen Benitor, Carlos Jericób,c,s, María I De-Miguel-Cabrerat..., Bakarne Ugarte-Sierrab,c,u, Cristina Barragán-Serranov, José A. García-Erceb,c,w, Henar Muñoz-Hernándezx, Sabela del- Río-Fernándezb,c,y, María L. Herrero-Bogajoc,z, Alma M. Espinosa-Morenoc,aa, Vanessa Concepción-Martínc,ab, Andrés Zorrilla-Vacab,ac,ad, Laura Vaquero-Pérezae, Irene Mojarroaf, Manuel Llácer-Pérezag, Leticia Gómez-Vianaah, María T. Fernández-Martínai, Alfredo Abad-Gurumetaa,b,c,d, Carlos Ferrando-Ortolàb,c,p,aj, José M. Ramírez-Rodríguezb,c,ak, César Aldecoab,c,ah, POWER Study Investigators Group d,2Ver más

a Department of Anaesthesia and Perioperative Medicine, Infanta Leonor University Hospital, Madrid, Spain

b Spanish Perioperative Audit and Research Network (REDGERM), Zaragoza, Spain

c Grupo Español de Rehabilitación Multimodal (GERM), Zaragoza, Spain

d Universidad Complutense de Madrid, Madrid, Spain

e Department of General Surgery, La Fe University Hospital, Valencia, Spain

f Department of General Surgery, Infanta Leonor University Hospital, Madrid, Spain

g Department of General Surgery, Hospital Álvaro Cunqueiro de Vigo (Complejo Hospitalario Universitario de Vigo), Vigo, Spain

h Department of General Surgery, Complejo Asistencial Universitario de Salamanca, Salamanca, Spain

i Department of Anaesthesia and Perioperative Medicine, Vall d’Hebrón University Hospital, Barcelona, Spain

j Department of Anaesthesia and Perioperative Medicine, 12 de Octubre University Hospital, Madrid, Spain

k Department of General Surgery, Hospital Universitario Puerta del Mar Cádiz, Cádiz, Spain

l Department of Anaesthesia and Perioperative Medicine, Complejo Hospitalario Navarra, Pamplona, Spain

m Department of Anaesthesia and Perioperative Medicine, Hospital POVISA Vigo, Vigo, Spain

n Department of Anaesthesia and Perioperative Medicine, Hospital de Sant Joan Despí Moisès Broggi, Spain

o Department of Anaesthesia and Perioperative Medicine, Hospital Universitario de Alava, Vitoria, Spain

p Department of Anesthesiology and Critical Care, Hospital Clínic, Institut D'investigació August Pi i Sunyer, Barcelona, Spain

q Department of Anaesthesia and Perioperative Medicine, Hospital General Universitario de Ciudad Real, Ciudad Real, Spain

r Department of Anaesthesia and Perioperative Medicine, Hospital General Universitario Gregorio Marañón, Madrid, Spain

s Department of Internal Medicine, Hospital Moisès Broggi, Consorci Sanitari Integral, Sant Joan Despí, Spain

t Department of Anaesthesia and Perioperative Medicine, Hospital General Universitari Castelló, Castellón de La Plana, Spain

u Department of General Surgery, Hospital Galdakao-Usansolo, Spain

v Department of General Surgery, Fundación Jiménez Díaz University Hospital, Madrid, Spain

w Banco de Sangre y Tejidos de Navarra, Pamplona, Spain

x Department of Anaesthesia and Perioperative Medicine, Hospital Clínico de Valladolid, Spain

y Department of Anaesthesia and Perioperative Medicine, Complexo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain

z Department of General Surgery, Hospital General La Mancha Centro, Alcázar de San Juan, Spain

aa Department of Anaesthesia and Perioperative Medicine, Hospital Universitario Fundación Alcorcón, Alcorcón, Spain

ab Department of General Surgery, Nuestra Señora de Candelaria Hospital Universitario, Spain

ac Department of Anesthesiology and Perioperative Medicine, University of Texas MD Anderson Cancer Center, Houston, TX, USA

ad Department of Anesthesiology, Perioperative, and Pain Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA

ae Department of Anaesthesia and Perioperative Medicine, Hospital Universitario Río Hortega, Valladolid, Spain

af Department of Anaesthesia and Perioperative Medicine, Juan Ramón Jiménez University Hospital, Huelva, Spain

ag Department of Anaesthesia and Perioperative Medicine, Hospital Costa del Sol, Marbella, Spain

ah Department of Anaesthesia and Perioperative Medicine, Complejo Hospitalario Universitario de Ourense, Ourense, Spain

ai Department of Anaesthesia and Perioperative Medicine, Hospital Medina del Campo, Medina del Campo, Spain

aj CIBER de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain

ak Department of General Surgery, Lozano Blesa University Hospital, Universidad de Zaragoza, Zaragoza, Spain

Read

Times
was read the article

Total PDF

Total HTML

Share statistics

 array:24 [
  "pii" => "S217350772300100X"
  "issn" => "21735077"
  "doi" => "10.1016/j.cireng.2023.04.011"
  "estado" => "S300"
  "fechaPublicacion" => "2023-10-01"
  "aid" => "2881"
  "copyright" => "AEC"
  "copyrightAnyo" => "2023"
  "documento" => "article"
  "crossmark" => 1
  "subdocumento" => "fla"
  "cita" => "Cir Esp. 2023;101:665-77"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:1 [
    "total" => 0
  ]
  "Traduccion" => array:1 [
    "en" => array:19 [
      "pii" => "S0009739X23000799"
      "issn" => "0009739X"
      "doi" => "10.1016/j.ciresp.2023.02.009"
      "estado" => "S300"
      "fechaPublicacion" => "2023-10-01"
      "aid" => "2881"
      "copyright" => "AEC"
      "documento" => "article"
      "crossmark" => 1
      "subdocumento" => "fla"
      "cita" => "Cir Esp. 2023;101:665-77"
      "abierto" => array:3 [
        "ES" => true
        "ES2" => true
        "LATM" => true
      ]
      "gratuito" => true
      "lecturas" => array:1 [
        "total" => 0
      ]
      "en" => array:14 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>"
        "titulo" => "Association between use of enhanced recovery after surgery protocols and postoperative complications after gastric surgery for cancer &#40;POWER 4&#41;&#58; a nationwide&#44; prospective multicentre study"
        "tienePdf" => "en"
        "tieneTextoCompleto" => "en"
        "tieneResumen" => array:3 [
          0 => "en"
          1 => "en"
          2 => "es"
        ]
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "665"
            "paginaFinal" => "677"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "es" => array:1 [
            "titulo" => "Asociaci&#243;n entre el uso de protocolos de recuperaci&#243;n intensificada y complicaciones postoperatorias tras cirug&#237;a g&#225;strica por c&#225;ncer &#40;POWER 4&#41;&#58; estudio nacional&#44; prospective multic&#233;ntrico"
          ]
        ]
        "contieneResumen" => array:2 [
          "en" => true
          "es" => true
        ]
        "contieneTextoCompleto" => array:1 [
          "en" => true
        ]
        "contienePdf" => array:1 [
          "en" => true
        ]
        "resumenGrafico" => array:2 [
          "original" => 1
          "multimedia" => array:5 [
            "identificador" => "fig0020"
            "tipo" => "MULTIMEDIAFIGURA"
            "mostrarFloat" => false
            "mostrarDisplay" => true
            "figura" => array:1 [
              0 => array:4 [
                "imagen" => "fx1.jpeg"
                "Alto" => 754
                "Ancho" => 1333
                "Tamanyo" => 89271
              ]
            ]
          ]
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "Javier Ripoll&#233;s-Melchor, Ane Abad-Motos, Marcos Bruna-Esteban, Mar&#237;a Garc&#237;a-Nebreda, Isabel Otero-Mart&#237;nez, Omar Abdel-lah Fern&#225;ndez, Mar&#237;a P&#46; Tormos-P&#233;rez, Gloria Paseiro-Crespo, Raquel Garc&#237;a-&#193;lvarez, Mar&#237;a A Mayo-Ossorio, Orreaga Zugasti-Echarte, Paula Nespereira-Garc&#237;a, Lucia Gil-G&#243;mez, Margarita Logro&#241;o-Ejea, Raquel Risco, Felipe C Parre&#241;o-Manchado, Silvia Gil-Trujillo, Carmen Benito, Carlos Jeric&#243;, Mar&#237;a I De-Miguel-Cabrera, Bakarne Ugarte-Sierra, Cristina Barrag&#225;n-Serrano, Jos&#233; A&#46; Garc&#237;a-Erce, Henar Mu&#241;oz-Hern&#225;ndez, Sabela del- R&#237;o-Fern&#225;ndez, Mar&#237;a L&#46; Herrero-Bogajo, Alma M&#46; Espinosa-Moreno, Vanessa Concepci&#243;n-Mart&#237;n, Andr&#233;s Zorrilla-Vaca, Laura Vaquero-P&#233;rez, Irene Mojarro, Manuel Ll&#225;cer-P&#233;rez, Leticia G&#243;mez-Viana, Mar&#237;a T&#46; Fern&#225;ndez-Mart&#237;n, Alfredo Abad-Gurumeta, Carlos Ferrando-Ortol&#224;, Jos&#233; M&#46; Ram&#237;rez-Rodr&#237;guez, C&#233;sar Aldecoa"
            "autores" => array:39 [
              0 => array:2 [
                "nombre" => "Javier"
                "apellidos" => "Ripoll&#233;s-Melchor"
              ]
              1 => array:2 [
                "nombre" => "Ane"
                "apellidos" => "Abad-Motos"
              ]
              2 => array:2 [
                "nombre" => "Marcos"
                "apellidos" => "Bruna-Esteban"
              ]
              3 => array:2 [
                "nombre" => "Mar&#237;a"
                "apellidos" => "Garc&#237;a-Nebreda"
              ]
              4 => array:2 [
                "nombre" => "Isabel"
                "apellidos" => "Otero-Mart&#237;nez"
              ]
              5 => array:2 [
                "nombre" => "Omar"
                "apellidos" => "Abdel-lah Fern&#225;ndez"
              ]
              6 => array:2 [
                "nombre" => "Mar&#237;a P&#46;"
                "apellidos" => "Tormos-P&#233;rez"
              ]
              7 => array:2 [
                "nombre" => "Gloria"
                "apellidos" => "Paseiro-Crespo"
              ]
              8 => array:2 [
                "nombre" => "Raquel"
                "apellidos" => "Garc&#237;a-&#193;lvarez"
              ]
              9 => array:2 [
                "nombre" => "Mar&#237;a"
                "apellidos" => "A Mayo-Ossorio"
              ]
              10 => array:2 [
                "nombre" => "Orreaga"
                "apellidos" => "Zugasti-Echarte"
              ]
              11 => array:2 [
                "nombre" => "Paula"
                "apellidos" => "Nespereira-Garc&#237;a"
              ]
              12 => array:2 [
                "nombre" => "Lucia"
                "apellidos" => "Gil-G&#243;mez"
              ]
              13 => array:2 [
                "nombre" => "Margarita"
                "apellidos" => "Logro&#241;o-Ejea"
              ]
              14 => array:2 [
                "nombre" => "Raquel"
                "apellidos" => "Risco"
              ]
              15 => array:2 [
                "nombre" => "Felipe C"
                "apellidos" => "Parre&#241;o-Manchado"
              ]
              16 => array:2 [
                "nombre" => "Silvia"
                "apellidos" => "Gil-Trujillo"
              ]
              17 => array:2 [
                "nombre" => "Carmen"
                "apellidos" => "Benito"
              ]
              18 => array:2 [
                "nombre" => "Carlos"
                "apellidos" => "Jeric&#243;"
              ]
              19 => array:2 [
                "nombre" => "Mar&#237;a I"
                "apellidos" => "De-Miguel-Cabrera"
              ]
              20 => array:2 [
                "nombre" => "Bakarne"
                "apellidos" => "Ugarte-Sierra"
              ]
              21 => array:2 [
                "nombre" => "Cristina"
                "apellidos" => "Barrag&#225;n-Serrano"
              ]
              22 => array:2 [
                "nombre" => "Jos&#233; A&#46;"
                "apellidos" => "Garc&#237;a-Erce"
              ]
              23 => array:2 [
                "nombre" => "Henar"
                "apellidos" => "Mu&#241;oz-Hern&#225;ndez"
              ]
              24 => array:2 [
                "nombre" => "Sabela del-"
                "apellidos" => "R&#237;o-Fern&#225;ndez"
              ]
              25 => array:2 [
                "nombre" => "Mar&#237;a L&#46;"
                "apellidos" => "Herrero-Bogajo"
              ]
              26 => array:2 [
                "nombre" => "Alma M&#46;"
                "apellidos" => "Espinosa-Moreno"
              ]
              27 => array:2 [
                "nombre" => "Vanessa"
                "apellidos" => "Concepci&#243;n-Mart&#237;n"
              ]
              28 => array:2 [
                "nombre" => "Andr&#233;s"
                "apellidos" => "Zorrilla-Vaca"
              ]
              29 => array:2 [
                "nombre" => "Laura"
                "apellidos" => "Vaquero-P&#233;rez"
              ]
              30 => array:2 [
                "nombre" => "Irene"
                "apellidos" => "Mojarro"
              ]
              31 => array:2 [
                "nombre" => "Manuel"
                "apellidos" => "Ll&#225;cer-P&#233;rez"
              ]
              32 => array:2 [
                "nombre" => "Leticia"
                "apellidos" => "G&#243;mez-Viana"
              ]
              33 => array:2 [
                "nombre" => "Mar&#237;a T&#46;"
                "apellidos" => "Fern&#225;ndez-Mart&#237;n"
              ]
              34 => array:2 [
                "nombre" => "Alfredo"
                "apellidos" => "Abad-Gurumeta"
              ]
              35 => array:2 [
                "nombre" => "Carlos"
                "apellidos" => "Ferrando-Ortol&#224;"
              ]
              36 => array:2 [
                "nombre" => "Jos&#233; M&#46;"
                "apellidos" => "Ram&#237;rez-Rodr&#237;guez"
              ]
              37 => array:2 [
                "nombre" => "C&#233;sar"
                "apellidos" => "Aldecoa"
              ]
              38 => array:1 [
                "colaborador" => "on behalf of the POWER Study Investigators Group"
              ]
            ]
          ]
        ]
        "resumen" => array:1 [
          0 => array:3 [
            "titulo" => "Graphical abstract"
            "clase" => "graphical"
            "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0065" class="elsevierStyleSimplePara elsevierViewall"><elsevierMultimedia ident="fig0020"></elsevierMultimedia></p></span>"
          ]
        ]
      ]
      "idiomaDefecto" => "en"
      "Traduccion" => array:1 [
        "en" => array:9 [
          "pii" => "S217350772300100X"
          "doi" => "10.1016/j.cireng.2023.04.011"
          "estado" => "S300"
          "subdocumento" => ""
          "abierto" => array:3 [
            "ES" => true
            "ES2" => true
            "LATM" => true
          ]
          "gratuito" => true
          "lecturas" => array:1 [
            "total" => 0
          ]
          "idiomaDefecto" => "en"
          "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S217350772300100X?idApp=UINPBA00004N"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0009739X23000799?idApp=UINPBA00004N"
      "url" => "/0009739X/0000010100000010/v1_202310100835/S0009739X23000799/v1_202310100835/en/main.assets"
    ]
  ]
  "itemSiguiente" => array:17 [
    "pii" => "S2173507723000911"
    "issn" => "21735077"
    "doi" => "10.1016/j.cireng.2023.04.003"
    "estado" => "S300"
    "fechaPublicacion" => "2023-10-01"
    "aid" => "2882"
    "documento" => "article"
    "crossmark" => 1
    "subdocumento" => "fla"
    "cita" => "Cir Esp. 2023;101:678-83"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:1 [
      "total" => 0
    ]
    "en" => array:14 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>"
      "titulo" => "Laparoscopic liver resections&#58; What have we learned after more than 20 years of experience&#63;"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:3 [
        0 => "en"
        1 => "en"
        2 => "es"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "678"
          "paginaFinal" => "683"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Resecciones hep&#225;ticas laparosc&#243;picas&#58; &#191;qu&#233; hemos aprendido luego de m&#225;s de 20 a&#241;os de experiencia&#63;"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "es" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 1
        "multimedia" => array:5 [
          "identificador" => "fig0030"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => false
          "mostrarDisplay" => true
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "fx1.jpeg"
              "Alto" => 499
              "Ancho" => 1333
              "Tamanyo" => 66812
            ]
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Catalina Poggi, Tom&#225;s Cifone, Luciana Peralta, Tom&#225;s d&#8217;Angelo, Oscar Mazza, Rodrigo S&#225;nchez Clari&#225;, Mart&#237;n de Santiba&#241;es, Juan Pekolj"
          "autores" => array:8 [
            0 => array:2 [
              "nombre" => "Catalina"
              "apellidos" => "Poggi"
            ]
            1 => array:2 [
              "nombre" => "Tom&#225;s"
              "apellidos" => "Cifone"
            ]
            2 => array:2 [
              "nombre" => "Luciana"
              "apellidos" => "Peralta"
            ]
            3 => array:2 [
              "nombre" => "Tom&#225;s"
              "apellidos" => "d&#8217;Angelo"
            ]
            4 => array:2 [
              "nombre" => "Oscar"
              "apellidos" => "Mazza"
            ]
            5 => array:2 [
              "nombre" => "Rodrigo"
              "apellidos" => "S&#225;nchez Clari&#225;"
            ]
            6 => array:2 [
              "nombre" => "Mart&#237;n"
              "apellidos" => "de Santiba&#241;es"
            ]
            7 => array:2 [
              "nombre" => "Juan"
              "apellidos" => "Pekolj"
            ]
          ]
        ]
      ]
      "resumen" => array:1 [
        0 => array:3 [
          "titulo" => "Graphical abstract"
          "clase" => "graphical"
          "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall"><elsevierMultimedia ident="fig0030"></elsevierMultimedia></p></span>"
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173507723000911?idApp=UINPBA00004N"
    "url" => "/21735077/0000010100000010/v2_202406091334/S2173507723000911/v2_202406091334/en/main.assets"
  ]
  "itemAnterior" => array:18 [
    "pii" => "S2173507723000157"
    "issn" => "21735077"
    "doi" => "10.1016/j.cireng.2023.01.003"
    "estado" => "S300"
    "fechaPublicacion" => "2023-10-01"
    "aid" => "2831"
    "documento" => "article"
    "crossmark" => 1
    "subdocumento" => "fla"
    "cita" => "Cir Esp. 2023;101:657-64"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:1 [
      "total" => 0
    ]
    "en" => array:13 [
      "idiomaDefecto" => true
      "titulo" => "Study of risk factors for delayed gastric emptying after partial pancretoduodenectomy"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:3 [
        0 => "en"
        1 => "en"
        2 => "es"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "657"
          "paginaFinal" => "664"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "An&#225;lisis de factores de riesgo de vaciamiento g&#225;strico lento tras la duodenopancreatectom&#237;a cef&#225;lica"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "es" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 1
        "multimedia" => array:5 [
          "identificador" => "fig0010"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => false
          "mostrarDisplay" => true
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "fx1.jpeg"
              "Alto" => 754
              "Ancho" => 1333
              "Tamanyo" => 87242
            ]
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "S&#46; Mart&#237;n, Ll Secanella, M&#46; Sorribas, N&#46; Pel&#225;ez, S&#46; Salord, R&#46; Lopez-Urdiales, J&#46; Fabregat, J&#46; Busquets"
          "autores" => array:8 [
            0 => array:2 [
              "nombre" => "S&#46;"
              "apellidos" => "Mart&#237;n"
            ]
            1 => array:2 [
              "nombre" => "Ll"
              "apellidos" => "Secanella"
            ]
            2 => array:2 [
              "nombre" => "M&#46;"
              "apellidos" => "Sorribas"
            ]
            3 => array:2 [
              "nombre" => "N&#46;"
              "apellidos" => "Pel&#225;ez"
            ]
            4 => array:2 [
              "nombre" => "S&#46;"
              "apellidos" => "Salord"
            ]
            5 => array:2 [
              "nombre" => "R&#46;"
              "apellidos" => "Lopez-Urdiales"
            ]
            6 => array:2 [
              "nombre" => "J&#46;"
              "apellidos" => "Fabregat"
            ]
            7 => array:2 [
              "nombre" => "J&#46;"
              "apellidos" => "Busquets"
            ]
          ]
        ]
      ]
      "resumen" => array:1 [
        0 => array:3 [
          "titulo" => "Graphical abstract"
          "clase" => "graphical"
          "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall"><elsevierMultimedia ident="fig0010"></elsevierMultimedia></p></span>"
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S0009739X22003499"
        "doi" => "10.1016/j.ciresp.2022.10.018"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => true
          "ES2" => true
          "LATM" => true
        ]
        "gratuito" => true
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "es"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0009739X22003499?idApp=UINPBA00004N"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173507723000157?idApp=UINPBA00004N"
    "url" => "/21735077/0000010100000010/v2_202406091334/S2173507723000157/v2_202406091334/en/main.assets"
  ]
  "en" => array:22 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>"
    "titulo" => "Association between use of enhanced recovery after surgery protocols and postoperative complications after gastric surgery for cancer &#40;POWER 4&#41;&#58; a nationwide&#44; prospective multicentre study"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "665"
        "paginaFinal" => "677"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "Javier Ripoll&#233;s-Melchor, Ane Abad-Motos, Marcos Bruna-Esteban, Mar&#237;a Garc&#237;a-Nebreda, Isabel Otero-Mart&#237;nez, Omar Abdel-lah Fern&#225;ndez, Mar&#237;a P&#46; Tormos-P&#233;rez, Gloria Paseiro-Crespo, Raquel Garc&#237;a-&#193;lvarez, Mar&#237;a A Mayo-Ossorio, Orreaga Zugasti-Echarte, Paula Nespereira-Garc&#237;a, Lucia Gil-G&#243;mez, Margarita Logro&#241;o-Ejea, Raquel Risco, Felipe C Parre&#241;o-Manchado, Silvia Gil-Trujillo, Carmen Benito, Carlos Jeric&#243;, Mar&#237;a I De-Miguel-Cabrera, Bakarne Ugarte-Sierra, Cristina Barrag&#225;n-Serrano, Jos&#233; A&#46; Garc&#237;a-Erce, Henar Mu&#241;oz-Hern&#225;ndez, Sabela del- R&#237;o-Fern&#225;ndez, Mar&#237;a L&#46; Herrero-Bogajo, Alma M&#46; Espinosa-Moreno, Vanessa Concepci&#243;n-Mart&#237;n, Andr&#233;s Zorrilla-Vaca, Laura Vaquero-P&#233;rez, Irene Mojarro, Manuel Ll&#225;cer-P&#233;rez, Leticia G&#243;mez-Viana, Mar&#237;a T&#46; Fern&#225;ndez-Mart&#237;n, Alfredo Abad-Gurumeta, Carlos Ferrando-Ortol&#224;, Jos&#233; M&#46; Ram&#237;rez-Rodr&#237;guez, C&#233;sar Aldecoa"
        "autores" => array:39 [
          0 => array:3 [
            "nombre" => "Javier"
            "apellidos" => "Ripoll&#233;s-Melchor"
            "referencia" => array:4 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
              2 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">c</span>"
                "identificador" => "aff0015"
              ]
              3 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">d</span>"
                "identificador" => "aff0020"
              ]
            ]
          ]
          1 => array:4 [
            "nombre" => "Ane"
            "apellidos" => "Abad-Motos"
            "email" => array:1 [
              0 => "ane.abadmotos@osakidetza.eus"
            ]
            "referencia" => array:5 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
              2 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">c</span>"
                "identificador" => "aff0015"
              ]
              3 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "cor0005"
              ]
              4 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">1</span>"
                "identificador" => "fn0005"
              ]
            ]
          ]
          2 => array:3 [
            "nombre" => "Marcos"
            "apellidos" => "Bruna-Esteban"
            "referencia" => array:3 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">c</span>"
                "identificador" => "aff0015"
              ]
              2 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">e</span>"
                "identificador" => "aff0025"
              ]
            ]
          ]
          3 => array:3 [
            "nombre" => "Mar&#237;a"
            "apellidos" => "Garc&#237;a-Nebreda"
            "referencia" => array:3 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">c</span>"
                "identificador" => "aff0015"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">d</span>"
                "identificador" => "aff0020"
              ]
              2 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">f</span>"
                "identificador" => "aff0030"
              ]
            ]
          ]
          4 => array:3 [
            "nombre" => "Isabel"
            "apellidos" => "Otero-Mart&#237;nez"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">g</span>"
                "identificador" => "aff0035"
              ]
            ]
          ]
          5 => array:3 [
            "nombre" => "Omar"
            "apellidos" => "Abdel-lah Fern&#225;ndez"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">h</span>"
                "identificador" => "aff0040"
              ]
            ]
          ]
          6 => array:3 [
            "nombre" => "Mar&#237;a P&#46;"
            "apellidos" => "Tormos-P&#233;rez"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">i</span>"
                "identificador" => "aff0045"
              ]
            ]
          ]
          7 => array:3 [
            "nombre" => "Gloria"
            "apellidos" => "Paseiro-Crespo"
            "referencia" => array:3 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">c</span>"
                "identificador" => "aff0015"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">d</span>"
                "identificador" => "aff0020"
              ]
              2 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">f</span>"
                "identificador" => "aff0030"
              ]
            ]
          ]
          8 => array:3 [
            "nombre" => "Raquel"
            "apellidos" => "Garc&#237;a-&#193;lvarez"
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">j</span>"
                "identificador" => "aff0050"
              ]
            ]
          ]
          9 => array:3 [
            "nombre" => "Mar&#237;a"
            "apellidos" => "A Mayo-Ossorio"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">k</span>"
                "identificador" => "aff0055"
              ]
            ]
          ]
          10 => array:3 [
            "nombre" => "Orreaga"
            "apellidos" => "Zugasti-Echarte"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">l</span>"
                "identificador" => "aff0060"
              ]
            ]
          ]
          11 => array:3 [
            "nombre" => "Paula"
            "apellidos" => "Nespereira-Garc&#237;a"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">m</span>"
                "identificador" => "aff0065"
              ]
            ]
          ]
          12 => array:3 [
            "nombre" => "Lucia"
            "apellidos" => "Gil-G&#243;mez"
            "referencia" => array:3 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">c</span>"
                "identificador" => "aff0015"
              ]
              2 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">n</span>"
                "identificador" => "aff0070"
              ]
            ]
          ]
          13 => array:3 [
            "nombre" => "Margarita"
            "apellidos" => "Logro&#241;o-Ejea"
            "referencia" => array:3 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">c</span>"
                "identificador" => "aff0015"
              ]
              2 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">o</span>"
                "identificador" => "aff0075"
              ]
            ]
          ]
          14 => array:3 [
            "nombre" => "Raquel"
            "apellidos" => "Risco"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">p</span>"
                "identificador" => "aff0080"
              ]
            ]
          ]
          15 => array:3 [
            "nombre" => "Felipe C"
            "apellidos" => "Parre&#241;o-Manchado"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">h</span>"
                "identificador" => "aff0040"
              ]
            ]
          ]
          16 => array:3 [
            "nombre" => "Silvia"
            "apellidos" => "Gil-Trujillo"
            "referencia" => array:3 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">c</span>"
                "identificador" => "aff0015"
              ]
              2 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">q</span>"
                "identificador" => "aff0085"
              ]
            ]
          ]
          17 => array:3 [
            "nombre" => "Carmen"
            "apellidos" => "Benito"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">r</span>"
                "identificador" => "aff0090"
              ]
            ]
          ]
          18 => array:3 [
            "nombre" => "Carlos"
            "apellidos" => "Jeric&#243;"
            "referencia" => array:3 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">c</span>"
                "identificador" => "aff0015"
              ]
              2 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">s</span>"
                "identificador" => "aff0095"
              ]
            ]
          ]
          19 => array:3 [
            "nombre" => "Mar&#237;a I"
            "apellidos" => "De-Miguel-Cabrera"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">t</span>"
                "identificador" => "aff0100"
              ]
            ]
          ]
          20 => array:3 [
            "nombre" => "Bakarne"
            "apellidos" => "Ugarte-Sierra"
            "referencia" => array:3 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">c</span>"
                "identificador" => "aff0015"
              ]
              2 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">u</span>"
                "identificador" => "aff0105"
              ]
            ]
          ]
          21 => array:3 [
            "nombre" => "Cristina"
            "apellidos" => "Barrag&#225;n-Serrano"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">v</span>"
                "identificador" => "aff0110"
              ]
            ]
          ]
          22 => array:3 [
            "nombre" => "Jos&#233; A&#46;"
            "apellidos" => "Garc&#237;a-Erce"
            "referencia" => array:3 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">c</span>"
                "identificador" => "aff0015"
              ]
              2 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">w</span>"
                "identificador" => "aff0115"
              ]
            ]
          ]
          23 => array:3 [
            "nombre" => "Henar"
            "apellidos" => "Mu&#241;oz-Hern&#225;ndez"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">x</span>"
                "identificador" => "aff0120"
              ]
            ]
          ]
          24 => array:3 [
            "nombre" => "Sabela del-"
            "apellidos" => "R&#237;o-Fern&#225;ndez"
            "referencia" => array:3 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">c</span>"
                "identificador" => "aff0015"
              ]
              2 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">y</span>"
                "identificador" => "aff0125"
              ]
            ]
          ]
          25 => array:3 [
            "nombre" => "Mar&#237;a L&#46;"
            "apellidos" => "Herrero-Bogajo"
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">c</span>"
                "identificador" => "aff0015"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">z</span>"
                "identificador" => "aff0130"
              ]
            ]
          ]
          26 => array:3 [
            "nombre" => "Alma M&#46;"
            "apellidos" => "Espinosa-Moreno"
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">c</span>"
                "identificador" => "aff0015"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">aa</span>"
                "identificador" => "aff0135"
              ]
            ]
          ]
          27 => array:3 [
            "nombre" => "Vanessa"
            "apellidos" => "Concepci&#243;n-Mart&#237;n"
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">c</span>"
                "identificador" => "aff0015"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">ab</span>"
                "identificador" => "aff0140"
              ]
            ]
          ]
          28 => array:3 [
            "nombre" => "Andr&#233;s"
            "apellidos" => "Zorrilla-Vaca"
            "referencia" => array:3 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">ac</span>"
                "identificador" => "aff0145"
              ]
              2 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">ad</span>"
                "identificador" => "aff0150"
              ]
            ]
          ]
          29 => array:3 [
            "nombre" => "Laura"
            "apellidos" => "Vaquero-P&#233;rez"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">ae</span>"
                "identificador" => "aff0155"
              ]
            ]
          ]
          30 => array:3 [
            "nombre" => "Irene"
            "apellidos" => "Mojarro"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">af</span>"
                "identificador" => "aff0160"
              ]
            ]
          ]
          31 => array:3 [
            "nombre" => "Manuel"
            "apellidos" => "Ll&#225;cer-P&#233;rez"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">ag</span>"
                "identificador" => "aff0165"
              ]
            ]
          ]
          32 => array:3 [
            "nombre" => "Leticia"
            "apellidos" => "G&#243;mez-Viana"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">ah</span>"
                "identificador" => "aff0170"
              ]
            ]
          ]
          33 => array:3 [
            "nombre" => "Mar&#237;a T&#46;"
            "apellidos" => "Fern&#225;ndez-Mart&#237;n"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">ai</span>"
                "identificador" => "aff0175"
              ]
            ]
          ]
          34 => array:3 [
            "nombre" => "Alfredo"
            "apellidos" => "Abad-Gurumeta"
            "referencia" => array:4 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
              2 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">c</span>"
                "identificador" => "aff0015"
              ]
              3 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">d</span>"
                "identificador" => "aff0020"
              ]
            ]
          ]
          35 => array:3 [
            "nombre" => "Carlos"
            "apellidos" => "Ferrando-Ortol&#224;"
            "referencia" => array:4 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">c</span>"
                "identificador" => "aff0015"
              ]
              2 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">p</span>"
                "identificador" => "aff0080"
              ]
              3 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">aj</span>"
                "identificador" => "aff0180"
              ]
            ]
          ]
          36 => array:3 [
            "nombre" => "Jos&#233; M&#46;"
            "apellidos" => "Ram&#237;rez-Rodr&#237;guez"
            "referencia" => array:3 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">c</span>"
                "identificador" => "aff0015"
              ]
              2 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">ak</span>"
                "identificador" => "aff0185"
              ]
            ]
          ]
          37 => array:3 [
            "nombre" => "C&#233;sar"
            "apellidos" => "Aldecoa"
            "referencia" => array:3 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">c</span>"
                "identificador" => "aff0015"
              ]
              2 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">ah</span>"
                "identificador" => "aff0170"
              ]
            ]
          ]
          38 => array:2 [
            "colaborador" => "POWER Study Investigators Group"
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">d</span>"
                "identificador" => "aff0020"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">2</span>"
                "identificador" => "fn2005"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:37 [
          0 => array:3 [
            "entidad" => "Department of Anaesthesia and Perioperative Medicine&#44; Infanta Leonor University Hospital&#44; Madrid&#44; Spain"
            "etiqueta" => "a"
            "identificador" => "aff0005"
          ]
          1 => array:3 [
            "entidad" => "Spanish Perioperative Audit and Research Network &#40;REDGERM&#41;&#44; Zaragoza&#44; Spain"
            "etiqueta" => "b"
            "identificador" => "aff0010"
          ]
          2 => array:3 [
            "entidad" => "Grupo Espa&#241;ol de Rehabilitaci&#243;n Multimodal &#40;GERM&#41;&#44; Zaragoza&#44; Spain"
            "etiqueta" => "c"
            "identificador" => "aff0015"
          ]
          3 => array:3 [
            "entidad" => "Universidad Complutense de Madrid&#44; Madrid&#44; Spain"
            "etiqueta" => "d"
            "identificador" => "aff0020"
          ]
          4 => array:3 [
            "entidad" => "Department of General Surgery&#44; La Fe University Hospital&#44; Valencia&#44; Spain"
            "etiqueta" => "e"
            "identificador" => "aff0025"
          ]
          5 => array:3 [
            "entidad" => "Department of General Surgery&#44; Infanta Leonor University Hospital&#44; Madrid&#44; Spain"
            "etiqueta" => "f"
            "identificador" => "aff0030"
          ]
          6 => array:3 [
            "entidad" => "Department of General Surgery&#44; Hospital &#193;lvaro Cunqueiro de Vigo &#40;Complejo Hospitalario Universitario de Vigo&#41;&#44; Vigo&#44; Spain"
            "etiqueta" => "g"
            "identificador" => "aff0035"
          ]
          7 => array:3 [
            "entidad" => "Department of General Surgery&#44; Complejo Asistencial Universitario de Salamanca&#44; Salamanca&#44; Spain"
            "etiqueta" => "h"
            "identificador" => "aff0040"
          ]
          8 => array:3 [
            "entidad" => "Department of Anaesthesia and Perioperative Medicine&#44; Vall d&#8217;Hebr&#243;n University Hospital&#44; Barcelona&#44; Spain"
            "etiqueta" => "i"
            "identificador" => "aff0045"
          ]
          9 => array:3 [
            "entidad" => "Department of Anaesthesia and Perioperative Medicine&#44; 12 de Octubre University Hospital&#44; Madrid&#44; Spain"
            "etiqueta" => "j"
            "identificador" => "aff0050"
          ]
          10 => array:3 [
            "entidad" => "Department of General Surgery&#44; Hospital Universitario Puerta del Mar C&#225;diz&#44; C&#225;diz&#44; Spain"
            "etiqueta" => "k"
            "identificador" => "aff0055"
          ]
          11 => array:3 [
            "entidad" => "Department of Anaesthesia and Perioperative Medicine&#44; Complejo Hospitalario Navarra&#44; Pamplona&#44; Spain"
            "etiqueta" => "l"
            "identificador" => "aff0060"
          ]
          12 => array:3 [
            "entidad" => "Department of Anaesthesia and Perioperative Medicine&#44; Hospital POVISA Vigo&#44; Vigo&#44; Spain"
            "etiqueta" => "m"
            "identificador" => "aff0065"
          ]
          13 => array:3 [
            "entidad" => "Department of Anaesthesia and Perioperative Medicine&#44; Hospital de Sant Joan Desp&#237; Mois&#232;s Broggi&#44; Spain"
            "etiqueta" => "n"
            "identificador" => "aff0070"
          ]
          14 => array:3 [
            "entidad" => "Department of Anaesthesia and Perioperative Medicine&#44; Hospital Universitario de Alava&#44; Vitoria&#44; Spain"
            "etiqueta" => "o"
            "identificador" => "aff0075"
          ]
          15 => array:3 [
            "entidad" => "Department of Anesthesiology and Critical Care&#44; Hospital Cl&#237;nic&#44; Institut D&#39;investigaci&#243; August Pi i Sunyer&#44; Barcelona&#44; Spain"
            "etiqueta" => "p"
            "identificador" => "aff0080"
          ]
          16 => array:3 [
            "entidad" => "Department of Anaesthesia and Perioperative Medicine&#44; Hospital General Universitario de Ciudad Real&#44; Ciudad Real&#44; Spain"
            "etiqueta" => "q"
            "identificador" => "aff0085"
          ]
          17 => array:3 [
            "entidad" => "Department of Anaesthesia and Perioperative Medicine&#44; Hospital General Universitario Gregorio Mara&#241;&#243;n&#44; Madrid&#44; Spain"
            "etiqueta" => "r"
            "identificador" => "aff0090"
          ]
          18 => array:3 [
            "entidad" => "Department of Internal Medicine&#44; Hospital Mois&#232;s Broggi&#44; Consorci Sanitari Integral&#44; Sant Joan Desp&#237;&#44; Spain"
            "etiqueta" => "s"
            "identificador" => "aff0095"
          ]
          19 => array:3 [
            "entidad" => "Department of Anaesthesia and Perioperative Medicine&#44; Hospital General Universitari Castell&#243;&#44; Castell&#243;n de La Plana&#44; Spain"
            "etiqueta" => "t"
            "identificador" => "aff0100"
          ]
          20 => array:3 [
            "entidad" => "Department of General Surgery&#44; Hospital Galdakao-Usansolo&#44; Spain"
            "etiqueta" => "u"
            "identificador" => "aff0105"
          ]
          21 => array:3 [
            "entidad" => "Department of General Surgery&#44; Fundaci&#243;n Jim&#233;nez D&#237;az University Hospital&#44; Madrid&#44; Spain"
            "etiqueta" => "v"
            "identificador" => "aff0110"
          ]
          22 => array:3 [
            "entidad" => "Banco de Sangre y Tejidos de Navarra&#44; Pamplona&#44; Spain"
            "etiqueta" => "w"
            "identificador" => "aff0115"
          ]
          23 => array:3 [
            "entidad" => "Department of Anaesthesia and Perioperative Medicine&#44; Hospital Cl&#237;nico de Valladolid&#44; Spain"
            "etiqueta" => "x"
            "identificador" => "aff0120"
          ]
          24 => array:3 [
            "entidad" => "Department of Anaesthesia and Perioperative Medicine&#44; Complexo Hospitalario Universitario de Santiago&#44; Santiago de Compostela&#44; Spain"
            "etiqueta" => "y"
            "identificador" => "aff0125"
          ]
          25 => array:3 [
            "entidad" => "Department of General Surgery&#44; Hospital General La Mancha Centro&#44; Alc&#225;zar de San Juan&#44; Spain"
            "etiqueta" => "z"
            "identificador" => "aff0130"
          ]
          26 => array:3 [
            "entidad" => "Department of Anaesthesia and Perioperative Medicine&#44; Hospital Universitario Fundaci&#243;n Alcorc&#243;n&#44; Alcorc&#243;n&#44; Spain"
            "etiqueta" => "aa"
            "identificador" => "aff0135"
          ]
          27 => array:3 [
            "entidad" => "Department of General Surgery&#44; Nuestra Se&#241;ora de Candelaria Hospital Universitario&#44; Spain"
            "etiqueta" => "ab"
            "identificador" => "aff0140"
          ]
          28 => array:3 [
            "entidad" => "Department of Anesthesiology and Perioperative Medicine&#44; University of Texas MD Anderson Cancer Center&#44; Houston&#44; TX&#44; USA"
            "etiqueta" => "ac"
            "identificador" => "aff0145"
          ]
          29 => array:3 [
            "entidad" => "Department of Anesthesiology&#44; Perioperative&#44; and Pain Medicine&#44; Brigham and Women&#8217;s Hospital&#44; Harvard Medical School&#44; Boston&#44; MA&#44; USA"
            "etiqueta" => "ad"
            "identificador" => "aff0150"
          ]
          30 => array:3 [
            "entidad" => "Department of Anaesthesia and Perioperative Medicine&#44; Hospital Universitario R&#237;o Hortega&#44; Valladolid&#44; Spain"
            "etiqueta" => "ae"
            "identificador" => "aff0155"
          ]
          31 => array:3 [
            "entidad" => "Department of Anaesthesia and Perioperative Medicine&#44; Juan Ram&#243;n Jim&#233;nez University Hospital&#44; Huelva&#44; Spain"
            "etiqueta" => "af"
            "identificador" => "aff0160"
          ]
          32 => array:3 [
            "entidad" => "Department of Anaesthesia and Perioperative Medicine&#44; Hospital Costa del Sol&#44; Marbella&#44; Spain"
            "etiqueta" => "ag"
            "identificador" => "aff0165"
          ]
          33 => array:3 [
            "entidad" => "Department of Anaesthesia and Perioperative Medicine&#44; Complejo Hospitalario Universitario de Ourense&#44; Ourense&#44; Spain"
            "etiqueta" => "ah"
            "identificador" => "aff0170"
          ]
          34 => array:3 [
            "entidad" => "Department of Anaesthesia and Perioperative Medicine&#44; Hospital Medina del Campo&#44; Medina del Campo&#44; Spain"
            "etiqueta" => "ai"
            "identificador" => "aff0175"
          ]
          35 => array:3 [
            "entidad" => "CIBER de Enfermedades Respiratorias&#44; Instituto de Salud Carlos III&#44; Madrid&#44; Spain"
            "etiqueta" => "aj"
            "identificador" => "aff0180"
          ]
          36 => array:3 [
            "entidad" => "Department of General Surgery&#44; Lozano Blesa University Hospital&#44; Universidad de Zaragoza&#44; Zaragoza&#44; Spain"
            "etiqueta" => "ak"
            "identificador" => "aff0185"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding author&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "Asociaci&#243;n entre el uso de protocolos de recuperaci&#243;n intensificada y complicaciones postoperatorias tras cirug&#237;a g&#225;strica por c&#225;ncer &#40;POWER 4&#41;&#58; estudio nacional&#44; prospective multic&#233;ntrico"
      ]
    ]
    "resumenGrafico" => array:2 [
      "original" => 1
      "multimedia" => array:5 [
        "identificador" => "fig0020"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => false
        "mostrarDisplay" => true
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "fx1.jpeg"
            "Alto" => 754
            "Ancho" => 1333
            "Tamanyo" => 89271
          ]
        ]
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Gastric cancer is the fifth most frequent malignant tumour worldwide&#44; and accounts for 732&#44;000 deaths per year&#44; ranking it as the fourth leading cause of cancer-related death&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> Gastrectomy for cancer is a technically challenging procedure&#44; with postoperative complications occurring in 20 to 46 &#37; of patients<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2&#44;3</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Enhanced Recovery After Surgery &#40;ERAS&#41; is a multidisciplinary perioperative approach that provides standardized evidence-based recommendations for the care of patients undergoing specific types of surgery&#46;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> ERAS began in patients undergoing colorectal surgery&#44;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> and resulted in a decrease in postoperative complications and length of hospital stay &#40;LOS&#41; when adequate adherence to the protocols was achieved&#46;<a class="elsevierStyleCrossRefs" href="#bib0030"><span class="elsevierStyleSup">6&#44;7</span></a> The ERAS model is well established for colorectal surgery as the optimal perioperative care&#46; ERAS implementation in gastric surgery<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a> has shown discrete decreases in LOS&#46;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a> Moreover&#44; despite the clinical reported benefits of ERAS&#44; its implementation in clinical practice has been quite slow for a variety of reasons&#44; such as lack of convincing data&#44; low level of knowledge about ERAS&#44; or expertise and institutional limitations&#44;<a class="elsevierStyleCrossRefs" href="#bib0050"><span class="elsevierStyleSup">10&#44;11</span></a> and lack of large studies assessing the association between ERAS adherence and postoperative outcomes&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">The aim of this study was to assess perioperative care in patients undergoing elective gastric surgery for cancer in Spain&#44; and to analyse the association between the individual ERAS elements and postoperative complications&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Methods</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Study design and participants</span><p id="par0020" class="elsevierStylePara elsevierViewall">The POWER 4study was a multicentre&#44; prospective&#44; three-month cohort study&#46; The study was approved by the Ethics Committee of the Instituto Aragon&#233;s de Ciencias de la Salud&#44; Zaragoza&#44; Spain &#40;C&#46;P&#46;-C&#46;I&#46; PI19&#47;106&#44; March 27&#44; 2019&#41; and was prospectively registered &#40;NCT03865810&#41;&#46; The study protocol was published&#44;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">12</span></a> and approved by the ethics committees or institutional review boards of each centre&#46; All patients signed a written informed consent before inclusion&#46; This study followed the STROBE reporting guideline for cohort studies&#44;<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">13</span></a> and the Reporting on ERAS Compliance&#44; Outcomes&#44; and Elements Research Checklist&#46;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a> The hospital and investigator involvement were provided through the Spanish Perioperative Audit and Research Network &#40;RedGERM&#41;&#46; All Spanish centres were invited to participate regardless of having or not an established ERAS pathway&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Procedures</span><p id="par0025" class="elsevierStylePara elsevierViewall">All consecutive adult patients scheduled for elective gastric surgery for cancer were assessed for inclusion during a single period of three months of recruitment at each participating hospital between October 2019 and October 2020&#46; Subtotal and total gastrectomies were included&#44; both laparoscopic and open&#46; Exclusion criteria were emergency surgery&#44; endoscopic procedures&#44; non-oncological gastric surgery and patient refusal&#46; Each patient was followed up for 30 days after surgery&#46; Patient information was acquired from hospital and primary care medical records&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">Data was collected using the Castor EDC platform<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">15</span></a> in a case record form designed specifically for POWER 4&#46; Centres declared themselves as centres with or without an established multidisciplinary ERAS pathway for gastric surgery&#44; regardless of <span class="elsevierStyleBold">the items that conformed the pathway and</span> their current adherence&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">The definition of the individual ERAS components was based on the ERAS Society&#174; Guidelines for gastric surgery&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a> For a simpler and more accurate data collection&#44; some of the 25 items of these guidelines<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a> were grouped and POWER4 included 22 elements of perioperative care<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">12</span></a><span class="elsevierStyleSup">&#40;</span><span class="elsevierStyleBold">Table S1 supplementary data</span>&#41;&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">Data included patient characteristics&#44; surgical procedure&#44; surgical approach&#44; duration of surgery&#44; preoperative laboratory results&#44; ERAS elements&#44; and 30-day outcomes &#40;postoperative complications&#44; LOS&#44; readmission&#44; reoperation&#44; and 30-day mortality&#41;&#46; Thirty-day postoperative complications were predefined and graded as mild&#44; moderate&#44; or severe as described by the European Perioperative Clinical Outcome definitions &#40;EPCO&#41;<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">16</span></a> &#40;<span class="elsevierStyleBold">Table S2&#44; supplementary data&#41;&#46;</span></p><p id="par0045" class="elsevierStylePara elsevierViewall">Data was censored at 30 days following surgery for patients who remained at the hospital&#46; To ensure the validity of the data&#44; they were validated and audited by another site investigator who was not involved in the initial data collection&#46; Our aim was to recruit as many hospitals and patients in Spain as possible&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Outcomes</span><p id="par0050" class="elsevierStylePara elsevierViewall">The primary outcome measure was 30-day moderate-to-severe postoperative complications&#46; Secondary outcomes were occurrence of overall postoperative complications&#44; adherence to the ERAS pathway&#44; 30 day-mortality and LOS&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">Adherence to the ERAS pathway was defined as the percentage of ERAS items that were applied to each patient over the total number of interventions recommended by the ERAS Society&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Statistical analysis</span><p id="par0060" class="elsevierStylePara elsevierViewall">The results were analysed according to whether the patient underwent surgery in a self-designed ERAS centre or in a non-ERAS centre&#46; Discrete variables were described as absolute frequencies and percentages and their differences were analysed using Fisher&#39;s or Pearson&#39;s exact tests&#46; Continuous variables were presented with medians with their corresponding interquartile ranges &#40;IQR&#41; and statistical differences were calculated using the Wilcoxon rank sum test&#46; Adherence to the ERAS pathway was calculated for each individual patient according to the number of the ERAS items achieved over the 22 analysed items &#40;ERAS adherence&#41;&#46; Subsequently&#44; the analysis was repeated&#44; subdividing the entire sample into four quartiles according to the rate of adherence to the ERAS items &#40;Q1&#58; highest adherence&#44; Q4&#58; lowest adherence&#41;&#44; regardless of whether or not the patients was treated at a self-designed ERAS centre&#46; Highest and lowest adherence quartiles were compared&#44; and linear adjustments of adherence were performed for each ERAS element&#46; We then analysed the rate of moderate-to-severe complications for each ERAS element using Fisher&#39;s exact test&#44; and we performed a multivariate analysis to study the association between the rate of each of the ERAS elements and the clinical and demographic variables&#46; We also used the same model in a multilevel multivariable logistic regression model to explore independent factors associated with moderate-to-severe postoperative complications assessing the variability of each centre&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">In order to avoid errors in the multiple comparisons&#44; the respective q value was calculated for each P value in order to maintain a false discovery rate of less than 5 &#37;&#46; Comparisons in which the P value and q value were less than 0&#46;05 were considered statistically significant&#46;</p></span></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Results</span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Participants</span><p id="par0070" class="elsevierStylePara elsevierViewall">A total of 743 patients from 72 centres were included in the analysis <span class="elsevierStyleBold">&#40;</span><a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a><span class="elsevierStyleBold">&#41;&#44;</span> of which 211 &#40;28&#46;4&#37;&#41; were included in self-declared ERAS centres&#59; 444 &#40;60 &#37;&#41; were men&#44; and median age was 70 years &#91;IQR 61 to 77&#93;&#46; Other characteristics are shown in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#46; More patients in the ERAS group received preoperative neoadjuvant therapy and were treated in a centre with a Patient Blood Management &#40;PBM&#41; program&#46; Duration of surgery was longer in the ERAS group&#46; <span class="elsevierStyleBold">&#40;</span><a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a><span class="elsevierStyleBold">&#41;&#46;</span></p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="tbl0005"></elsevierMultimedia></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Outcomes in self-declared ERAS vs&#46; non-ERAS groups</span><p id="par0075" class="elsevierStylePara elsevierViewall">A total of 172 patients &#40;23&#46;1&#37;&#41; suffered moderate-to-severe complications&#44; and 245 patients &#40;33 &#37;&#41; experienced overall postoperative complications&#46; There were no differences in the incidence of moderate-to-severe complications &#40;47 &#40;22&#46;3&#37;&#41; vs&#46; 125 &#40;23&#46;5&#37;&#41;&#59; OR&#44; 0&#46;92 &#40;95&#37; CI&#44; 0&#46;59 to 1&#46;41&#41;&#59; P&#8201;&#61;&#8201;0&#46;068&#41; or overall postoperative complications &#40;71 &#40;33&#46;6&#37;&#41; vs&#46; 174 &#40;32&#46;7&#37;&#41;&#59; OR&#44; 1&#46;05&#44; 95 &#37; CI&#44; 0&#46;70 to 1&#46;56&#59; P&#8201;&#61;&#8201;0&#46;825&#41; between the self-declared ERAS and non-ERAS groups&#46; Patients in the ERAS group had less bloodstream infection compared to the non-ERAS group&#46; There were no differences in the rest of the predefined complications and there were no differences in readmissions&#44; reoperations&#44; mortality and LOS&#46; <span class="elsevierStyleBold">&#40;</span><a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a><span class="elsevierStyleBold">&#41;&#46;</span></p><elsevierMultimedia ident="fig0010"></elsevierMultimedia></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Adherence data</span><p id="par0080" class="elsevierStylePara elsevierViewall">The overall adherence rate to the ERAS individual items was 52&#37; &#91;IQR 45 to 60&#93;&#46; Adherence was significantly higher in self-declared ERAS centres compared to non-ERAS centres 60&#37; &#91;IQR 52 to 70&#93; vs&#46; 50&#37; &#91;IQR 43 to 57&#93; &#40;P&#8201;&#60;&#8201;0&#46;001&#41;&#46; Adherence to most of the individual ERAS elements was higher in the self-declared ERAS cohort&#46; <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a> shows the adherence for each of the individual ERAS elements&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Outcomes in higher versus lower ERAS adherence groups</span><p id="par0085" class="elsevierStylePara elsevierViewall">Adherence to the ERAS elements in the highest adherence quartile &#40;Q1&#41; was &#62; 60 &#37;&#44; while in the lowest adherence quartile &#40;Q4&#41; &#8804; 45 &#37;&#46; There were no differences in the number of patients with moderate to severe complications&#44; overall complications&#44; readmissions&#44; mortality or LOS&#46; Patients in the Q1 had more anastomotic leak compared with those in the low adherence group &#40;Q4&#41;&#46; There were no other differences in any of the predefined complications between the highest and lowest adherence groups <span class="elsevierStyleBold">&#40;</span><a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 3</a><span class="elsevierStyleBold">&#41;&#46;</span> Linear adherence adjustment also showed that additional adherence to the ERAS pathway in the Q1 did not improve any of the outcomes compared to Q4&#46;</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0130">Individual ERAS elements&#44; patients characteristics and moderate-to-severe postoperative complications</span><p id="par0090" class="elsevierStylePara elsevierViewall">Multivariable and multilevel analyses of individual ERAS elements showed a statistically significant reduction of moderate-to-severe complications in those patients in which early mobilization was achieved while patients not receiving preoperative mechanical bowel preparation and postoperative nutritional care had more moderate-severe postoperative complications&#46; No other associations were found for the other ERAS elements <span class="elsevierStyleBold">&#40;Table S3&#44;</span> supplementary data&#46;<span class="elsevierStyleBold">&#41;&#46;</span></p><p id="par0095" class="elsevierStylePara elsevierViewall">Patients who received neoadjuvant therapy had a lower risk of moderate-severe postoperative complications&#46; Frail patients&#44; patients with cirrhosis&#44; patients undergoing total gastrectomy&#44; and patients with a longer lasting surgery had a higher risk of moderate-to-severe complications <span class="elsevierStyleBold">&#40;Table S3&#44;</span> supplementary data&#41;&#46;</p></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0135">Individual ERAS elements and patients characteristics and LOS</span><p id="par0100" class="elsevierStylePara elsevierViewall">LOS was significantly lower in patients in whom nasogastric tube was not used&#44; and in those who received early feeding&#46; However&#44; patients who underwent total gastrectomy and those who received postoperative nutritional support had a longer LOS&#46; None of the other ERAS elements&#44; neither being treated at a self-declared ERAS centre&#44; were associated with shorter LOS &#40;<span class="elsevierStyleBold">Table S4</span>&#44; supplementary data&#41;&#46;</p></span></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0140">Discussion</span><p id="par0105" class="elsevierStylePara elsevierViewall">The main finding of this study was that neither treatment at a self-declared ERAS centre nor high compliance &#40;Q1&#41; with ERAS measures were associated with improved outcomes after elective gastric cancer surgery&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">Given the success of ERAS in colorectal surgery&#44; this multimodal perioperative care approach has emerged as an optimal perioperative strategy to improve clinical outcomes in gastric cancer surgery and in many other procedures&#46; However&#44; numerous controversies exist regarding the practice of ERAS in patients undergoing gastrectomy&#46; A recent meta-analysis of randomized controlled trials which assessed the role of ERAS in radical gastrectomy showed that ERAS results in accelerated convalescence&#44; improved nutritional status&#44; and improved quality of life for gastric cancer patients&#46;<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">17</span></a> Similarly to our findings&#44; Blumenthaler et al did not find that the application of an ERAS pathway in gastric surgery resulted in fewer postoperative complications&#46;<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">18</span></a> It has been reported that the efficacy of protocols that are incompletely or incipiently applied is markedly reduced&#46;<a class="elsevierStyleCrossRefs" href="#bib0090"><span class="elsevierStyleSup">18&#44;19</span></a> Although this has been mainly reported for colorectal surgery <a class="elsevierStyleCrossRefs" href="#bib0030"><span class="elsevierStyleSup">6&#44;20</span></a> it was also recently shown that greater adherence to ERAS recommendations for gastric surgery resulted in improved postoperative outcomes&#46;<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">21</span></a> However&#44; we did not find that greater adherence to protocols was associated with better outcomes&#44; although the adherence in our highest adherence quartile was lower than previously reported as required to improve postoperative outcomes<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a>&#44; so it is possible that our low overall adherence in Spain was one of the determinants of the ineffectiveness of the ERAS protocol in this cohort&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">Early mobilization was the only ERAS element that was associated with fewer moderate-severe complications&#46; Several studies have shown that the application of this part of the ERAS program can significantly accelerate the recovery of postoperative intestinal function<a class="elsevierStyleCrossRefs" href="#bib0110"><span class="elsevierStyleSup">22&#44;23</span></a> and improve postoperative outcomes&#46;<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">7&#44;24&#44;25</span></a> On the other hand&#44; those who received postoperative nutritional support had more postoperative complications and higher LOS probably due to a previous poorer nutritional status or the presence of postoperative complications&#46;&#46; The length of stay was also shorter in patients who did not have a nasogastric tube and who received an early feeding&#46; The number and relative combination of ERAS elements implemented&#44; and the relative importance of individual items&#44; especially those considered as &#34;core elements&#39;&#39; of ERAS is currently a debated topic&#46;<a class="elsevierStyleCrossRefs" href="#bib0130"><span class="elsevierStyleSup">26&#44;27</span></a> It is accepted that early mobilization is a core element in most ERAS guidelines<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a>&#44; its fulfilment may be due to both a dedicated effort by the postoperative multidisciplinary team and a sign of favourable clinical outcome&#44;<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">28</span></a> and conversely&#44; the inability to mobilize early in the immediate postoperative period may be considered as a warning sign of poor clinical outcome&#46;<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">29</span></a> Early deviation of postoperative ERAS elements appears to be the most significant in terms of association with ERAS failure and delayed discharge&#46;<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">29</span></a> Early restoration of the oral feeding promotes early recovery of normal bowel function&#44; so it seems logical that patients who achieve early tolerance will have a shorter LOS&#44;<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">30</span></a> while those with impediments to achieving this&#44; such as the presence of a nasogastric tube or the need for nutritional support&#44; will have a longer LOS&#46; Once again&#44; this postoperative element could be considered as a success of the pathway&#44; or as an early warning sign in those cases in which compliance is not achieved&#46;<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">31</span></a></p><p id="par0120" class="elsevierStylePara elsevierViewall">A recent study provided unique insight into changes in gastric cancer presentation&#44; management and outcomes over a 30-year period and highlighted the importance of perioperative chemotherapy in long-term survival&#44; as well as the reduction in the number of total gastrectomy as a milestone in the management of patients undergoing gastric cancer surgery to improve postoperative outcomes&#46;<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">32</span></a> We found similar results&#44; patients with neoadjuvant therapy presented fewer complications&#44; but longer surgeries and total gastrectomy were associated with more postoperative complications&#46; On the other hand&#44; although the partial application of ERAS did not lead to better outcomes&#44; it was not associated with more readmissions or more reoperations&#44; so its practice seems safe&#44; and efforts should be undertaken to achieve greater adherence to the protocol&#44; since it is ultimately the standard of care in many cases&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">Most of the studies on gastric surgery were performed in the Asian population&#44; and this study is the largest study to date on gastric surgery in the ERAS setting in a Western population&#59; however&#44; we must acknowledge some limitations of the study&#46; First&#44; in an optimally designed study&#44; the groups would be blindly assigned to ERAS or non-ERAS for the same period of time to avoid allocation bias&#46; However&#44; we consider that a randomized clinical trial comparing an ERAS protocol versus a clinical practice in which none of the ERAS elements were used would be unethical&#46; On the other hand&#44; information bias may be inherent in the design of this study&#44; and could have influenced an increase in adherence to the ERAS elements&#44; so that the actual ERAS adherence could even be lower&#46; The elements of ERAS themselves are interrelated&#46; For example&#44; conservative intraoperative fluid administration is arguably more applicable in patients who did not receive preoperative bowel preparation&#44; and administration of carbohydrate drinks mandates adequate adherence to preoperative fasting time&#46; In addition&#44; the use of some of the ERAS elements are related to the severity of the patient&#44; e&#46;g&#46;&#44; goal-directed fluid therapy&#44; usually recommended for the high-risk patient&#46;<a class="elsevierStyleCrossRefs" href="#bib0165"><span class="elsevierStyleSup">33&#44;34</span></a> We tried to avoid selection bias by including a majority of Spanish centres that were performing gastrectomy&#44; regardless of whether they self-designated as ERAS or not&#46; The effect of these problems was partly offset by the large sample size and the number of institutions reporting data&#44; but we also have to recognize that gastrectomy is not as frequent a procedure as&#44; for example&#44; colorectal surgery&#44; and many centres recruited a low number of patients&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">The application of ERAS protocols for gastric surgery in our cohort was very low&#46; Neither partial compliance with ERAS protocols nor treatment with self-designated ERAS centres improved postoperative outcomes in patients undergoing gastric surgery for cancer&#46;</p></span><span id="sec0075" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0145">Funding</span><p id="par0135" class="elsevierStylePara elsevierViewall">Support was only provided by institutional sources&#46; The POWER 4 study was supported by the Spanish Perioperative Audit and Research Network &#40;RedGERM&#41; and the Grupo Espa&#241;ol de Rehabilitaci&#243;n Multimodal &#40;GERM&#41;&#46;</p><p id="par0140" class="elsevierStylePara elsevierViewall">RedGERM conducted and designed the study&#59; provided collection and management of the data&#59; but had no role in the analysis and interpretation of the data&#59; preparation&#44; review&#44; or approval of the manuscript&#59; and decision to submit the manuscript for publication&#46;</p></span><span id="sec0080" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0150">COI&#47;Disclosures</span><p id="par0145" class="elsevierStylePara elsevierViewall">Dr&#46; Ripolle&#769;s-Melchor reports personal fees from Edwards Lifesciences&#44; Vifor Pharma&#44; MSD and Fresenius Kabi outside the submitted work&#46; Dr&#46; Alfredo Abad-Gurumeta reports personal fees from Edwards Lifesciences&#44; MSD&#44; 3&#8201;M&#44; Braun&#44; Ferrer&#44; Rovi and ALTAN outside the submitted work&#46; Dr&#46; Aldecoa reports personal fees from Fresenius Kabi and Octapharma outside the submitted work&#46; Dr Garc&#237;a-Erce declares no conflict of interest with this study&#46; However&#44; he has previously given talks&#44; chaired tables at congresses and conferences and organized courses with scholarships or funding from Amgen&#44; Jansen&#44; Sandoz&#44; Vifor Pharma and Zambon&#46; Carlos Jeric&#243; has given talks and received consultancy fees from Viphor Pharma Espa&#241;a SL&#44; Bial and Zambon&#46; Ane Abad-Motos&#44; Marcos Bruna-Esteban&#44; Mar&#237;a Garc&#237;a-Nebreda&#44; Isabel Otero-Mart&#237;nez&#44; Omar Abdel-lah Fern&#225;ndez&#44; Mar&#237;a P&#46; Tormos-P&#233;rez&#44; Gloria Paseiro-Crespo&#44; Raquel Garc&#237;a-&#193;lvarez&#44; Mar&#237;a A Mayo-Ossorio&#44; Orreaga Zugasti-Echarte&#44; Paula Nespereira-Garc&#237;a&#44; Lucia Gil-G&#243;mez&#44; Margarita Logro&#241;o-Ejea&#44; Raquel Risco&#44; Felipe C Parre&#241;o-Manchado&#44; Silvia Gil-Trujillo&#44; Carmen Benito&#44; Mar&#237;a I De-Miguel-Cabrera&#44; Bakarne Ugarte-Sierra&#44; Cristina Barrag&#225;n-Serrano&#44; Henar Mu&#241;oz-Hern&#225;ndez&#44; Sabela del- R&#237;o-Fern&#225;ndez&#44; Mar&#237;a L&#46; Herrero-Bogajo&#44; Alma M&#46; Espinosa-Moreno&#44; Vanessa Concepci&#243;n-Mart&#237;n&#44; Andr&#233;s Zorrilla-Vaca&#44; Laura Vaquero-P&#233;rez&#44; Irene Mojarro&#44; Manuel Ll&#225;cer-P&#233;rez&#44; Leticia G&#243;mez-Viana&#44; Mar&#237;a T&#46; Fern&#225;ndez-Mart&#237;n&#44; Carlos Ferrando-Ortol&#224;&#44; Jos&#233; M&#46; Ram&#237;rez-Rodr&#237;guez report no potential conflicts of interest&#46;</p></span><span id="sec1080" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect1150">Appendix 1&#58; POWER 4 Investigators Group</span><p id="par9045" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Althaia&#46; Xarxa Assistencial i Universit&#224;ria de Manresa</span></p><p id="par8145" class="elsevierStylePara elsevierViewall">Merc&#232; G&#252;ell Farr&#233;<span class="elsevierStyleSup">1&#44;2</span>&#44; Roser Farr&#233; Font&#44; Rafael Diaz del Gobbo&#44; Raquel S&#225;nchez Jimenez &#40;Surgery Department&#41; Isabel P&#233;rez Reche&#44; Belen Gil Calvo&#44; Jordi Llorca Garc&#237;a&#44; Laura Carrasco S&#225;nchez&#44; Cristina Prat llimargas &#40;Anesthesia Department&#41;&#46;</p><p id="par7145" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Complejo Asistencial de Zamora</span></p><p id="par6145" class="elsevierStylePara elsevierViewall">Ana Mar&#237;a Garc&#237;a-S&#225;nchez<span class="elsevierStyleSup">1</span>&#44; Gema Mart&#237;nez-Rag&#252;&#233;s<span class="elsevierStyleSup">1</span>&#44; Mar&#237;a G&#243;mez-Fern&#225;ndez &#40;Anesthesia Department&#41;&#59; &#193;lvaro del-Castillo-Criado<span class="elsevierStyleSup">2</span>&#44; Ruth Mart&#237;nez-D&#237;az&#44; Sara Alegr&#237;a-Rebollo &#40;Surgery Department&#41;</p><p id="par5145" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Complejo Asistencial Universitario de Le&#243;n</span></p><p id="par4145" class="elsevierStylePara elsevierViewall">Javier Ferrero-de-Paz<span class="elsevierStyleSup">1&#44;2</span>&#44; Cristina Garc&#237;a-P&#233;rez&#44; Sergio Marcos-Contreras&#44; Diana Fern&#225;ndez-Garc&#237;a&#44; Maeva Tor&#237;o-Marcos &#40;Anesthesia Department&#41;</p><p id="par3145" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Complejo Asistencial Universitario de Salamanca</span></p><p id="par2045" class="elsevierStylePara elsevierViewall">Omar Abdel-lah Fern&#225;ndez<span class="elsevierStyleSup">1&#44;2</span>&#44; Felipe Carlos Parre&#241;o-Manchado<span class="elsevierStyleSup">1</span> &#40;Surgery Department&#41;&#59; Mar&#237;a &#193;ngeles Mart&#237;n &#40;Anesthesia Department&#41;</p><p id="par9145" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Complejo Hospitalario de M&#233;rida</span></p><p id="par6245" class="elsevierStylePara elsevierViewall">Jos&#233; Mar&#237;a Tena-Guerrero<span class="elsevierStyleSup">1&#44;2</span>&#44; Estefan&#237;a Palma-Gonz&#225;lez &#40;Anesthesia Department&#41;&#59; Gustavo Flores-Flores<span class="elsevierStyleSup">1</span> &#40;Surgery Department&#41;</p><p id="par9645" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Complejo Hospitalario de Navarra</span></p><p id="par9445" class="elsevierStylePara elsevierViewall">Orreaga Zugasti-Echarte<span class="elsevierStyleSup">1&#44;2</span>&#44; Elena P&#233;rez-Bergara&#44; Susana Hern&#225;ndez-Garc&#237;a&#44; Marta Mart&#237;n-Vizca&#237;no&#44; Francisco Javier Yoldi-Murillo&#44; Maider Valencia-Alzueta &#40;Anesthesia Department&#41;&#59; Carlos Chaveli-D&#237;az&#44; Coro Miranda-Murua&#44; Concepci&#243;n Y&#225;rnoz-Iraz&#225;bal &#40;Surgery Department&#41;&#59; Sonsoles Botella-Mart&#237;nez &#40;Nutrition Department&#41;</p><p id="par9545" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Complejo Hospitalario de Toledo</span></p><p id="par2645" class="elsevierStylePara elsevierViewall">Rafael L&#243;pez-Pardo<span class="elsevierStyleSup">1&#44;2</span> &#40;Surgery Department&#41;&#59; Marta Torres-Montalvo &#40;Anesthesia Department&#41;</p><p id="par2640" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Complejo Hospitalario Don Benito Villanueva de la Serena</span></p><p id="par2644" class="elsevierStylePara elsevierViewall">Isabel Pinilla-Pico&#44; Enrique del-Cojo-Peces<span class="elsevierStyleSup">1&#44;2</span>&#44; Mar&#237;a del Pilar Rodr&#237;guez-Chaparro &#40;Anesthesia Department&#41;</p><p id="par2641" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Complejo Hospitalario Universitario A Coru&#241;a</span></p><p id="par2646" class="elsevierStylePara elsevierViewall">Manuel &#193;ngel G&#243;mez-R&#237;os<span class="elsevierStyleSup">1&#44;2</span>&#44; Sara del-R&#237;o-Regueira&#44; Eva Mosquera-Rodr&#237;guez &#40;Anesthesia Department&#41;</p><p id="par2642" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Complejo Hospitalario Universitario de Canarias</span></p><p id="par2643" class="elsevierStylePara elsevierViewall">Jessica Hern&#225;ndez-Beslmeisl<span class="elsevierStyleSup">1&#44;2</span>&#44; Mar&#237;a Alejandra Perozo-Medina<span class="elsevierStyleSup">1</span>&#44; Beneharo Darias-Delbey&#44; Mar&#237;a del Carmen Mart&#237;n- Lorenzo&#44; Vanessa Gonz&#225;lez-Fari&#241;a&#44; Montserrat Rodr&#237;guez-Dom&#237;nguez&#44; Jaime Fern&#225;ndez-de-la-Vega-Medina&#44; Pilar Berrotar&#225;n-Ayub &#40;Anesthesia Department&#41;</p><p id="par2647" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Complejo Hospitalario Universitario Insular Materno Infantil de Gran Canaria</span></p><p id="par2648" class="elsevierStylePara elsevierViewall">Jos&#233; Val&#237;n-Mart&#237;nez<span class="elsevierStyleSup">1&#44;2</span>&#44; Laura Concepci&#243;n-Santana&#44; Ra&#250;l Cruz-Zorio&#44; Dolores Betancort-Guti&#233;rrez Rodr&#237;guez &#40;Anesthesia Department&#41;</p><p id="par2649" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Complexo Hospitalario Universitario de Ourense</span></p><p id="par2615" class="elsevierStylePara elsevierViewall">Leticia G&#243;mez-Viana<span class="elsevierStyleSup">1&#44;2</span>&#44; Olalla Figueiredo&#44; Ariadna Rodr&#237;guez&#44; Manuel Gonz&#225;lez &#40;Anesthesia Department&#41;&#59; David Iglesias&#44; Jos&#233; Manuel Dom&#237;nguez-Carrera &#40;Surgery Department&#41;&#59; Jorge do Olmo &#40;Adminisitrative support&#41;</p><p id="par2625" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Complexo Hospitalario Universitario de Santiago</span></p><p id="par2635" class="elsevierStylePara elsevierViewall">Sabela Del-R&#237;o-Fern&#225;ndez<span class="elsevierStyleSup">1&#44;2</span>&#44; Laura Dos-Santos-Carregal&#44; Mar&#237;a Jes&#250;s Rodr&#237;guez-Forja&#44; Olga Campa&#241;a-Figueira&#44; Juli&#225;n &#193;lvarez-Escudero &#40;Anesthesia Department&#41;&#59; Luc&#237;a Lesquereux-Mart&#237;nez&#44; Purificaci&#243;n Parada-Gonz&#225;lez&#44; Ricardo Montenegro-Romero&#44; Manuel Bustamante-Montalvo &#40;Surgery Department&#41;&#59; Ana Rosa Garc&#237;a-Plac&#237;n&#44; Carmen Carpintero-Rama&#44; Sergio Brea-Bahamonde &#40;Nursing Department&#41;</p><p id="par2655" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Fundaci&#243;n J&#237;menez D&#237;az</span></p><p id="par2665" class="elsevierStylePara elsevierViewall">Jos&#233; Ram&#243;n Torres-Alfonso<span class="elsevierStyleSup">1</span>&#44; Cristina Barrag&#225;n-Serrano<span class="elsevierStyleSup">1&#44;2</span>&#44; Mar&#237;a Posada-Gonz&#225;lez&#44; Gabriel Salcedo-Caba&#241;as&#44; Peter Vorwald-Wolfgang &#40;Surgery Department&#41;</p><p id="par2675" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Hospital &#193;lvaro Cunqueiro de Vigo &#40;Complejo Hospitalario Universitario de Vigo&#41;</span></p><p id="par2685" class="elsevierStylePara elsevierViewall">Isabel Otero-Mart&#237;nez<span class="elsevierStyleSup">1&#44;2</span>&#44; Patricia Jove-Albor&#233;s&#44; Marta L&#243;pez-Otero&#44; Hermelinda Pardellas-Rivera&#44; Ignacio Maruri-Chimeno&#44; Sonia Gonz&#225;lez-Fern&#225;ndez&#44; Raquel S&#225;nchez-Santos &#40;Surgery Department&#41;&#59; Luis Luna-Mendoza &#40;Anesthesia Department&#41;</p><p id="par2695" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Hospital Arnau de Vilanova&#44; Valencia</span></p><p id="par9995" class="elsevierStylePara elsevierViewall">Enrique Lloria-Pons<span class="elsevierStyleSup">1&#44;2</span>&#44; Francisco Gramuntell-Marco &#40;Anesthesia Department&#41;&#160;&#59; Ra&#250;l C&#225;novas-de-Lucas&#44; Cristina Sancho-Moya &#40;Surgery Department&#41;</p><p id="par2145" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Hospital Cl&#237;nic de Barcelona</span></p><p id="par2345" class="elsevierStylePara elsevierViewall">Raquel Risco<span class="elsevierStyleSup">1&#44;2</span>&#44; Anna Fern&#225;ndez-Esmerats&#44; Josep Mart&#237; Sanahuja-Blasco&#44; Manuel L&#243;pez-Baamonde&#44; Marta Ubr&#233;&#44; Graciela Mart&#237;nez-Pall&#237; &#40;Anesthesia Department&#41;&#59; Dulce Mombl&#225;n &#40;Surgery Department&#41;&#59; Nuria Rivas-Gallardo &#40;Nurse&#41;</p><p id="par2245" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Hospital Cl&#237;nico San Carlos</span></p><p id="par2445" class="elsevierStylePara elsevierViewall">Rub&#233;n S&#225;nchez-Mart&#237;n<span class="elsevierStyleSup">1&#44;2</span>&#44; Pedro Moral&#44; Rosal&#237;a Navarro&#44; Luis Sant&#233; &#40;Anesthesia Department&#41;&#59; Esther Almenta &#40;Surgery Department&#41;</p><p id="par2545" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Hospital Cl&#237;nico Universitario de Valladolid</span></p><p id="par2745" class="elsevierStylePara elsevierViewall">Henar Mu&#241;oz-Hern&#225;ndez<span class="elsevierStyleSup">1&#44;2</span>&#44; Rita Pilar Rodr&#237;guez-Jim&#233;nez&#44; Nuria Ruiz&#44; Mar&#237;a Teresa Pel&#225;ez&#44; Juan Jos&#233; Rojo&#44; Carlota Gordaliza &#40;Anesthesia Department&#41;&#59; Carlos Jezieniecki &#40;Surgery Department&#41;</p><p id="par2845" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Hospital Comarcal de Inca</span></p><p id="par5445" class="elsevierStylePara elsevierViewall">Carlos Jimenez-Vi&#241;as<span class="elsevierStyleSup">1&#44;2</span>&#44; Carlo Brugiotti&#44; Ulices Onchalos-Lopez &#40;Surgery Department&#41;</p><p id="par2945" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Hospital Costa del Sol&#44; Marbella &#40;M&#225;laga&#41;</span></p><p id="par7645" class="elsevierStylePara elsevierViewall">Manuel Ll&#225;cer-P&#233;rez<span class="elsevierStyleSup">1&#44;2</span> &#40;Anesthesia Department&#41;</p><p id="par5000" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Hospital de la Santa Creu i Sant Pau</span></p><p id="par5001" class="elsevierStylePara elsevierViewall">Astrid Batalla<span class="elsevierStyleSup">1&#44;2</span>&#44; Gonzalo Azparren&#44; Micaela Bastitta&#44; Luisa Cueva&#44; Mar Felipe&#44; Marta Gin&#233;&#44; Ana M&#46; G&#243;mez&#44; Inmaculada India&#44; Santiago Pi&#241;ol &#40;Anesthesia Department&#41;</p><p id="par5002" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Hospital de Sagunto</span></p><p id="par5103" class="elsevierStylePara elsevierViewall">Maria Jos&#233; Gimeno-Campos<span class="elsevierStyleSup">1&#44;2</span>&#44; Aurora Moreno-G&#225;zquez<span class="elsevierStyleSup">1</span>&#44; Julio Llorens-Herrer&#237;as&#44; Gema Del-Castillo-Rodrigo &#40;Anesthesia Department&#41;</p><p id="par5004" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Hospital General La Mancha Centro</span></p><p id="par5005" class="elsevierStylePara elsevierViewall">Mar&#237;a Luz Herrero-Bogajo &#40;Surgery Department&#41;</p><p id="par5006" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Hospital General Universitario de Castellon</span></p><p id="par5007" class="elsevierStylePara elsevierViewall">Mar&#237;a Isabel De Miguel-Cabrera<span class="elsevierStyleSup">1&#44;2</span>&#44; Jos&#233; Miguel Espa&#241;a-Pamplona&#44; Mar&#237;a Gellida-Vilarroig&#44; Laura Jord&#225;-Sanz &#40;Anesthesia Department&#41;</p><p id="par5008" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Hospital General Universitario de Ciudad Real</span></p><p id="par5009" class="elsevierStylePara elsevierViewall">Silvia Gil-Trujillo<span class="elsevierStyleSup">1&#44;2</span>&#44; Laura Calatayud-G&#243;mez&#44; Juan David Valencia-Echeverri&#44; V&#237;ctor Baladr&#243;n-Gonz&#225;lez &#40;Anesthesia Department&#41;&#59; Aurora Gil-Rendo<span class="elsevierStyleSup">1&#44;2</span>&#44; Susana Sanchez-Garc&#237;a&#44; Esther Garc&#237;a-Santos &#40;Surgery Department&#41;</p><p id="par5010" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Hospital General Universitario Gregorio Mara&#241;&#243;n&#160;de Madrid</span></p><p id="par5011" class="elsevierStylePara elsevierViewall">Carmen Benito<span class="elsevierStyleSup">1&#44;2</span>&#44; Cristina Lisbona&#44; Pilar Benito &#40;Anesthesia Department&#41;</p><p id="par5012" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Hospital General Universitario Santa Lucia</span></p><p id="par5013" class="elsevierStylePara elsevierViewall">Olga Cecilia Correa-Chac&#243;n<span class="elsevierStyleSup">1&#44;2</span>&#44; Alejandro Alc&#225;zar-Urrea&#44; Ana Bel&#233;n Fern&#225;ndez-L&#243;pez&#44; Ramiro Betancourt-Bastidas &#40;Anesthesia Department&#41;&#59; Inmaculada Navarro-Garc&#237;a&#44; Elena Romera-Barba &#40;Surgery Department&#41;</p><p id="par5014" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Hospital Joan XXIII de Tarragona</span></p><p id="par5015" class="elsevierStylePara elsevierViewall">Nuria Mira-Jovells<span class="elsevierStyleSup">1&#44;2</span>&#44; Liz Karime Estevez-Perez&#44; Judit Saludes-Serra &#40;Anesthesia Department&#41;&#59; Carles Olona-Casas<span class="elsevierStyleSup">2</span>&#44; Jordi Vadillo-Bargall&#243;&#46; Rosa Jorba-Mart&#237;n &#40;Surgery Department&#41;</p><p id="par5016" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Hospital Juan Ramon Jimenez&#44; Huelva</span></p><p id="par5017" class="elsevierStylePara elsevierViewall">Irene Mojarro<span class="elsevierStyleSup">1&#44;2</span>&#44; Juan Victor Lorente&#44; Pablo Longo-Guridi&#44; Ana Maria Quintero-Moreno&#44; David Soriano-L&#243;pez&#44; Maria de la Pe&#241;a G&#243;mez-Dominguez&#44; Cecilia Prieto-Candau&#44; Marisol Hern&#225;ndez-Castillo&#44; Irene Jarana&#44; Francisco Garc&#237;a-Andreu&#44; Jose Gonz&#225;lez-Gonz&#225;lez&#44; Mar&#237;a Dolores D&#237;az-Lara &#40;Anesthesia Department&#41;</p><p id="par5018" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Hospital Llu&#237;s Alcany&#237;s</span></p><p id="par5019" class="elsevierStylePara elsevierViewall">Elena A&#241;&#243;n-Iranzo&#44; Javier Aguil&#243;-Lucia &#40;Surgery Department&#41;</p><p id="par5020" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Hospital Medina del Campo</span></p><p id="par5021" class="elsevierStylePara elsevierViewall">Maria Teresa Fernandez-Martin<span class="elsevierStyleSup">1&#44;2</span>&#44; Yessica Guerra &#40;Anesthesia Department&#41;</p><p id="par5022" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Hospital Nuestra Se&#241;ora del Prado&#46; Talavera de la Reina</span></p><p id="par5023" class="elsevierStylePara elsevierViewall">Pablo Gimeno-Fern&#225;ndez<span class="elsevierStyleSup">1&#44;2</span>&#44; Carla Iglesias-Morales&#44; Ana Mar&#237;a R&#237;os Villalba &#40;Anesthesia Department&#41;</p><p id="par5024" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Hospital Povisa&#44; Vigo</span></p><p id="par5025" class="elsevierStylePara elsevierViewall">Paula Nespereira-Garc&#237;a<span class="elsevierStyleSup">1&#44;2</span>&#44; Mar&#237;a Jos&#233; Castro-Neira&#44; Mar&#237;a Ochoa-D&#237;ez &#40;Anesthesia Department&#41;</p><p id="par5026" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Hospital Sierrallana&#44; Torrelavega</span></p><p id="par5027" class="elsevierStylePara elsevierViewall">Silvia Garc&#237;a-Orallo&#160;&#40;Anesthesia Department&#41;&#59; Maialen Mozo-Segurado&#44;&#160;Jose Manuel Guti&#233;rrez-Cabezas<span class="elsevierStyleSup">1&#44;2</span>&#44; Ruben Gonzalo-Gonz&#225;lez&#160;&#40;Surgery Department&#41;</p><p id="par5028" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Hospital Universitario 12 de Octubre</span></p><p id="par5029" class="elsevierStylePara elsevierViewall">Raquel Garc&#237;a-&#193;lvarez<span class="elsevierStyleSup">1&#44;2</span>&#44; &#193;lvaro Ramiro-Ru&#237;z<span class="elsevierStyleSup">1&#44;2</span>&#44; Mar&#237;a Gonz&#225;lez-Cofrade&#44; Estefan&#237;a Carvajal-Revuelta&#44; Ana Bellido-L&#243;pez&#44; Guillermo Redondo-Crist&#243;bal &#40;Anesthesia Department&#41;&#59;</p><p id="par5030" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Hospital Universitario Central de Asturias</span></p><p id="par5031" class="elsevierStylePara elsevierViewall">Sonia Amoza-Pais<span class="elsevierStyleSup">1&#44;2</span>&#44; Tamara D&#237;az-Vico&#44; Mar&#237;a Moreno-Gij&#243;n&#44; Sandra Sanz-Navarro&#44; Lourdes M Sanz-&#193;lvarez&#44; Estrella Olga Turienzo-Santos&#44; Jose Luis Rodicio-Miravalles&#44; Amaya Rizzo-Ramos &#40;Surgery Department&#41;&#59; Ana Cu&#233;llar-Mart&#237;nez&#44; Rosa Ana &#193;lvarez-Fern&#225;ndez&#44; Carmen Fern&#225;ndez-Seijo&#44; Amelia &#193;lvarez-Barrial&#44; Carmen G&#243;nzalez-Ortea&#44; Silvia Fern&#225;ndez-Rodriguez&#44; Nerea Garc&#237;a-Gonz&#225;lez&#44; Lorena Varela-Rodriguez&#44; Elena Berzal-Canga&#44; &#193;ngela Garc&#237;a-D&#237;az-Negrete&#44; Helena Garc&#237;a-S&#225;nchez&#44; Javier Saenz-Abos&#44; Beatriz Ayuso-I&#241;igo&#44; Mar&#237;a Vega-Col&#243;n &#40;Anesthesia Department&#41;</p><p id="par5032" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Hospital Universitario Cl&#237;nico San Cecilio&#44; Granada</span></p><p id="par5033" class="elsevierStylePara elsevierViewall">&#193;ngela Catalina Palacios-C&#243;rdoba<span class="elsevierStyleSup">1</span>&#44; Mar&#237;a Teresa Quel-Collado<span class="elsevierStyleSup">2</span>&#44; Mercedes Olvera-Garc&#237;a&#44; Agustina Martinez-S&#225;nchez&#44; Carmen Serrano-Alvarez &#40;Anesthesia Department&#41;</p><p id="par5034" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Hospital Universitario Cruces</span></p><p id="par5035" class="elsevierStylePara elsevierViewall">Eunate Ganuza-Mart&#237;nez&#44; Mar&#237;a Jes&#250;s Maro&#241;o-Boedo<span class="elsevierStyleSup">2</span>&#44; Alberto S&#225;nchez-Campos&#44; Blanca Anuncia Escontrela-Rodr&#237;guez&#44; Alberto Mart&#237;nez-Ruiz<span class="elsevierStyleSup">1</span> &#40;Anesthesia Department&#41;&#59; Gaizka Errazti-Olartecoechea&#44; Iratxe Rode&#241;o-Esteban&#44; Tamara Moreno-Allende&#44; Oihane Gutierrez-Grijalba&#44; Yanina Kataryniuk-Di-Costanzo&#44; Irene Alvarez-Abad&#44; Patricia Sendino-Ca&#241;izares&#44; Patricia Mifsut-Porcel&#44; Aingeru Sarriugarte-Lasarte<span class="elsevierStyleSup">1</span>&#44; Mikel Guerra-Lerma &#40;Surgery Department&#41;</p><p id="par5036" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Hospital Universitario de &#193;lava</span></p><p id="par5037" class="elsevierStylePara elsevierViewall">Margarita Logro&#241;o-Ejea<span class="elsevierStyleSup">1&#44;2</span>&#44; Mar&#237;a Del Carmen Iturricastillo-P&#233;rez&#44; Mar&#237;a Gastaca-Abasolo</p><p id="par5999" class="elsevierStylePara elsevierViewall">Mar&#237;a Jos&#233; Mu&#241;oz-Sanz&#44; Ibai Iriarte-Zaranton&#44; Erika Olea-De-La-Fuente&#44; Ana Mendiguren-Murua &#40;Anesthesia Department&#41;&#59; Lorena Reka-Mediavilla&#44; Alberto Gast&#243;n-Moreno&#44; Gabriel Jes&#250;s Mart&#237;nez-De-Arag&#243;n-Remirez-De-Esparza&#44; Valent&#237;n Sierra-Esteban &#40;Surgery Department&#41;</p><p id="par5038" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Hospital Universitario de Badajoz</span></p><p id="par5039" class="elsevierStylePara elsevierViewall">Gema Montero-Mej&#237;as&#44; Claudia Pardo-Mart&#237;nez&#44; Teresa Valad&#233;s-Peria&#241;ez&#44; Ana Mar&#237;n-Moreno&#44; Juan Ricardo Caro-Gonz&#225;lez&#44; Mar&#237;a Jos&#233; Rodr&#237;guez- P&#233;rez<span class="elsevierStyleSup">1&#44;2</span> &#40;Anesthesia Department&#41;</p><p id="par5040" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Hospital Universitario de Basurto</span></p><p id="par5041" class="elsevierStylePara elsevierViewall">Jos&#233; Carlos Herrero-Herrero<span class="elsevierStyleSup">1&#44;2</span>&#44; Pablo Renedo-Corc&#243;stegui&#44; Alejandro Mart&#237;n-Oliva&#44; Ana Isabel Fern&#225;ndez-Herrero&#44; Nerea Andrieu-Estefan&#237;a &#40;Anesthesia Department&#41;</p><p id="par5042" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Hospital Universitario de Cabue&#241;es</span></p><p id="par5043" class="elsevierStylePara elsevierViewall">Javier Albaladejo-Magdalena&#44; Mar&#237;a &#193;lvarez-Rodriguez &#40;Anesthesia Department&#41;&#59; Valentina Sosa-Rodr&#237;guez&#44; Raquel Mar&#237;a Fresnedo-P&#233;rez &#40;Surgery Department&#41;</p><p id="par5044" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Hospital Universitario de Fuenlabrada</span></p><p id="par5045" class="elsevierStylePara elsevierViewall">Cristina Gil-Lapetra<span class="elsevierStyleSup">1&#44;2</span>&#44; Beatriz Bolzoni-Marciel&#44; Maria Isabel Herrera-L&#243;pez&#44; Fernando Seti&#233;n-Moreno&#44; Ana Zulema Castro-Costoya&#44; Jos&#233; Olarra-Nuel &#40;Anesthesia Department&#41;&#59; Marta De-Vega-Ira&#241;eta &#40;Surgery Department&#41;</p><p id="par5046" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Hospital Universitario de Galdakao</span></p><p id="par5047" class="elsevierStylePara elsevierViewall">Bakarne Ugarte-Sierra<span class="elsevierStyleSup">1&#44;2</span>&#44; Irune Vicente-Rodr&#237;guez&#44; Francisco Javier Fern&#225;ndez-Pablos&#44; Rafael Alberto Abad-Alonso&#44; Roberto Maniega-Alba&#44; Francisco Javier Ib&#225;&#241;ez-Aguirre &#40;Surgery Department&#41;&#59; Susana Postigo-Morales&#44; Karmelo Intxaurraga-Fern&#225;ndez&#44; Sorkunde Telletxea-Benguria &#40;Anesthesia Department&#41;&#59; &#193;ngela Out&#243;n-Guerrero &#40;Nurse&#41;</p><p id="par5048" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Hospital Universitario de Gran Canaria Dr&#46; Negr&#237;n</span></p><p id="par5049" class="elsevierStylePara elsevierViewall">Mar&#237;a Asunci&#243;n Acosta-M&#233;rida<span class="elsevierStyleSup">1&#44;2</span> &#40;Surgery Department&#41;</p><p id="par5050" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Hospital Universitario de Guadalajara</span></p><p id="par5051" class="elsevierStylePara elsevierViewall">Roberto de la Plaza-Llamas<span class="elsevierStyleSup">1&#44;2</span>&#44; Jos&#233; Manuel Garc&#237;a-Gil&#44; Ignacio Antonio Gemio-del-Rey &#40;Surgery Department&#41;&#59; Mercedes Cabellos-Olivares &#40;Anesthesia Department&#41;</p><p id="par5052" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Hospital Universitario de M&#243;stoles</span></p><p id="par5053" class="elsevierStylePara elsevierViewall">Raquel Fern&#225;ndez-Garc&#237;a<span class="elsevierStyleSup">1&#44;2</span>&#44; Lidia Castro Freitas&#44; Beatriz Nacarino Alcorta&#44; Mar&#237;a Mart&#237;n Ayuso &#40;Anesthesia Department&#41;&#59; Mar&#237;a Moral Gonz&#225;lez&#44; David Garc&#237;a Teruel &#40;Surgery Department&#41;</p><p id="par5054" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Hospital Universitario de Vic</span></p><p id="par5055" class="elsevierStylePara elsevierViewall">Jordi Serrat-Puyol<span class="elsevierStyleSup">1&#44;2</span> &#40;Anesthesia Department&#41;&#44; Joan Molinas-Bruguera&#44; Sara Fern&#225;ndez &#40;Surgery Department&#41;</p><p id="par5056" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Hospital Universitario Doctor Peset</span></p><p id="par5057" class="elsevierStylePara elsevierViewall">Nuria Peris-Tom&#225;s<span class="elsevierStyleSup">1&#44;2</span>&#44; Jose &#193;ngel D&#237;ez-Ares&#44; Dolores Peri&#225;&#241;ez-G&#243;mez&#44; Paula Gonz&#225;lvez-Guardiola&#44; Ram&#243;n Trullenque-Juan&#44; Ezequiel Mart&#237;nez-Mas &#40;Surgery Department&#41;&#59; Estefan&#237;a Mart&#237;nez&#44; Julia Mart&#237;n&#44; Raquel Higueras&#44; Sara Cuenca &#40;Anesthesia Department&#41;</p><p id="par5058" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Hospital Universitario Fundaci&#243;n de Alcorc&#243;n</span></p><p id="par5059" class="elsevierStylePara elsevierViewall">Beatriz Mart&#237;n-Vaquerizo<span class="elsevierStyleSup">1</span>&#44; Alma M&#46; Espinosa-Moreno<span class="elsevierStyleSup">1&#44;2</span>&#44; Miriam S&#225;nchez-Merchante&#44; Rebeca Alca&#241;iz-Sobrino&#44; Guillermo Egea-Hita&#44; Santiago Garc&#237;a-del-Valle-y-Manzano &#40;Anesthesia Department&#41;</p><p id="par5060" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Hospital Universitari i Polit&#232;cnic La Fe</span></p><p id="par5061" class="elsevierStylePara elsevierViewall">Virginia Moreno-Blanco<span class="elsevierStyleSup">1</span> &#40;Research Nurse&#41;&#59; Marcos Bruna-Esteban<span class="elsevierStyleSup">2</span>&#44; Fernando Mingol-Navarro&#44; Javier Vaqu&#233;-Urbaneja &#40;Surgery Department&#41;&#59; &#211;scar D&#237;az-Cambronero &#40;Anesthesia Department&#41;&#59; Beatriz Luj&#225;n-Sandemetrio&#44; Bisila Copariate-Piqueras&#44; Sonia Gim&#233;nez-Salcedo &#40;OR Nurse&#41;</p><p id="par5062" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Hospital Universitario Infanta Leonor</span></p><p id="par5063" class="elsevierStylePara elsevierViewall">Javier Ripolles-Melchor<span class="elsevierStyleSup">1</span>&#44; Ane Abad-Motos<span class="elsevierStyleSup">1&#44;2</span>&#44; Alfredo Abad-Gurumeta&#44; Norma Aracil-Escoda&#44; Elena Saez-Ruiz&#44; Rut Salvachua-Fernandez &#40;Anesthesia Department&#41;&#59; Gloria Paseiro-Crespo&#44; Mar&#237;a Garc&#237;a-Nebreda &#40;Surgery Department&#41;&#160;&#59; Bego&#241;a Toribio &#40;OR Nurse&#41;</p><p id="par5064" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Hospital Universitario Infanta Sof&#237;a</span></p><p id="par5065" class="elsevierStylePara elsevierViewall">Esther Ferrero-Celemin<span class="elsevierStyleSup">1&#44;2</span>&#44; Luis Garc&#237;a-Sancho-T&#233;llez&#44; Jos&#233; Daniel S&#225;nchez-L&#243;pez&#44; Sara N&#250;&#241;ez-O&#39;Sullivan&#44; Mariana Garc&#237;a-Virosta&#44; Carmen Rodriguez-Haro&#44; Mar&#237;a Hern&#225;ndez-O&#39;Reilly &#40;Surgery Department&#41;</p><p id="par5066" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Hospital Universitario La Paz</span></p><p id="par5067" class="elsevierStylePara elsevierViewall">Alejandro Suarez-de-la-Rica<span class="elsevierStyleSup">1&#44;2</span>&#44; Mercedes Lopez-Martinez&#44; Bryant Croes&#44; Jaime Mujica&#44; Emilio Maseda &#40;Anesthesia Department&#41;&#59;</p><p id="par5068" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Hospital Universitario La Princesa</span></p><p id="par5069" class="elsevierStylePara elsevierViewall">Enrique Alday-Mu&#241;oz<span class="elsevierStyleSup">1&#44;2</span>&#44; Esperanza Mata-Mena &#40;Anesthesia Department&#41;&#59; I&#241;igo Garc&#237;a-Sanz&#44;</p><p id="par5003" class="elsevierStylePara elsevierViewall">Cristina Mar&#237;n &#40;Surgery Department&#41;</p><p id="par5070" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Hospital Universitario La Zarzuela</span></p><p id="par5071" class="elsevierStylePara elsevierViewall">Antonio Pedraza Mu&#241;oz&#44; Jorge Puertas Dominguez &#40;Anesthesia Department&#41;</p><p id="par5072" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Hospital Universitario Lucus Augusti</span></p><p id="par5073" class="elsevierStylePara elsevierViewall">Roc&#237;o Gonz&#225;lez-L&#243;pez<span class="elsevierStyleSup">1&#44;2</span>&#44; Gisela Navarro-Quir&#243;s<span class="elsevierStyleSup">1&#44;2</span>&#44; M&#46; Isabel P&#233;rez-Moreiras&#44; Mar&#237;a Conde-Rodriguez&#44; Manuel Muinelo-Lorenzo &#40;Surgery Department&#41;</p><p id="par5074" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Hospital Universitario Marqu&#233;s de Valdecilla</span></p><p id="par5075" class="elsevierStylePara elsevierViewall">Miren Jasone D&#237;ez-Zapirain<span class="elsevierStyleSup">1&#44;2</span>&#44; Guillermo Tej&#243;n-P&#233;rez<span class="elsevierStyleSup">1</span>&#44; Mar&#237;a Asunci&#243;n &#193;lvarez-Cebri&#225;n&#44; Eva Barrero-Ruiz&#44; Eva Capa-Fuertes&#44; Mariana Carrillo-Rivas&#44; Isabel Hernandez-Sanchez&#44; Valvanuz Monteagudo-Cimiano&#44; &#193;ngela Pascual-Casado&#44; Jose Luis R&#225;bago-Morill&#243;n &#40;Anesthesia Department&#41;</p><p id="par5076" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Hospital Universitario Miguel Servet de Zaragoza</span></p><p id="par5077" class="elsevierStylePara elsevierViewall">Javier Martinez-Ubieto<span class="elsevierStyleSup">1</span>&#44; Ana Pascual-Bellosta<span class="elsevierStyleSup">1</span>&#44; Sonia Ortega-Lucea&#44; Berta Perez-Otal<span class="elsevierStyleSup">2</span>&#44; Lucia Tardos-Ascaso<span class="elsevierStyleSup">2</span> &#40;Anesthesia Department&#41;&#59; Luis Antonio Ligorred-Padilla &#40;Surgery Department&#41;</p><p id="par5078" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Hospital Universitari M&#250;tua Terrassa</span></p><p id="par5079" class="elsevierStylePara elsevierViewall">Jaume Tur-Mart&#237;nez<span class="elsevierStyleSup">1&#44;2</span>&#44; Joaquin Rodr&#237;guez-Santiago&#44; Noelia P&#233;rez-Romero&#44; Noelia Pu&#233;rtolas-Rico&#44; Laura Hern&#225;ndez-Gim&#233;nez &#40;Surgery Department&#41;</p><p id="par5080" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Hospital Universitario Nuestra Se&#241;ora de Candelaria</span></p><p id="par5081" class="elsevierStylePara elsevierViewall">Vanessa Concepci&#243;n-Mart&#237;n<span class="elsevierStyleSup">1&#44;2</span> &#40;Surgery Department&#41;</p><p id="par5082" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Hospital Universitario Puerta de Hierro&#44; Majadahonda</span></p><p id="par5083" class="elsevierStylePara elsevierViewall">Viktoria Molnar<span class="elsevierStyleSup">1&#44;2</span>&#44; Macarena Barbero&#44; Bel&#233;n San-Antonio &#40;Anesthesia Department&#41;&#59; Alberto Pueyo &#40;Surgery Department&#41;</p><p id="par5084" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Hospital Universitario Puerta del Mar</span></p><p id="par5085" class="elsevierStylePara elsevierViewall">M de los Angeles Mayo-Ossorio<span class="elsevierStyleSup">1&#44;2</span>&#44; Ander Bengoechea-Trujillo&#44; Jos&#233; Manuel Pacheco-Garcia &#40;Surgery Department&#41;</p><p id="par5086" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Hospital Universitario Ram&#243;n y Cajal</span></p><p id="par5087" class="elsevierStylePara elsevierViewall">Yolanda Diez-Remesal<span class="elsevierStyleSup">1&#44;2</span>&#44; Alba Gonzalo-Mill&#225;n&#44; Alberto Berruezo-Camacho&#44; Azucena Alaez-Cort&#233;s&#44; Bego&#241;a Ortol&#225;-Rocher&#44; Berta Iglesias-Gallego&#44; Eduardo Mart&#237;n-Montero&#44; Gerardo Arias-Cuesta&#44; In&#233;s de la Hoz-Polo&#44; Isabel Recuero-Torrijos&#44; Lucia Pereira-Torres&#44; Maria Ca&#241;amas-Catal&#225;&#44; Maria C&#46; Martin-Gonz&#225;lez&#44; Paloma Zambrana-Garc&#237;a&#44; Sergio Llorente -Damas</p><p id="par5088" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Hospital Universitario Rio Hortega</span></p><p id="par5089" class="elsevierStylePara elsevierViewall">Cesar Aldecoa<span class="elsevierStyleSup">1&#44;2</span>&#44; Alba Perez-Gonzalez&#44; Clara Bola&#241;o-Perez&#44; Delia Velasco-Andres&#44; Esther Aguado-Saster&#44; Irene Arranz&#44; Itziar Mendez-Torrubiano&#44; Laura Vaquero-Perez&#44; Maria Jesus Sanz-de-Leon&#44; Pablo Rodicio&#44; Silvia Martin-Alfonso&#44; David Martin-Tappi</p><p id="par5490" class="elsevierStylePara elsevierViewall">Mario Madrid-Tribano&#44; Rocio Rioja-Garrido&#44; Borja Morales-Jaquete &#40;Dept&#46; of Anesthesia&#41;</p><p id="par5090" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Hospital Universitario Severo Ochoa</span></p><p id="par5091" class="elsevierStylePara elsevierViewall">Marta Vicente-Orgaz<span class="elsevierStyleSup">1&#44;2</span>&#44; Adriana Carolina Orozco-Vinasco&#44; Gema Fraga-Casais&#59; Any Minerva Miyagi-Yonamine&#44; Raquel Ramos-de-Castro&#44; Rossel Alina Mej&#237;a-Arnaud&#44; Rub&#233;n Saz-Castro &#40;Anesthesia Department&#41;&#59; Patricia D&#237;az-Pe&#241;a &#40;Surgery Department&#41;</p><p id="par5092" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Hospital Universitario Vall d&#8217;Hebr&#243;n</span></p><p id="par5093" class="elsevierStylePara elsevierViewall">Angels Camps-Cervantes<span class="elsevierStyleSup">1</span>&#44; M Pilar Tormos-Perez&#44; Patricia Galan-Menendez<span class="elsevierStyleSup">1&#44;2</span>&#44; Elena Esclapez-Sampere&#44; Laura Villarino-Villa&#44; Yuri Loaiza-Alde&#225;n&#44; Ivette Chocron-Dapratt&#44; Olga Martinez-Silva&#44; Silvia Matarin-Olmo &#40;Surgery Department&#41;</p><p id="par5094" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Hospital Universitario Virgen Macarena</span></p><p id="par5095" class="elsevierStylePara elsevierViewall">H&#233;ctor Berges-Guti&#233;rrez<span class="elsevierStyleSup">1&#44;2</span>&#44; Macarena P&#233;rez-Serrano&#44; Juan Javier Diaz-Castillo&#44; &#193;lvaro Sancho-Mu&#241;oz-de-Verger&#44; Jes&#250;s Alejandro Villanueva-Mena-Bernal &#40;Anesthesia Department&#41;</p><p id="par5096" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Hospital Sant Joan Despi Moises Broggi</span></p><p id="par5097" class="elsevierStylePara elsevierViewall">Maria Lucia Gil-G&#243;mez<span class="elsevierStyleSup">1&#44;2</span>&#44; Jes&#250;s Fernanz-Anton<span class="elsevierStyleSup">2</span>&#44; Sandra Marma&#241;a-Mezquita &#40;Anesthesia Department&#41;&#59; Gonzalo Galofr&#233;-Pujol &#40;Surgery Department&#41;&#59; Carlos Jeric&#243; &#40;Internal Medicine Department&#46;&#41;</p><p id="par5098" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Hospital Virgen de los Lirios de Alcoy</span></p><p id="par5099" class="elsevierStylePara elsevierViewall">Jos&#233; Jacob Motos-Mic&#243;<span class="elsevierStyleSup">1&#44;2</span>&#44; Francisco Jos&#233; Orts-Mic&#243;<span class="elsevierStyleSup">1</span>&#44; Carlos Serra-D&#237;az&#44; Francisco Arlandis-F&#233;lix&#44; Nieves P&#233;rez-Climent &#40;Surgery Department&#41;&#59; Lorena Blanes-Pastor&#44; Jose Luis Jover-Pinillos &#40;Anesthesia Department&#41;</p><p id="par5100" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">MD Anderson Cancer Center Madrid</span></p><p id="par5101" class="elsevierStylePara elsevierViewall">David Salvaterra<span class="elsevierStyleSup">1&#44;2</span>&#44; Manuel Linero&#44; Javier Galipienzo &#40;Anesthesia Department&#41;&#59;</p><p id="par5102" class="elsevierStylePara elsevierViewall">&#211;scar Alonso&#44; Gloria Ortega&#44; Santiago Gonzalez&#44; Irene Lopez-Rojo &#40;Surgery Department&#41;&#59;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:14 [
        0 => array:3 [
          "identificador" => "xres2162345"
          "titulo" => "Graphical abstract"
          "secciones" => array:1 [
            0 => array:1 [
              "identificador" => "abst0005"
            ]
          ]
        ]
        1 => array:3 [
          "identificador" => "xres2162344"
          "titulo" => "Abstract"
          "secciones" => array:5 [
            0 => array:2 [
              "identificador" => "abst0010"
              "titulo" => "Introduction"
            ]
            1 => array:2 [
              "identificador" => "abst0015"
              "titulo" => "Methods"
            ]
            2 => array:2 [
              "identificador" => "abst0020"
              "titulo" => "Results"
            ]
            3 => array:2 [
              "identificador" => "abst0025"
              "titulo" => "Conclusions"
            ]
            4 => array:2 [
              "identificador" => "abst0030"
              "titulo" => "Trial Registration"
            ]
          ]
        ]
        2 => array:2 [
          "identificador" => "xpalclavsec1834461"
          "titulo" => "Keywords"
        ]
        3 => array:3 [
          "identificador" => "xres2162346"
          "titulo" => "Resumen"
          "secciones" => array:4 [
            0 => array:2 [
              "identificador" => "abst0035"
              "titulo" => "Introducci&#243;n"
            ]
            1 => array:2 [
              "identificador" => "abst0040"
              "titulo" => "M&#233;todos"
            ]
            2 => array:2 [
              "identificador" => "abst0045"
              "titulo" => "Resultados"
            ]
            3 => array:2 [
              "identificador" => "abst0050"
              "titulo" => "Conclusiones"
            ]
          ]
        ]
        4 => array:2 [
          "identificador" => "xpalclavsec1834462"
          "titulo" => "Palabras clave"
        ]
        5 => array:2 [
          "identificador" => "sec0005"
          "titulo" => "Introduction"
        ]
        6 => array:3 [
          "identificador" => "sec0010"
          "titulo" => "Methods"
          "secciones" => array:4 [
            0 => array:2 [
              "identificador" => "sec0015"
              "titulo" => "Study design and participants"
            ]
            1 => array:2 [
              "identificador" => "sec0020"
              "titulo" => "Procedures"
            ]
            2 => array:2 [
              "identificador" => "sec0025"
              "titulo" => "Outcomes"
            ]
            3 => array:2 [
              "identificador" => "sec0030"
              "titulo" => "Statistical analysis"
            ]
          ]
        ]
        7 => array:3 [
          "identificador" => "sec0035"
          "titulo" => "Results"
          "secciones" => array:6 [
            0 => array:2 [
              "identificador" => "sec0040"
              "titulo" => "Participants"
            ]
            1 => array:2 [
              "identificador" => "sec0045"
              "titulo" => "Outcomes in self-declared ERAS vs&#46; non-ERAS groups"
            ]
            2 => array:2 [
              "identificador" => "sec0050"
              "titulo" => "Adherence data"
            ]
            3 => array:2 [
              "identificador" => "sec0055"
              "titulo" => "Outcomes in higher versus lower ERAS adherence groups"
            ]
            4 => array:2 [
              "identificador" => "sec0060"
              "titulo" => "Individual ERAS elements&#44; patients characteristics and moderate-to-severe postoperative complications"
            ]
            5 => array:2 [
              "identificador" => "sec0065"
              "titulo" => "Individual ERAS elements and patients characteristics and LOS"
            ]
          ]
        ]
        8 => array:2 [
          "identificador" => "sec0070"
          "titulo" => "Discussion"
        ]
        9 => array:2 [
          "identificador" => "sec0075"
          "titulo" => "Funding"
        ]
        10 => array:2 [
          "identificador" => "sec0080"
          "titulo" => "COI&#47;Disclosures"
        ]
        11 => array:2 [
          "identificador" => "sec1080"
          "titulo" => "Appendix 1&#58; POWER 4 Investigators Group"
        ]
        12 => array:2 [
          "identificador" => "xack750440"
          "titulo" => "Acknowledgments"
        ]
        13 => array:1 [
          "titulo" => "References"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2022-12-27"
    "fechaAceptado" => "2023-02-21"
    "PalabrasClave" => array:2 [
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec1834461"
          "palabras" => array:6 [
            0 => "ERAS"
            1 => "gastric surgery"
            2 => "postoperative complications"
            3 => "perioperative management"
            4 => "optimization"
            5 => "enhanced recovery"
          ]
        ]
      ]
      "es" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palabras clave"
          "identificador" => "xpalclavsec1834462"
          "palabras" => array:5 [
            0 => "ERAS"
            1 => "cirug&#237;a g&#225;strica"
            2 => "complicaciones postoperatorias"
            3 => "manejo perioperatorio"
            4 => "recuperaci&#243;n intensificada"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "en" => array:3 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Introduction</span><p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">The effectiveness of the Enhanced Recovery After Surgery &#40;ERAS&#41; protocols in gastric cancer surgery remains controversial&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Methods</span><p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Multicentre prospective cohort study of adult patients undergoing surgery for gastric cancer&#46; Adherence with 22 individual components of ERAS pathways were assessed in all patients&#44; regardless of whether they were treated in a self-designed ERAS centre&#46; Each centre had a three-month recruitment period between October 2019 and September 2020&#46; The primary outcome was moderate-to-severe postoperative complications within 30 days after surgery&#46; Secondary outcomes were overall postoperative complications&#44; adherence to the ERAS pathway&#44; 30 day-mortality and hospital length of stay &#40;LOS&#41;&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Results</span><p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">A total of 743 patients in 72 Spanish hospitals were included&#44; 211 of them &#40;28&#46;4 &#37;&#41; from self-declared ERAS centres&#46; A total of 245 patients &#40;33 &#37;&#41; experienced postoperative complications&#44; graded as moderate-to-severe complications in 172 patients &#40;23&#46;1 &#37;&#41;&#46; There were no differences in the incidence of moderate-to-severe complications &#40;22&#46;3&#37; vs&#46; 23&#46;5&#37;&#59; OR&#44; 0&#46;92 &#40;95&#37; CI&#44; 0&#46;59 to 1&#46;41&#41;&#59; P&#8201;&#61;&#8201;0&#46;068&#41;&#44; or overall postoperative complications between the self-declared ERAS and non-ERAS groups &#40;33&#46;6&#37; vs&#46; 32&#46;7&#37;&#59; OR&#44; 1&#46;05 &#40;95 &#37; CI&#44; 0&#46;70 to 1&#46;56&#41;&#59; P&#8201;&#61;&#8201;0&#46;825&#41;&#46; The overall rate of adherence to the ERAS pathway was 52&#37; &#91;IQR 45 to 60&#93;&#46; There were no differences in postoperative outcomes between higher &#40;Q1&#44; &#62; 60 &#37;&#41; and lower &#40;Q4&#44; &#8804; 45 &#37;&#41; ERAS adherence quartiles&#46;</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Conclusions</span><p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">Neither the partial application of perioperative ERAS measures nor treatment in self-designated ERAS centres improved postoperative outcomes in patients undergoing gastric surgery for cancer&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Trial Registration</span><p id="spar0090" class="elsevierStyleSimplePara elsevierViewall">ClinicalTrials&#46;gov Identifier NCT03865810</p></span>"
        "secciones" => array:5 [
          0 => array:2 [
            "identificador" => "abst0010"
            "titulo" => "Introduction"
          ]
          1 => array:2 [
            "identificador" => "abst0015"
            "titulo" => "Methods"
          ]
          2 => array:2 [
            "identificador" => "abst0020"
            "titulo" => "Results"
          ]
          3 => array:2 [
            "identificador" => "abst0025"
            "titulo" => "Conclusions"
          ]
          4 => array:2 [
            "identificador" => "abst0030"
            "titulo" => "Trial Registration"
          ]
        ]
      ]
      "es" => array:3 [
        "titulo" => "Resumen"
        "resumen" => "<span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Introducci&#243;n</span><p id="spar0095" class="elsevierStyleSimplePara elsevierViewall">La efectividad de los protocolos de recuperaci&#243;n intensificada o ERAS en la cirug&#237;a del c&#225;ncer g&#225;strico sigue siendo controvertida&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">M&#233;todos</span><p id="spar0100" class="elsevierStyleSimplePara elsevierViewall">Estudio de cohortes prospectivo multic&#233;ntrico de pacientes intervenidos de c&#225;ncer g&#225;strico&#46; Se evalu&#243; la adherencia a 22 elementos ERAS en todos los pacientes&#44; independientemente de la existencia de un protocolo ERAS&#46; Cada centro tuvo un per&#237;odo de reclutamiento de tres meses&#44; con un seguimiento de 30 d&#237;as&#46; La medida de resultado primario fue el numero de complicaciones posoperatorias moderadas a graves&#46; Las medidas de resultado secundarias fueron el n&#250;mero total de complicaciones&#44; la adherencia a los elementos ERAS&#44; la mortalidad y la estancia&#46;</p></span> <span id="abst0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Resultados</span><p id="spar0105" class="elsevierStyleSimplePara elsevierViewall">Se incluyeron 743 pacientes en 72 hospitales&#44; 211 &#40;28&#44;4 &#37;&#41; en centros ERAS&#46; 245 pacientes &#40;33 &#37;&#41; experimentaron complicaciones posoperatorias&#44; moderadas o graves en 172 &#40;23&#44;1 &#37;&#41;&#46; No hubo diferencias en la incidencia de complicaciones moderadas a graves &#40;22&#44;3 &#37; vs&#46; 23&#44;5 &#37;&#59; OR&#44; 0&#44;92 &#40;IC 95 &#37;&#44; 0&#44;59 a 1&#44;41&#41;&#59; P&#8201;&#61;&#8201;0&#44;068&#41;&#44; o complicaciones posoperatorias totales entre los centros ERAS y no ERAS &#40;33&#44;6 &#37; vs&#46; 32&#44;7 &#37;&#59; OR&#44; 1&#44;05 &#40;IC 95 &#37;&#44; 0&#44;70 a 1&#44;56&#41;&#59; P&#8201;&#61;&#8201;0&#44;825&#41;&#46; La adherencia a los elementos ERAS fue del 52&#37; &#91;IQR 45 a 60&#93;&#46; No hubo diferencias entre los cuartiles de cumplimiento ERAS m&#225;s alto &#40;Q1&#44; &#62; 60 &#37;&#41; y m&#225;s bajo &#40;Q4&#44; &#8804; 45 &#37;&#41;&#46;</p></span> <span id="abst0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Conclusiones</span><p id="spar0110" class="elsevierStyleSimplePara elsevierViewall">Ni la aplicaci&#243;n parcial de medidas ERAS ni el tratamiento en centros ERAS mejoraron los resultados en pacientes sometidos a cirug&#237;a g&#225;strica por c&#225;ncer&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0035"
            "titulo" => "Introducci&#243;n"
          ]
          1 => array:2 [
            "identificador" => "abst0040"
            "titulo" => "M&#233;todos"
          ]
          2 => array:2 [
            "identificador" => "abst0045"
            "titulo" => "Resultados"
          ]
          3 => array:2 [
            "identificador" => "abst0050"
            "titulo" => "Conclusiones"
          ]
        ]
      ]
    ]
    "NotaPie" => array:2 [
      0 => array:3 [
        "etiqueta" => "1"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Current address&#58; Hospital Universitario Donostia&#44; Paseo Doctor Beguiristain s&#47;n&#46; 20014&#46; Donostia-San Sebasti&#225;n&#46; Spain</p>"
        "identificador" => "fn0005"
      ]
      1 => array:3 [
        "etiqueta" => "2"
        "nota" => "<p class="elsevierStyleNotepara" id="npar2005"><a class="elsevierStyleCrossRef" href="#sec1080">Appendix 1</a>&#58; POWER 4 Investigators Group&#46;</p>"
        "identificador" => "fn2005"
      ]
    ]
    "apendice" => array:1 [
      0 => array:1 [
        "seccion" => array:1 [
          0 => array:4 [
            "apendice" => "<p id="par0160" class="elsevierStylePara elsevierViewall">The following is Supplementary data to this article&#58;<elsevierMultimedia ident="upi0005"></elsevierMultimedia></p>"
            "etiqueta" => "Appendix A"
            "titulo" => "Supplementary data"
            "identificador" => "sec0090"
          ]
        ]
      ]
    ]
    "multimedia" => array:7 [
      0 => array:8 [
        "identificador" => "fig0005"
        "etiqueta" => "Fig&#46; 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 1690
            "Ancho" => 1667
            "Tamanyo" => 115722
          ]
        ]
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at0005"
            "detalle" => "Fig&#46; "
            "rol" => "short"
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">STROBE flow diagram for included patients&#46;</p>"
        ]
      ]
      1 => array:8 [
        "identificador" => "fig0010"
        "etiqueta" => "Fig&#46; 2"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr2.jpeg"
            "Alto" => 1843
            "Ancho" => 3341
            "Tamanyo" => 586566
          ]
        ]
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at0010"
            "detalle" => "Fig&#46; "
            "rol" => "short"
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Title&#58; Postoperative outcomes&#46; Complications in all included patients and in patients who did or did not receive the Enhanced Recovery After Surgery &#40;ERAS&#41; protocol&#46;</p> <p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Note&#46; Data are expressed as number &#40;&#37;&#41; or median &#40;Q1-Q3&#41;&#46;</p>"
        ]
      ]
      2 => array:8 [
        "identificador" => "fig0015"
        "etiqueta" => "Fig&#46; 3"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr3.jpeg"
            "Alto" => 2377
            "Ancho" => 3341
            "Tamanyo" => 686615
          ]
        ]
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at0015"
            "detalle" => "Fig&#46; "
            "rol" => "short"
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Title&#58; Postoperative outcomes and Enhanced Recovery After Surgery &#40;ERAS&#41; adherence&#46;</p> <p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Postoperative complications in all included patients depending on the quartile &#40;Q&#41; of adherence to the ERAS protocol&#46;</p> <p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Note&#46; Data are expressed as number &#40;&#37;&#41; or median &#40;Q1-Q3&#41;&#46;</p>"
        ]
      ]
      3 => array:8 [
        "identificador" => "tbl0005"
        "etiqueta" => "Table 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at0020"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">ASA&#58; American Society of Anesthesiology&#59; ERAS&#58; Enhanced recovery after surgery&#59; PBM&#58; Patient Blood Management&#46;</p><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Percentage reflects over non-missing sample size&#46; Discrete variables n &#40;&#37;&#41;&#46; Continuous variables Median&#91;Q1-Q3&#93;&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">All patients &#40;N&#8201;&#61;&#8201;743&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Self-declared ERAS &#40;N&#8201;&#61;&#8201;211&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Non-ERAS &#40;N&#8201;&#61;&#8201;532&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">P overall&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Age&#44; years&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">70 &#91;61-77&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">69 &#91;59-77&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">70 &#91;61-77&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;379&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Sex&#58; male&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">444 &#40;60&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">136 &#40;65&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">308 &#40;58&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;118&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">BMI&#44; kg&#47;m<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">25&#46;6 &#91;23 - 28&#46;7&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">26 &#91;23&#46;1 - 29&#46;2&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">25&#46;6 &#91;22&#46;9 - 28&#46;6&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;366&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">ASA physical status&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">I&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">27 &#40;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#40;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">19 &#40;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;111&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">II&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">353 &#40;48&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">110 &#40;52&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">243 &#40;46&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">III&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">336 &#40;45&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">82 &#40;39&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">254 &#40;48&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">IV&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">27 &#40;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11 &#40;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">16 &#40;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Smoking status&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Smoker&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">107 &#40;14&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">33 &#40;16&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">74 &#40;14&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;188&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Ex-smoker &#62; 1&#8201;year&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">207 &#40;28&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">61 &#40;29&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">146 &#40;27&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Ex-smoker &#60; 1&#8201;year&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">30 &#40;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13 &#40;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">17 &#40;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Rockwood Clinical Frailty Scale&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Score &#8804; 4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">656 &#40;88&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">190 &#40;90&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">466 &#40;88&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;417&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Score &#62; 4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">87 &#40;12&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">21 &#40;10&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">66 &#40;12&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hypertension&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">369 &#40;50&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">102 &#40;48&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">267 &#40;50&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;709&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Diabetes Mellitus&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">178 &#40;24&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">46 &#40;22&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">132 &#40;25&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;440&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Ischaemic heart disease&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">88 &#40;12&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">22 &#40;10&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">66 &#40;12&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;531&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Heart Failure&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">46 &#40;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13 &#40;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">33 &#40;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Stroke&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;0&#46;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0 &#40;0&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;0&#46;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Chronic obstructive pulmonary disease&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">103 &#40;14&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">31 &#40;15&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">72 &#40;14&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;769&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Chronic kidney disease&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">64 &#40;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">14 &#40;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">50 &#40;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;287&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Liver cirrhosis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11 &#40;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9 &#40;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;737&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Preoperative laboratory tests</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Haemoglobin &#40;g&#47;dl&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12&#46;4 &#91;11&#46;1- 13&#46;6&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12&#46;6 &#91;11&#46;2 -13&#46;7&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12&#46;4 &#91;11- 13&#46;5&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;264&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Creatinine &#40;mg&#47;dl&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;8 &#91;0&#46;7 - 0&#46;9&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;8 &#91;0&#46;7- 0&#46;9&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;8 &#91;0&#46;7- 1&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;872&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Albumin &#40;g&#47;dl&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#46;9 &#91;3&#46;5 - 4&#46;3&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#46;9 &#91;3&#46;4 - 4&#46;3&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#46;9 &#91;3&#46;5 - 4&#46;3&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;672&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">TNM staging&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">I A&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">120 &#40;16&#46;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">32 &#40;15&#46;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">88 &#40;16&#46;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;130&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">I B&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">102 &#40;14&#46;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">21 &#40;10&#46;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">81 &#40;15&#46;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">II A&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">128 &#40;17&#46;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">38 &#40;18&#46;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">90 &#40;17&#46;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">II B&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">112 &#40;15&#46;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">30 &#40;14&#46;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">82 &#40;15&#46;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">III A&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">114 &#40;15&#46;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">30 &#40;14&#46;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">84 &#40;16&#46;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">III B&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">73 &#40;10&#46;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">28 &#40;13&#46;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">45 &#40;8&#46;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">III C&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">21 &#40;2&#46;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10 &#40;4&#46;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11 &#40;2&#46;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">IV&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">56 &#40;7&#46;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">17 &#40;8&#46;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">39 &#40;7&#46;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Preoperative neoadjuvancy&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">292 &#40;39&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">106 &#40;50&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">186 &#40;36&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#46;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="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Surgical Procedure</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Subtotal Gastrectomy&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">472 &#40;64&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">123 &#40;58&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">349 &#40;66&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;065&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Total Gastrectomy&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">269 &#40;36&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">88 &#40;42&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">181 &#40;34&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Duration of surgery&#44; minutes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">235 &#91;180 - 300&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">245 &#91;188 - 300&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">215 &#91;170 - 270&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#46;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="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Intraoperative fluid balance&#44; ml&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">850 &#91;493 -1394&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">851 &#91;490 - 1369&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">850 &#91;495 -1437&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;777&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Centre with an established PBM protocol&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">444 &#40;60&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">171 &#40;81&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">273 &#40;51&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab3563201.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Patient characteristics&#46;</p>"
        ]
      ]
      4 => array:8 [
        "identificador" => "tbl0010"
        "etiqueta" => "Table 2"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at0025"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Percentage reflects over non-missing sample size&#46; Discrete variables n &#40;&#37;&#41;&#46;</p><p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Continuous variables Median &#91;Q1-Q3&#93;&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">All patients &#40;N&#8201;&#61;&#8201;743&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Self-declared ERAS &#40;N&#8201;&#61;&#8201;211&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Non-ERAS &#40;N&#8201;&#61;&#8201;532&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">P value&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">ERAS overall adherence&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">52 &#91;45 - 60&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">60 &#91;52 - 70&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">50 &#91;43 - 57&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#46;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="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Preadmission information&#44; education and counselling&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">145 &#40;19&#46;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">114 &#40;54&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">31 &#40;5&#46;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#46;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="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Preoperative exercise and prehabilitation&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">115 &#40;16&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">90 &#40;43&#46;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">25 &#40;4&#46;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#46;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="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Preoperative optimisation&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">15 &#40;14&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5 &#40;15&#46;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10 &#40;13&#46;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;773&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Preoperative nutrition&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">217 &#40;65&#46;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">79 &#40;79&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">138 &#40;59&#46;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;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="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Avoid bowel preparation&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">632 &#40;85&#46;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">188 &#40;89&#46;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">444 &#40;83&#46;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;053&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Preoperative fasting&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">281 &#40;37&#46;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">135 &#40;64&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">146 &#40;27&#46;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#46;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="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Preoperative carbohydrate loading&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">129 &#40;17&#46;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">86 &#40;40&#46;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">43 &#40;8&#46;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#46;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="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Avoid preoperative administration of immediate or long-acting sedatives&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">604 &#40;81&#46;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">162 &#40;76&#46;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">442 &#40;83&#46;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;053&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Perioperative fluid management&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">202 &#40;27&#46;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">64 &#40;30&#46;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">138 &#40;26&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;274&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Deep neuromuscular block&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">361 &#40;48&#46;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">88 &#40;41&#46;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">273 &#40;51&#46;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;018&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Anesthetic depth monitoring&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">699 &#40;94&#46;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">197 &#40;93&#46;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">502 &#40;94&#46;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;520&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Laparoscopic approach&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">415 &#40;55&#46;85&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">116 &#40;54&#46;98&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">299 &#40;56&#46;20&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;731&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Avoid nasogastric tube&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">446 &#40;60&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">160 &#40;75&#46;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">286 &#40;53&#46;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#46;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="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Avoid surgical drains&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">132 &#40;17&#46;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">38 &#40;18&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">94 &#40;17&#46;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;998&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Analgesia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">458 &#40;61&#46;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">179 &#40;84&#46;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">279 &#40;52&#46;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#46;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="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Antithrombotic prophylaxis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">713 &#40;96&#46;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">210 &#40;99&#46;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">503 &#40;94&#46;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;005&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Prevention of nausea and vomiting&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">717 &#40;96&#46;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">206 &#40;97&#46;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">511 &#40;96&#46;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;468&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Prevention of intraoperative hypothermia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">720 &#40;97&#46;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">208 &#40;98&#46;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">512 &#40;96&#46;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;269&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Postoperative nutrition&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">419 &#40;56&#46;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">113 &#40;53&#46;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">306 &#40;57&#46;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;368&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Postoperative glycaemic control&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">642 &#40;86&#46;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">185 &#40;87&#46;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">457 &#40;85&#46;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;604&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Early mobilization n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">439 &#40;60&#46;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">143 &#40;69&#46;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">296 &#40;56&#46;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;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="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Early feeding n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">51 &#40;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">22 &#40;10&#46;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">29 &#40;5&#46;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;022&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Time to oral intake &#40;hours&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">48 &#91;24 - 96&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">30 &#91;24 -72&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">72 &#91;25 - 120&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#46;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="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Time to mobilization &#40;hours&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">24 &#91;22 - 48&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">24 <a class="elsevierStyleCrossRefs" href="#bib0105"><span class="elsevierStyleSup">21&#8211;30</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">24 &#91;23 - 48&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab3563200.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Adherence to ERAS elements in self-declared ERAS and non-ERAS centres&#46;</p>"
        ]
      ]
      5 => array:5 [
        "identificador" => "upi0005"
        "tipo" => "MULTIMEDIAECOMPONENTE"
        "mostrarFloat" => false
        "mostrarDisplay" => true
        "Ecomponente" => array:2 [
          "fichero" => "mmc1.docx"
          "ficheroTamanyo" => 46053
        ]
      ]
      6 => array:5 [
        "identificador" => "fig0020"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => false
        "mostrarDisplay" => true
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "fx1.jpeg"
            "Alto" => 754
            "Ancho" => 1333
            "Tamanyo" => 89271
          ]
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:34 [
            0 => array:3 [
              "identificador" => "bib0005"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Global Cancer Statistics 2020&#58; GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "H&#46; Sung"
                            1 => "J&#46; Ferlay"
                            2 => "R&#46;L&#46; Siegel"
                            3 => "M&#46; Laversanne"
                            4 => "I&#46; Soerjomataram"
                            5 => "A&#46; Jemal"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3322/caac.21660"
                      "Revista" => array:6 [
                        "tituloSerie" => "CA Cancer J Clin&#46;"
                        "fecha" => "2021"
                        "volumen" => "71"
                        "paginaInicial" => "209"
                        "paginaFinal" => "249"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/33538338"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0010"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Morbidity and mortality associated with gastrectomy for gastric cancer"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "W&#46;A&#46; Papenfuss"
                            1 => "M&#46; Kukar"
                            2 => "J&#46; Oxenberg"
                            3 => "K&#46; Attwood"
                            4 => "S&#46; Nurkin"
                            5 => "U&#46; Malhotra"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1245/s10434-014-3664-z"
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Surg Oncol&#46;"
                        "fecha" => "2014"
                        "volumen" => "21"
                        "paginaInicial" => "3008"
                        "paginaFinal" => "3014"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24700300"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0015"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Post-operative complications of gastric cancer surgery&#58; female gender at high risk"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "B&#46;K&#46; Sah"
                            1 => "Z&#46;G&#46; Zhu"
                            2 => "X&#46;Y&#46; Wang"
                            3 => "Q&#46;M&#46; Yang"
                            4 => "M&#46;M&#46; Chen"
                            5 => "M&#46; Xiang"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1365-2354.2008.01036.x"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur J Cancer Care &#40;Engl&#41;&#46;"
                        "fecha" => "2009"
                        "volumen" => "18"
                        "paginaInicial" => "202"
                        "paginaFinal" => "208"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19267738"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0020"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Enhanced recovery after surgery a review"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "O&#46; Ljungqvist"
                            1 => "M&#46; Scott"
                            2 => "K&#46;C&#46; Fearon"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "JAMA Surg&#46;"
                        "fecha" => "2017"
                        "volumen" => "1"
                        "numero" => "152"
                        "paginaInicial" => "292"
                        "paginaFinal" => "298"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0025"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The History of Enhanced Recovery After Surgery and the ERAS Society"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "O&#46; Ljungqvist"
                            1 => "T&#46; Young-Fadok"
                            2 => "N&#46; Demartines"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1089/lap.2017.0350"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Laparoendosc Adv Surg Tech A&#46;"
                        "fecha" => "2017"
                        "volumen" => "27"
                        "paginaInicial" => "860"
                        "paginaFinal" => "862"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28795858"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0030"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Adherence to the enhanced recovery after surgery protocol and outcomes after colorectal cancer surgery"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "U&#46;O&#46; Gustafsson"
                            1 => "J&#46; Hausel"
                            2 => "A&#46; Thorell"
                            3 => "O&#46; Ljungqvist"
                            4 => "M&#46; Soop"
                            5 => "J&#46; Nygren"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1001/archsurg.2010.309"
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Surg&#46;"
                        "fecha" => "2011"
                        "volumen" => "146"
                        "paginaInicial" => "571"
                        "paginaFinal" => "577"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21242424"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0035"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Association between Use of Enhanced Recovery after Surgery Protocol and Postoperative Complications in Colorectal Surgery&#58; The Postoperative Outcomes Within Enhanced Recovery after Surgery Protocol &#40;POWER&#41; Study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46; Ripoll&#233;s-Melchor"
                            1 => "J&#46;M&#46; Ram&#237;rez-Rodr&#237;guez"
                            2 => "R&#46; Casans-Franc&#233;s"
                            3 => "C&#46; Aldecoa"
                            4 => "A&#46; Abad-Motos"
                            5 => "M&#46; Logro&#241;o-Egea"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "tituloSerie" => "JAMA Surg&#46;"
                        "fecha" => "2019"
                        "paginaInicial" => "1"
                        "paginaFinal" => "11"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0040"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Consensus guidelines for enhanced recovery after gastrectomy&#58; Enhanced Recovery After Surgery &#40;ERAS&#174;&#41; Society recommendations"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "K&#46; Mortensen"
                            1 => "M&#46; Nilsson"
                            2 => "K&#46; Slim"
                            3 => "M&#46; Sch&#228;fer"
                            4 => "C&#46; Mariette"
                            5 => "M&#46; Braga"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/bjs.9582"
                      "Revista" => array:6 [
                        "tituloSerie" => "Br J Surg&#46;"
                        "fecha" => "2014"
                        "volumen" => "101"
                        "paginaInicial" => "1209"
                        "paginaFinal" => "1229"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25047143"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0045"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The benefits of enhanced recovery after surgery for gastric cancer&#58; A large before-and-after propensity score matching study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "O&#46; Jeong"
                            1 => "A&#46; Jang"
                            2 => "M&#46;R&#46; Jung"
                            3 => "J&#46;H&#46; Kang"
                            4 => "S&#46;Y&#46; Ryu"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.clnu.2020.09.042"
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Nutr&#46;"
                        "fecha" => "2021"
                        "volumen" => "40"
                        "paginaInicial" => "2162"
                        "paginaFinal" => "2168"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/33069509"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0050"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Implementation of a fast-track perioperative care program&#58; what are the difficulties&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "S&#46;W&#46; Polle"
                            1 => "J&#46; Wind"
                            2 => "J&#46;W&#46; Fuhring"
                            3 => "J&#46; Hofland"
                            4 => "D&#46;J&#46; Gouma"
                            5 => "W&#46;A&#46; Bemelman"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1159/000108327"
                      "Revista" => array:6 [
                        "tituloSerie" => "Dig Surg&#46;"
                        "fecha" => "2007"
                        "volumen" => "24"
                        "paginaInicial" => "441"
                        "paginaFinal" => "449"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17851238"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0055"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Risk factors for acute kidney injury in an enhanced recovery pathway for colorectal surgery"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "A&#46; Zorrilla-Vaca"
                            1 => "G&#46;E&#46; Mena"
                            2 => "J&#46; Ripolles-Melchor"
                            3 => "J&#46;V&#46; Lorente"
                            4 => "J&#46;J&#46;M&#46; Ramirez-Rodriguez"
                            5 => "M&#46;C&#46; Grant"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s00595-020-02107-2"
                      "Revista" => array:6 [
                        "tituloSerie" => "Surg Today"
                        "fecha" => "2021"
                        "volumen" => "51"
                        "paginaInicial" => "537"
                        "paginaFinal" => "544"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32785846"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib0060"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Postoperative Outcomes Within an Enhanced Recovery after surgery protocol in gastric surgery for cancer &#40;POWER&#46;4&#41;&#58; Study protocol for a prospective&#44; multicentre&#44; observational cohort study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46; Abad-Motos"
                            1 => "J&#46; Ripoll&#233;s-Melchor"
                            2 => "M&#46; Bruna-Esteban"
                            3 => "C&#46; Ferrando-Ortol&#225;"
                            4 => "G&#46; Paseiro-Crespo"
                            5 => "A&#46; Abad-Gurumeta"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.redar.2019.10.004"
                      "Revista" => array:6 [
                        "tituloSerie" => "Rev Esp Anestesiol Reanim &#40;Engl Ed&#41;"
                        "fecha" => "2020"
                        "volumen" => "67"
                        "paginaInicial" => "130"
                        "paginaFinal" => "138"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31767197"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib0065"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The Strengthening the Reporting of Observational Studies in Epidemiology &#40;STROBE&#41; Statement&#58; guidelines for reporting observational studies"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "E&#46; von Elm"
                            1 => "D&#46;G&#46; Altman"
                            2 => "M&#46; Egger"
                            3 => "S&#46;J&#46; Pocock"
                            4 => "P&#46;C&#46; Gotzsche"
                            5 => "J&#46;P&#46; Vandenbroucke"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.ijsu.2014.07.013"
                      "Revista" => array:6 [
                        "tituloSerie" => "Int J Surg&#46;"
                        "fecha" => "2014"
                        "volumen" => "12"
                        "paginaInicial" => "1495"
                        "paginaFinal" => "1499"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25046131"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib0070"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The Reporting on ERAS Compliance&#44; Outcomes&#44; and Elements Research &#40;RECOvER&#41; Checklist&#58; A Joint Statement by the ERAS&#174; and ERAS&#174; USA Societies"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "K&#46;M&#46; Elias"
                            1 => "A&#46;B&#46; Stone"
                            2 => "K&#46; McGinigle"
                            3 => "J&#46;A&#46;I&#46; Tankou"
                            4 => "M&#46;J&#46; Scott"
                            5 => "W&#46;J&#46; Fawcett"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:3 [
                        "tituloSerie" => "World J Surg&#46;"
                        "fecha" => "2019"
                        "volumen" => "43"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib0075"
              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "Castor Electronic Data Capture&#46; Ciwit BV&#46; Amsterdam&#44; the Netherlands&#59; 2018&#46;"
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib0080"
              "etiqueta" => "16"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Standards for definitions and use of outcome measures for clinical effectiveness research in perioperative medicine&#58; European Perioperative Clinical Outcome &#40;EPCO&#41; definitions&#58; A statement from the ESA-ESICM joint taskforce on perioperative outcome measures"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "I&#46; Jammer"
                            1 => "N&#46; Wickboldt"
                            2 => "M&#46; Sander"
                            3 => "A&#46; Smith"
                            4 => "M&#46;J&#46; Schultz"
                            5 => "P&#46; Pelosi"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/EJA.0000000000000118"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur J Anaesthesiol&#46;"
                        "fecha" => "2015"
                        "volumen" => "32"
                        "paginaInicial" => "88"
                        "paginaFinal" => "105"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25058504"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib0085"
              "etiqueta" => "17"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Application of enhanced recovery after gastric cancer surgery&#58; An updated meta-analysis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "L&#46;-H&#46; Wang"
                            1 => "R&#46;-F&#46; Zhu"
                            2 => "C&#46; Gao"
                            3 => "S&#46;-L&#46; Wang"
                            4 => "L&#46;-Z&#46; Shen"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3748/wjg.v24.i14.1562"
                      "Revista" => array:6 [
                        "tituloSerie" => "World J Gastroenterol&#46;"
                        "fecha" => "2018"
                        "volumen" => "24"
                        "paginaInicial" => "1562"
                        "paginaFinal" => "1578"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29662294"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib0090"
              "etiqueta" => "18"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Implementation of a perioperative-enhanced recovery protocol in patients undergoing open gastrectomy for gastric cancer"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46;N&#46; Blumenthaler"
                            1 => "K&#46;A&#46; Robinson"
                            2 => "B&#46;C&#46; Kruse"
                            3 => "K&#46; Munder"
                            4 => "N&#46; Ikoma"
                            5 => "P&#46;F&#46; Mansfield"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/jso.26591"
                      "Revista" => array:2 [
                        "tituloSerie" => "J Surg Oncol"
                        "fecha" => "2021"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib0095"
              "etiqueta" => "19"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "ERAS protocol compliance impact on functional recovery in colorectal surgery"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46; Barbero"
                            1 => "J&#46; Garc&#237;a"
                            2 => "I&#46; Alonso"
                            3 => "L&#46; Alonso"
                            4 => "B San Antonio-San Rom&#225;n"
                            5 => "V Molnar"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.ciresp.2020.05.010"
                      "Revista" => array:6 [
                        "tituloSerie" => "Cir Esp&#46;"
                        "fecha" => "2021"
                        "volumen" => "99"
                        "paginaInicial" => "108"
                        "paginaFinal" => "114"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32564875"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib0100"
              "etiqueta" => "20"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "ERAS guidelines adherence and outcome correlation in colorectal surgery&#58; 100 patients experience"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "G&#46; Pernazza"
                            1 => "R&#46; Mancini"
                            2 => "P&#46; Marino"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Clinical Nutrition ESPEN"
                        "fecha" => "2019"
                        "volumen" => "31"
                        "paginaInicial" => "143"
                        "paginaFinal" => "144"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib0105"
              "etiqueta" => "21"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Short- and long-term outcomes associated with enhanced recovery after surgery protocol vs conventional management in patients undergoing laparoscopic gastrectomy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "Y&#46;-L&#46; Tian"
                            1 => "S&#46;-G&#46; Cao"
                            2 => "X&#46;-D&#46; Liu"
                            3 => "Z&#46;-Q&#46; Li"
                            4 => "G&#46; Liu"
                            5 => "X&#46;-Q&#46; Zhang"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3748/wjg.v26.i37.5646"
                      "Revista" => array:6 [
                        "tituloSerie" => "World J Gastroenterol&#46;"
                        "fecha" => "2020"
                        "volumen" => "26"
                        "paginaInicial" => "5646"
                        "paginaFinal" => "5660"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/33088158"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib0110"
              "etiqueta" => "22"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Usefulness of enhanced recovery after surgery protocol as compared with conventional perioperative care in gastric surgery"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "T&#46; Yamada"
                            1 => "T&#46; Hayashi"
                            2 => "H&#46; Cho"
                            3 => "T&#46; Yoshikawa"
                            4 => "H&#46; Taniguchi"
                            5 => "R&#46; Fukushima"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Gastric cancer Off J Int Gastric Cancer Assoc Japanese Gastric Cancer Assoc&#46;"
                        "fecha" => "2012"
                        "volumen" => "15"
                        "paginaInicial" => "34"
                        "paginaFinal" => "41"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            22 => array:3 [
              "identificador" => "bib0115"
              "etiqueta" => "23"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Enhanced Recovery after Surgery for Gastric Cancer Patients Improves Clinical Outcomes at a US Cancer Center"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46; Desiderio"
                            1 => "C&#46;L&#46; Stewart"
                            2 => "V&#46; Sun"
                            3 => "L&#46; Melstrom"
                            4 => "S&#46; Warner"
                            5 => "B&#46; Lee"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.5230/jgc.2018.18.e24"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Gastric Cancer&#46;"
                        "fecha" => "2018"
                        "volumen" => "18"
                        "paginaInicial" => "230"
                        "paginaFinal" => "241"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30276000"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            23 => array:3 [
              "identificador" => "bib0120"
              "etiqueta" => "24"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Association Between Use of Enhanced Recovery After Surgery Protocol and Postoperative Complications in Total Hip and Knee Arthroplasty in the Postoperative Outcomes Within Enhanced Recovery After Surgery Protocol in Elective Total Hip and Knee Arthroplasty Study &#40;POWER2&#41;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46; Ripoll&#233;s-Melchor"
                            1 => "A&#46; Abad-Motos"
                            2 => "Y&#46; D&#237;ez-Remesal"
                            3 => "M&#46; Aseguinolaza-Pagola"
                            4 => "L&#46; Padin-Barreiro"
                            5 => "R&#46; S&#225;nchez-Mart&#237;n"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "tituloSerie" => "JAMA Surg&#46;"
                        "fecha" => "2020"
                        "volumen" => "1"
                        "paginaInicial" => "155"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            24 => array:3 [
              "identificador" => "bib0125"
              "etiqueta" => "25"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "&#91;Enhanced recovery after surgery protocol versus conventional perioperative care in colorectal surgery&#46; A single center cohort study&#93;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J Ripoll&#233;s-Melchor"
                            1 => "Fuenmayor-Varela ML de"
                            2 => "SC Camargo"
                            3 => "PJ Fern&#225;ndez"
                            4 => "Barrio &#193;C Del"
                            5 => "E Mart&#237;nez-Hurtado"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Brazilian J Anesthesiol"
                        "fecha" => "2018"
                        "volumen" => "68"
                        "paginaInicial" => "358"
                        "paginaFinal" => "368"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            25 => array:3 [
              "identificador" => "bib0130"
              "etiqueta" => "26"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Modern perioperative medicine - past&#44; present&#44; and future"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "H&#46;F&#46; Dean"
                            1 => "F&#46; Carter"
                            2 => "N&#46;K&#46; Francis"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Innov Surg Sci&#46;"
                        "fecha" => "2019"
                        "volumen" => "5"
                        "numero" => "4"
                        "paginaInicial" => "123"
                        "paginaFinal" => "131"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            26 => array:3 [
              "identificador" => "bib0135"
              "etiqueta" => "27"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Enhanced Recovery after Surgery in the United States&#58; From Evidence-Based Practice to Uncertain Science&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "S&#46;G&#46; Memtsoudis"
                            1 => "J&#46; Poeran"
                            2 => "H&#46; Kehlet"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "JAMA - J Am Med Assoc&#46;"
                        "fecha" => "2019"
                        "volumen" => "321"
                        "paginaInicial" => "1049"
                        "paginaFinal" => "1050"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            27 => array:3 [
              "identificador" => "bib0140"
              "etiqueta" => "28"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Studying Enhanced Recovery After Surgery &#40;ERAS&#174;&#41; Core Items in Colorectal Surgery&#58; A Causal Model with Latent Variables"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "M&#46; Gemma"
                            1 => "F&#46; Pennoni"
                            2 => "M&#46; Braga"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s00268-020-05940-1"
                      "Revista" => array:6 [
                        "tituloSerie" => "World J Surg&#46;"
                        "fecha" => "2021"
                        "volumen" => "45"
                        "paginaInicial" => "928"
                        "paginaFinal" => "939"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/33575826"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            28 => array:3 [
              "identificador" => "bib0145"
              "etiqueta" => "29"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Deviation and failure of enhanced recovery after surgery following laparoscopic colorectal surgery&#58; early prediction model"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "N&#46;J&#46; Smart"
                            1 => "P&#46; White"
                            2 => "A&#46;S&#46; Allison"
                            3 => "J&#46;B&#46; Ockrim"
                            4 => "R&#46;H&#46; Kennedy"
                            5 => "N&#46;K&#46; Francis"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Color Dis Off J Assoc Coloproctology Gt Britain Irel&#46;"
                        "fecha" => "2012"
                        "volumen" => "14"
                        "paginaInicial" => "e727"
                        "paginaFinal" => "34"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            29 => array:3 [
              "identificador" => "bib0150"
              "etiqueta" => "30"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Effects of early oral feeding after radical total gastrectomy in gastric cancer patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "Y&#46;-X&#46; Lu"
                            1 => "Y&#46;-J&#46; Wang"
                            2 => "T&#46;-Y&#46; Xie"
                            3 => "S&#46; Li"
                            4 => "D&#46; Wu"
                            5 => "X&#46;-G&#46; Li"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3748/wjg.v26.i36.5508"
                      "Revista" => array:6 [
                        "tituloSerie" => "World J Gastroenterol&#46;"
                        "fecha" => "2020"
                        "volumen" => "26"
                        "paginaInicial" => "5508"
                        "paginaFinal" => "5519"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/33024401"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            30 => array:3 [
              "identificador" => "bib0155"
              "etiqueta" => "31"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Intolerance to early oral feeding in enhanced recovery after colorectal surgery&#58; an early red flag&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "K&#46; Slim"
                            1 => "T&#46; Reymond"
                            2 => "J&#46; Joris"
                            3 => "S&#46; Paul"
                            4 => "B&#46; Pereira"
                            5 => "E&#46; Cotte"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Color Dis Off J Assoc Coloproctology Gt Britain Irel&#46;"
                        "fecha" => "2020"
                        "volumen" => "22"
                        "paginaInicial" => "95"
                        "paginaFinal" => "101"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            31 => array:3 [
              "identificador" => "bib0160"
              "etiqueta" => "32"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Evolution of gastrectomy for cancer over 30-years&#58; Changes in presentation&#44; management&#44; and outcomes"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "S&#46;M&#46; Griffin"
                            1 => "S&#46;K&#46; Kamarajah"
                            2 => "M&#46; Navidi"
                            3 => "S&#46; Wahed"
                            4 => "A&#46; Immanuel"
                            5 => "N&#46; Hayes"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.surg.2021.01.040"
                      "Revista" => array:6 [
                        "tituloSerie" => "Surgery&#46;"
                        "fecha" => "2021"
                        "volumen" => "170"
                        "paginaInicial" => "2"
                        "paginaFinal" => "10"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/33674126"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            32 => array:3 [
              "identificador" => "bib0165"
              "etiqueta" => "33"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Goal directed hemodynamic therapy based in esophageal Doppler flow parameters&#58; A systematic review&#44; meta-analysis and trial sequential analysis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46; Ripolles-Melchor"
                            1 => "R&#46; Casans-Frances"
                            2 => "A&#46; Espinosa"
                            3 => "A&#46; Abad-Gurumeta"
                            4 => "A&#46; Feldheiser"
                            5 => "F&#46; Lopez-Timoneda"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.redar.2015.07.009"
                      "Revista" => array:6 [
                        "tituloSerie" => "Rev Esp Anestesiol Reanim&#46;"
                        "fecha" => "2016"
                        "volumen" => "63"
                        "paginaInicial" => "384"
                        "paginaFinal" => "405"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26873025"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            33 => array:3 [
              "identificador" => "bib0170"
              "etiqueta" => "34"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Perioperative goal-directed hemodynamic therapy in noncardiac surgery&#58; a systematic review and meta-analysis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46; Ripolles-Melchor"
                            1 => "A&#46; Espinosa"
                            2 => "E&#46; Martinez-Hurtado"
                            3 => "A&#46; Abad-Gurumeta"
                            4 => "R&#46; Casans-Frances"
                            5 => "C&#46; Fernandez-Perez"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jclinane.2015.08.004"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Clin Anesth&#46;"
                        "fecha" => "2016"
                        "volumen" => "28"
                        "paginaInicial" => "105"
                        "paginaFinal" => "115"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26440438"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
    "agradecimientos" => array:1 [
      0 => array:4 [
        "identificador" => "xack750440"
        "titulo" => "Acknowledgments"
        "texto" => "<p id="par0150" class="elsevierStylePara elsevierViewall">Javier Garc&#237;a-Fern&#225;ndez as President Elect of the Spanish Society of Anesthesiology and Critical Care &#40;SEDAR&#41;&#59; the Spanish Surgeons Association &#40;AEC&#41;&#44; and the European Society of Regional Anaesthesia and Pain Management-Spain &#40;ESRA Spain&#41; provided non compensated pre recruitment announcement of the study on their websites and social networks&#46; Alejandro Bona-Enguita &#40;GERM Secretary&#41; was the POWER 4 website webmaster&#46; Alberto Cebollada-Solanas provided statistical analysis&#46; No financial compensation was provided&#46;</p>"
        "vista" => "all"
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/21735077/0000010100000010/v2_202406091334/S217350772300100X/v2_202406091334/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "7443"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Original Article"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/21735077/0000010100000010/v2_202406091334/S217350772300100X/v2_202406091334/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S217350772300100X?idApp=UINPBA00004N"
]