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Mortalidad tras un episodio de insuficiencia cardiaca aguda en una cohorte de pacientes con función ventricular intermedia: análisis global y en relación con el lugar de ingreso
Mortality after an episode of acute heart failure in a cohort of patients with intermediate ventricular function: Global analysis and relationship with admission department
Òscar Miróa,b, Patricia Javaloyesc, Víctor Gila, Javier Jacobd, Pablo Herrero-Puentee, Francisco Javier Martín-Sánchezf,g, Eva Salvoh, Héctor Alonsoi, María Ángeles Juan Gómezj, John Parissisk, Pere Llorensc,l,
Autor para correspondencia
llorens@gva.es

Autor para correspondencia.
, en nombre del grupo de investigación ICA-SEMES ◊
a Grupo de investigación «Urgencias: Procesos y Patologías», Área de Urgencias, Hospital Clínic, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, España
b Departamento de Medicina, Facultad de Medicina, Universitat de Barcelona, Barcelona, España
c Unidad de Corta Estancia y Hospitalización a Domicilio, Servicio de Urgencias, Hospital General Universitario de Alicante, Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL)-Fundación FISABIO, Alicante, España
d Servicio de Urgencias, Hospital Universitario de Bellvitge, L’Hospitalet de Llobregat, Barcelona, España
e Servicio de Urgencias, Hospital Universitario Central de Asturias, Instituto de Investigación Sanitaria del Principado de Asturias (IISPA), Oviedo, Asturias, España
f Servicio de Urgencias, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, España
g Facultad de Medicina, Universidad Complutense de Madrid, Madrid, España
h Servicio de Urgencias, Hospital La Fe, Valencia, España
i Servicio de Urgencias, Hospital Marqués de Valdecilla, Santander, España
j Servicio de Urgencias, Hospital Doctor Peset, Valencia, España
k Heart Failure Unit, Department of Cardiology, Attikon University Hospital, Athens, Grecia
l Departamento de Medicina Clínica, Universidad Miguel Hernández, Elche, Alicante, España
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          "es" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Supervivencia a un a&#241;o en funci&#243;n de la fracci&#243;n de eyecci&#243;n del ventr&#237;culo izquierdo&#46; An&#225;lisis bruto &#40;izquierda&#41; y ajustado por 30 covariables &#40;derecha&#41;&#46;</p> <p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">HR&#58; <span class="elsevierStyleItalic">hazard ratio&#59;</span> ICFEc&#58; insuficiencia cardiaca con fracci&#243;n de eyecci&#243;n conservada&#59; ICFEd&#58; insuficiencia cardiaca con fracci&#243;n de eyecci&#243;n deprimida&#59; ICFEi&#58; insuficiencia cardiaca con fracci&#243;n de eyecci&#243;n intermedia&#46;</p>"
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introducci&#243;n</span><p id="par0005" class="elsevierStylePara elsevierViewall">La fracci&#243;n de eyecci&#243;n del ventr&#237;culo izquierdo &#40;FEVI&#41; es uno de los elementos principales que permite clasificar a los pacientes con insuficiencia cardiaca &#40;IC&#41;&#46; Cl&#225;sicamente&#44; este par&#225;metro separa a los pacientes con este s&#237;ndrome entre aquellos que presentan una FEVI normal o conservada &#40;&#8805;<span class="elsevierStyleHsp" style=""></span>50&#37;&#41;&#44; y que se identifican como IC con FEVI conservada &#40;ICFEc&#41;&#44; y los que la tienen reducida &#40;&#60;<span class="elsevierStyleHsp" style=""></span>50&#37;&#41;&#44; identificados como IC con FEVI deprimida &#40;ICFEd&#41;&#46; Esta clasificaci&#243;n permite hacer distingos importantes en t&#233;rminos etiol&#243;gicos&#44; cl&#237;nicos&#44; terap&#233;uticos y pron&#243;sticos<a class="elsevierStyleCrossRefs" href="#bib0160"><span class="elsevierStyleSup">1&#44;2</span></a>&#46; Sin embargo&#44; el punto frontera entre ambas categor&#237;as no est&#225; del todo claro&#44; como lo refleja el hecho de que los ensayos cl&#237;nicos en ICFEd hayan utilizado puntos de corte de la FEVI por debajo del 40&#37; o incluso del 35&#37;&#44; en tanto que en los ensayos cl&#237;nicos de ICFEc el punto de corte ha fluctuado entre el 40 y el 50&#37;<a class="elsevierStyleCrossRefs" href="#bib0315"><span class="elsevierStyleSup">3&#44;4</span></a>&#46; Probablemente en parte por ello&#44; la Sociedad Europea de Cardiolog&#237;a ha definido una nueva categor&#237;a en sus &#250;ltimas gu&#237;as de IC&#44; denominada IC con FEVI intermedia &#40;ICFEi&#41;&#44; que incluye a los pacientes que presentan una FEVI entre un 40 y un 49&#37;<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">5</span></a>&#46; Sin embargo&#44; se desconoce si esta nueva categor&#237;a de IC presenta un comportamiento evolutivo diferenciado de las 2 categor&#237;as cl&#225;sicas &#40;ICFEd y ICFEc&#41; o si puede aportar valor en los pacientes que presentan un episodio de descompensaci&#243;n &#40;IC aguda &#91;ICA&#93;&#41;&#46; Tampoco es conocido cu&#225;l es el principal destino de estos pacientes tras su asistencia en Urgencias&#46; Se sabe que&#44; en el caso de las ICFEc e ICFEd&#44; su distribuci&#243;n entre las diferentes opciones de hospitalizaci&#243;n no es homog&#233;nea&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">El Registro <span class="elsevierStyleItalic">Epidemiology of Acute Heart Failure in Emergency Departments</span> &#40;EAHFE&#41; est&#225; formado por una base de datos de pacientes con ICA&#44; incluidos consecutivamente en 41 servicios de urgencias hospitalarios &#40;SUH&#41; espa&#241;oles&#46; Dado que contiene tanto a los pacientes que ingresan en cualquier servicio del hospital como a los que son dados de alta directamente desde Urgencias&#44; se trata de una cohorte bastante cercana al universo de pacientes con ICA&#44; ya que la mayor&#237;a de los descompensados acaban consultando en un SUH<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">6</span></a>&#46; El objetivo del presente estudio fue comparar las caracter&#237;sticas evolutivas de los pacientes con ICFEi que presentan un episodio de ICA respecto a los pacientes con ICFEd y ICFEc mediante el an&#225;lisis secundario del Registro EAHFE&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">M&#233;todo</span><p id="par0015" class="elsevierStylePara elsevierViewall">El Registro EAHFE es una cohorte multiprop&#243;sito de car&#225;cter anal&#237;tico no intervencionista&#44; multic&#233;ntrica&#44; con un seguimiento prospectivo&#44; que incluye pacientes diagnosticados de ICA en SUH&#46; Hasta la fecha ha completado 5 fases de inclusi&#243;n &#40;2007&#44; 2009&#44; 2011&#44; 2014 y 2016&#41;&#44; han participado 41 SUH y ha incluido a 13&#46;793 pacientes diferentes&#46; La sistem&#225;tica de inclusi&#243;n de pacientes en el Registro EAHFE y las variables recogidas han sido descritas extensamente en trabajos anteriores<a class="elsevierStyleCrossRefs" href="#bib0185"><span class="elsevierStyleSup">6&#44;7</span></a>&#46; Los criterios diagn&#243;sticos se basan en los criterios de Framingham<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">8</span></a>&#44; junto con los de las gu&#237;as de la ESC disponibles en el momento de la inclusi&#243;n de los pacientes<a class="elsevierStyleCrossRefs" href="#bib0180"><span class="elsevierStyleSup">5&#44;8</span></a>&#44; y&#44; siempre que es posible&#44; se complementan con datos de p&#233;ptidos natriur&#233;ticos y estudios ecocardiogr&#225;ficos realizados en Urgencias o durante el ingreso del paciente&#46; El Registro EAHFE &#250;nicamente excluye a los pacientes con infarto agudo de miocardio con elevaci&#243;n del ST como diagn&#243;stico principal y que concomitantemente desarrollen una ICA&#44; puesto que siguen un circuito asistencial diferenciado que con frecuencia omite el paso por Urgencias&#46; El Registro no contempla intervenci&#243;n alguna en el paciente&#44; el cual es manejado enteramente a criterio de los m&#233;dicos asistenciales de Urgencias&#44; tanto por lo que respecta al tratamiento como a la decisi&#243;n de su destino tras la asistencia &#40;ingreso o alta a domicilio&#41;&#46; La &#250;nica sistem&#225;tica com&#250;n entre los centros es que los m&#233;dicos siguen en general el consenso acordado entre las sociedades de cardiolog&#237;a&#44; medicina interna y urgencias y emergencias<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">9</span></a>&#44; el cual es distribuido y comentado a todos los m&#233;dicos asistenciales de Urgencias una semana antes de iniciar la selecci&#243;n&#46; El Registro EAHFE cumple con la Declaraci&#243;n de Helsinki y todos los pacientes firman el consentimiento informado para formar parte del Registro&#46; El protocolo fue aprobado por el Comit&#233; de &#201;tica en Investigaci&#243;n Cl&#237;nica del Hospital Universitario Central de Asturias &#40;Oviedo&#41;&#44; con los n&#250;meros de protocolo 49&#47;2010&#44; 69&#47;2011&#44; 166&#47;13 y 160&#47;15&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">El estudio se plante&#243; como un an&#225;lisis secundario del Registro EAHFE que incluy&#243; a los pacientes de los que ya se dispon&#237;a de seguimiento al a&#241;o en el momento del an&#225;lisis &#40;pacientes incluidos en las fases 1&#44; 2&#44; 3 y 4 del Registro&#44; realizadas en 2007&#44; 2009&#44; 2011 y 2014&#41; y de los que se dispusiese de un estudio ecogr&#225;fico realizado durante el ingreso o durante los 6 meses anteriores en el que se estimase la FEVI&#46; La muestra se dividi&#243; en 3 grupos en funci&#243;n de dicha FEVI&#44; que fue la variable clasificadora&#58; ICFEd &#40;FEVI<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>40&#37;&#41;&#44; 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clase funcional de la disnea seg&#250;n la clasificaci&#243;n de la NYHA&#41;&#44; 5 referentes al tratamiento cr&#243;nico habitual en el domicilio &#40;diur&#233;ticos&#44; inhibidores de la enzima conversiva de la angiotensina o antagonistas del receptor de la angiotensina <span class="elsevierStyleSmallCaps">ii</span>&#44; betabloqueantes&#44; bloqueantes del receptor de la aldosterona &#91;BRA&#93;&#44; digoxina&#41;&#44; 3 referentes a la situaci&#243;n en Urgencias &#40;presi&#243;n arterial sist&#243;lica&#44; frecuencia cardiaca&#44; saturaci&#243;n arterial basal de ox&#237;geno de la hemoglobina&#41;&#44; 7 anal&#237;ticas &#40;hematocrito&#44; tasa de filtrado glomerular estimada&#44; sodio&#44; potasio&#44; troponina&#44; BNP y NT-proBNP&#41;&#44; 3 electrocardiogr&#225;ficas &#40;fibrilaci&#243;n auricular&#44; bloqueo completo de rama izquierda del haz de His e hipertrofia ventricular izquierda&#41; y 4 de tratamiento en Urgencias &#40;uso de diur&#233;ticos intravenosos&#44; nitroglicerina intravenosa&#44; inotropos o vasopresores y ventilaci&#243;n no invasiva&#41;&#46; La variable principal de resultado del estudio fue la mortalidad por cualquier causa a un a&#241;o&#44; la cual se verific&#243; mediante llamada telef&#243;nica al paciente y consulta de la historia cl&#237;nica del hospital y de atenci&#243;n primaria&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">Las variables fueron expresadas como valores absolutos y relativos si eran categ&#243;ricas y como media y desviaci&#243;n est&#225;ndar si eran continuas&#46; En el caso de no seguir una distribuci&#243;n normal&#44; lo cual se comprob&#243; mediante el test de Kolmogorov-Smirnov&#44; las variables continuas se expresaron como mediana y percentiles 25 y 75&#46; Se realiz&#243; un estudio univariante para detectar diferencias en las variables independientes entre los 3 grupos de pacientes &#40;ICFEd&#44; ICFEi y ICFEc&#41; utilizando el test de ji cuadrado para contrastar las variables categ&#243;ricas y ANOVA de una v&#237;a para muestras independientes para las continuas &#40;o el test no param&#233;trico de Kruskal-Wallis en caso de distribuci&#243;n no normal&#41;&#46; Para el an&#225;lisis de supervivencia se utilizaron curvas de supervivencia de Kaplan-Meier truncadas a un a&#241;o&#44; se elaboraron tablas de supervivencia y se contrast&#243; la diferencia entre curvas mediante el estad&#237;stico de log-rank&#46; Posteriormente&#44; mediante el m&#233;todo de regresi&#243;n de Cox se calcularon las <span class="elsevierStyleItalic">hazard ratio</span> &#40;HR&#41; con su intervalo de confianza del 95&#37; &#40;IC 95&#37;&#41; para los pacientes con ICFEi respecto a los pacientes con ICFEd y con ICFEc&#44; tanto brutas como ajustadas por aquellas variables que resultaron con una distribuci&#243;n estad&#237;sticamente diferente entre los grupos en el estudio univariable&#46; Los valores perdidos se sustituyeron por la mediana si las variables eran continuas y por la moda si eran categ&#243;ricas&#44; previa comprobaci&#243;n de la inexistencia de un patr&#243;n de p&#233;rdida&#46; Adem&#225;s&#44; se repiti&#243; el an&#225;lisis de supervivencia estratificado por los 4 principales destinos de los pacientes una vez finalizada la asistencia urgente&#58; Cardiolog&#237;a&#44; Medicina Interna&#44; Unidad de Corta Estancia o alta directa a domicilio&#46; Se consideraron las diferencias estad&#237;sticamente significativas cuando el valor de p fue inferior a 0&#44;05 o cuando el IC 95&#37; de la HR exclu&#237;a el valor 1&#46; Para todos los c&#225;lculos se utiliz&#243; el programa estad&#237;stico SPSS de IBM &#40;Armonk&#44; North Castle&#44; Nueva York&#44; EE&#46; UU&#46;&#41;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Resultados</span><p id="par0030" class="elsevierStylePara elsevierViewall">De los 9&#46;078 pacientes incluidos en el Registro EAHFE en sus fases 1&#44; 2&#44; 3 y 4&#44; se dispon&#237;a de la FEVI en 3&#46;958 &#40;43&#44;6&#37;&#41;&#46; De ellos&#44; 580 &#40;14&#44;6&#37;&#41; se clasificaron como ICFEi &#40;FEVI media 43&#91;3&#37;&#93;&#41;&#44; mientras que el resto se repartieron en 929 &#40;23&#44;5&#37;&#41; con ICFEd &#40;FEVI media 29&#91;6&#93;&#37;&#41; y 2&#46;449 &#40;61&#44;9&#37;&#41; con ICFEc &#40;FEVI media 61&#91;8&#93;&#37;&#41;&#46; Globalmente&#44; la cohorte incluye una poblaci&#243;n a&#241;osa &#40;edad media 79 a&#241;os&#41;&#44; con elevada comorbilidad&#44; y que antes de ser atendidos en el SUH y en situaci&#243;n de estabilidad cl&#237;nica&#44; un 22&#37; presenta alg&#250;n grado de d&#233;ficit funcional y un 27&#37; de los pacientes presentaba una clase funcional <span class="elsevierStyleSmallCaps">iii</span>-<span class="elsevierStyleSmallCaps">iv</span> de la clasificaci&#243;n de la NYHA&#46; Adem&#225;s&#44; como puede apreciarse en la <a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a>&#44; los 3 grupos de pacientes difirieron en 30 de las 38 variables recogidas&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0035" class="elsevierStylePara elsevierViewall">La mortalidad acumulada a 30 d&#237;as y a 3&#44; 6 y 12 meses para toda la cohorte fue del 8&#44;4&#44; 15&#44;5&#44; 21&#44;5 y 28&#44;5&#37;&#44; respectivamente&#46; Globalmente&#44; se observaron diferencias significativas entre los 3 grupos de pacientes &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;016&#41;&#44; con una mortalidad mayor en el grupo de ICFEd &#40;<a class="elsevierStyleCrossRef" href="#fig0005">fig&#46; 1</a>&#41;&#46; Cuando se analiz&#243; espec&#237;ficamente el grupo de ICFEi&#44; se vio que estos pacientes ten&#237;an una mortalidad muy similar a la del grupo de ICFEc &#40;HR 1&#44;009&#59; IC 95&#37; 0&#44;819-1&#44;243&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;933&#41;&#44; y menor que la del grupo de ICFEd &#40;HR 0&#44;800&#59; IC 95&#37; 0&#44;635-1&#44;008&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;058&#41;&#46; Al ajustar las HR por las variables discordantes entre los grupos&#44; tampoco se encontraron diferencias de mortalidad significativas para el grupo de ICFEi respecto al grupo de ICFEc &#40;HRa 1&#44;025&#59; IC 95&#37; 0&#44;825-1&#44;275&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;821&#41; o al grupo de ICFEd &#40;HRa 0&#44;924&#59; IC 95&#37; 0&#44;720-1&#44;186&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;535&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0005">fig&#46; 1</a>&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0040" class="elsevierStylePara elsevierViewall">El destino de los pacientes tras su atenci&#243;n en Urgencias se recoge en la <a class="elsevierStyleCrossRef" href="#tbl0010">tabla 2</a>&#46; El 23&#44;3&#37; fueron dados de alta directamente desde Urgencias sin ingreso&#44; y los principales servicios de hospitalizaci&#243;n fueron Medicina Interna &#40;31&#44;0&#37;&#41;&#44; Cardiolog&#237;a &#40;20&#44;1&#37;&#41; y unidades de corta estancia &#40;12&#44;4&#37;&#41;&#46; Estos 4 destinos recogen el 86&#44;8&#37; de todos los pacientes&#46; Los pacientes con ICFEd ingresaron con mayor frecuencia en Cardiolog&#237;a&#44; mientras que los pacientes con ICFEc ingresaron con mayor frecuencia en Geriatr&#237;a y con menor frecuencia en unidades de cuidados intensivos o coronarios&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0045" class="elsevierStylePara elsevierViewall">Las caracter&#237;sticas cl&#237;nicas de los pacientes en funci&#243;n de los 4 destinos m&#225;s frecuentes tras la asistencia en Urgencias &#40;Medicina Interna&#44; Cardiolog&#237;a&#44; Corta Estancia o alta directa&#41; fueron claramente diferentes y difirieron en 32 de las 38 variables estudiadas &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">tabla 3</a>&#41;&#44; as&#237; como la mortalidad acumulada observada en cada uno de ellos &#40;<a class="elsevierStyleCrossRef" href="#fig0010">fig&#46; 2</a>&#41;&#46; Cuando se compar&#243; la mortalidad acumulada bruta a un a&#241;o de los pacientes en funci&#243;n de la FEVI de forma estratificada por estos 4 destinos&#44; los pacientes con ICFEi no mostraron diferencias con los otros 2 grupos cuando ingresaron en Medicina Interna&#44; Corta Estancia o fueron dados de alta directamente desde Urgencias&#44; mientras que para los ingresados en Cardiolog&#237;a se observ&#243; que ten&#237;an una mortalidad significativamente menor a la de los pacientes con ICFEd &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;02&#41; y similar a los que ten&#237;an una ICFEc &#40;<a class="elsevierStyleCrossRef" href="#fig0010">fig&#46; 2</a>&#41;&#46; Sin embargo&#44; cuando se ajustaron por las diferencias cl&#237;nicas entre estos 3 grupos de pacientes &#40;ICFEc&#44; ICFEi e ICFEd&#41; no se observaron diferencias significativas en ninguna de las comparaciones&#44; independientemente del destino posterior tras la asistencia en Urgencias &#40;<a class="elsevierStyleCrossRef" href="#fig0015">fig&#46; 3</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Discusi&#243;n</span><p id="par0050" class="elsevierStylePara elsevierViewall">En este trabajo se demuestra que la nueva categor&#237;a de ICFEi en pacientes con ICA atendidos en SUH&#58; 1&#41; tiene unas caracter&#237;sticas cl&#237;nicas intermedias entre el grupo de preservada y disminuida&#59; 2&#41; de forma bruta no se asocia con un pron&#243;stico a corto&#44; medio y largo plazo diferente al grupo con fracci&#243;n de eyecci&#243;n conservada&#44; y 3&#41; de forma ajustada no presenta diferencias en mortalidad frente a los otros 2 grupos &#40;ICFEd e ICFEc&#41; ni de forma global ni cuando se estratifica por el lugar de ingreso y es una de las escasas series que analiza desde la perspectiva de la atenci&#243;n urgente un conjunto de pacientes con ICA fuera de estudios controlados<a class="elsevierStyleCrossRefs" href="#bib0205"><span class="elsevierStyleSup">10&#44;11</span></a>&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">En nuestra serie&#44; solo uno de cada 7 pacientes &#40;el 14&#44;6&#37;&#41; atendidos con ICA en el SUH ten&#237;an una FEVI entre el 40 y el 49&#37; &#40;ICFEi&#41;&#46; Este grupo representa un peque&#241;o porcentaje de pacientes con ICA&#44; similar al encontrado en otros estudios realizados en pacientes con IC hospitalizados y en pacientes ambulantes<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">12</span></a>&#46; En el ensayo CHARM<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">13</span></a> la prevalencia fue del 17&#37; &#40;con FEVI entre 43 y 53&#37;&#41;&#44; en el <span class="elsevierStyleItalic">Cardiovascular Health Study</span><a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">14</span></a>&#44; del 14&#37; &#40;FEVI 45-54&#37;&#41;&#44; y en la base de datos <span class="elsevierStyleItalic">Get With The Guidelines-Heart Failure</span><a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">15</span></a> &#40;2005-2013&#41; fue del 12&#44;8&#37; &#40;40-49&#37;&#41;&#46; En nuestro grupo los pacientes con ICFEi son mayoritariamente mujeres y de mayor edad cuando los comparamos con el subgrupo de ICFEd&#44; pero similares al subgrupo de ICFEc&#46; Adem&#225;s&#44; tienen una elevada prevalencia de hipertensi&#243;n arterial y cardiopat&#237;a isqu&#233;mica&#46; Con respecto al tratamiento cr&#243;nico&#44; son tratados en mayor medida con betabloqueantes y BRA que el grupo ICFEc&#46; Se presentan en Urgencias con presiones arteriales sist&#243;licas m&#225;s elevadas y concentraciones de p&#233;ptidos natriur&#233;ticos menores que los pacientes con ICFEd&#46; La administraci&#243;n de diur&#233;ticos y nitroglicerina intravenosa y el uso de ventilaci&#243;n no invasiva en el SUH es similar en los 3 grupos&#44; y son ingresados tambi&#233;n en similares proporciones&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">Cl&#237;nicamente&#44; en el momento de la valoraci&#243;n se comportaban como formas de cardiopat&#237;a menos avanzadas&#44; al poseer grados funcionales mejores de la NYHA y menores elevaciones de los p&#233;ptidos natriur&#233;ticos&#44; como se ha mostrado en otros estudios<a class="elsevierStyleCrossRefs" href="#bib0235"><span class="elsevierStyleSup">16&#8211;18</span></a>&#46; La presencia de un mayor porcentaje de cardiopat&#237;a isqu&#233;mica en la ICFEi respecto a la ICFEc y muy similar al grupo ICFEd&#44; asociado a una elevada prevalencia de hipertensi&#243;n arterial similar a la de pacientes con ICFEc ya ha sido descrita previamente<a class="elsevierStyleCrossRefs" href="#bib0235"><span class="elsevierStyleSup">16&#44;19</span></a>&#46; Estas caracter&#237;sticas han sido utilizadas para explicar el origen de este grupo<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">17</span></a>&#44; que podr&#237;a corresponder a pacientes con ICFEd que han recuperado o mejorado con el paso del tiempo la FEVI en virtud de tratamientos modificadores de la enfermedad &#40;lo que explicar&#237;a el mayor porcentaje de utilizaci&#243;n de betabloqueantes o de BRA en este grupo respecto a ICFEc&#41;&#44; o podr&#237;a representar a pacientes con ICFEc con un progresivo empeoramiento de la FEVI&#44; como se ha evidenciado en un estudio reciente donde pacientes con ICFEc con cardiopat&#237;a isqu&#233;mica mostraban un mayor deterioro de la FEVI y una mayor mortalidad durante su seguimiento&#44; con lo que representar&#237;an un estadio precoz de ICFEd<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">20</span></a>&#46; Estos aspectos son relevantes en la discusi&#243;n actual sobre si los grupos de ICFEc e ICFEd son entidades independientes o son parte de un mismo proceso din&#225;mico<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">18</span></a>&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">En cuanto a los tratamientos administrados en Urgencias&#44; no se han encontrado diferencias significativas en la utilizaci&#243;n de diur&#233;ticos intravenosos&#44; vasodilatadores del tipo de la nitroglicerina intravenosa o con el uso de ventilaci&#243;n no invasiva&#44; sin embargo&#44; era m&#225;s frecuente la administraci&#243;n de vasopresores o inotr&#243;picos en las formas con FEVI reducida&#44; quiz&#225;s relacionado con probables episodios de bajo gasto cardiaco con hipotensi&#243;n e hipoperfusi&#243;n m&#225;s frecuentemente unidas a esta entidad<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">5</span></a>&#46; Sin embargo&#44; cabe destacar que a diferencia de la IC cr&#243;nica&#44; donde los tratamientos est&#225;n diferenciados entre la forma de ICFEd y la ICFEc&#44; en la ICA esta diferenciaci&#243;n terap&#233;utica no se da&#44; y las variaciones de tratamiento que se utilizan durante las descompensaciones agudas&#44; especialmente en la fase prehospitalaria y hospitalaria de la atenci&#243;n urgente&#44; est&#225;n m&#225;s en relaci&#243;n con la presencia de factores precipitantes o de escenarios cl&#237;nicos que con la FEVI<a class="elsevierStyleCrossRefs" href="#bib0260"><span class="elsevierStyleSup">21&#8211;28</span></a>&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">En cuanto al pron&#243;stico de la ICFEi tras un episodio de agudizaci&#243;n&#44; se observ&#243; que estos pacientes ten&#237;an una mortalidad similar a la de los del grupo de ICFEc y de ICFEd al ajustar las HR por las variables discordantes entre ellos&#46; Creemos que este es un hallazgo relevante&#46; Diferentes registros han analizado el pron&#243;stico en pacientes con ICFEi&#58; en el <span class="elsevierStyleItalic">Cardiovascular Health Study</span><a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">14</span></a> la mortalidad se situaba entre los otros 2 grupos&#44; con 115 muertes por 1&#46;000 personas-a&#241;o&#44; comparada con 154 y 87 muertes por 1&#46;000 personas-a&#241;o en ICFEd e ICFEc&#44; respectivamente&#59; en el CHARM<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">13</span></a>&#44; la HR ajustada para todas las causas de mortalidad aumentaba un 39&#37; por cada 10&#37; de reducci&#243;n de la FEVI en pacientes con FEVI menor del 45&#37;&#59; sin embargo&#44; con FEVI mayores del 45&#37;&#44; el aumento del porcentaje de FEVI no se asociaba a una menor mortalidad&#59; as&#237;&#44; todas las causas de mortalidad permanecieron relativamente estables a pesar de tener mayores porcentajes de FEVI&#46; Diferentes estudios con pacientes hospitalizados describen una mortalidad similar en individuos con ICFEc e ICFEd<a class="elsevierStyleCrossRef" href="#bib0285"><span class="elsevierStyleSup">26</span></a>&#46; En otras publicaciones que estudian espec&#237;ficamente la mortalidad en grupos de pacientes con FEVI deprimida&#44; conservada o intermedia no se observaron diferencias significativas en el seguimiento a uno&#44; 6 y 12 meses<a class="elsevierStyleCrossRefs" href="#bib0235"><span class="elsevierStyleSup">16&#44;17&#44;27&#44;28</span></a>&#46; Nuestro estudio va en este sentido&#46; Aunque aparentemente nuestros pacientes con ICFEi ten&#237;an una mortalidad muy similar a la del grupo de ICFEc y menor que los del grupo de ICFEd&#44; al ajustar las HR por las variables discordantes entre ellos no se encontraron diferencias de mortalidad significativas para el grupo de ICFEi respecto al grupo de ICFEc o al grupo de ICFEd&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">Adem&#225;s&#44; esta falta de diferencias en mortalidad a un a&#241;o tras un episodio de descompensaci&#243;n se observ&#243; de forma independiente de los principales destinos del paciente tras su atenci&#243;n en Urgencias&#44; lo cual refuerza el valor de nuestros hallazgos&#46; Aunque estos destinos seleccionan habitualmente perfiles cl&#237;nicos diferentes de pacientes<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">29</span></a>&#44; aquellos con ICFEi presentan mortalidades similares a los otros grupos en cada uno de estos destinos una vez que se ajustan sus diferencias poblacionales&#46; Es tambi&#233;n resaltable el hecho que hemos observado de que&#44; mientras que no se encuentran diferencias en cuanto a la distribuci&#243;n de la ICFEi tras la asistencia en Urgencias en los servicios de Medicina Interna&#44; Corta Estancia o alta directa sin ingreso&#44; s&#237; que estos pacientes ingresan m&#225;s en unidades de Cuidados Intensivos y menos en las unidades de Cardiolog&#237;a y Geriatr&#237;a&#46; Excede el objetivo de este estudio el profundizar en este aspecto&#44; aunque creemos que el an&#225;lisis de estas causas es de inter&#233;s en un futuro&#44; pues los resultados obtenidos en las diferentes unidades asistenciales&#44; en funci&#243;n de la intensidad del tratamiento y el abordaje general&#44; podr&#237;a ser diferente&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">Finalmente&#44; encontramos que los pacientes ingresados en Medicina Interna eran de mayor edad y con un mayor d&#233;ficit funcional que aquellos ingresados en Cardiolog&#237;a&#44; lo que va en consonancia con lo mostrado en otros estudios<a class="elsevierStyleCrossRefs" href="#bib0305"><span class="elsevierStyleSup">30&#44;31</span></a>&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">Nuestro estudio tiene una serie de limitaciones&#46; Primera&#44; los hospitales que participan en el Registro EAHFE no son escogidos aleatoriamente&#44; sino por el inter&#233;s del centro en participar&#44; por lo que existe un sesgo de selecci&#243;n&#46; Segunda&#44; como todo registro observacional&#44; no permite hacer inferencias firmes y&#44; a pesar del ajuste estad&#237;stico realizado por las diferencias entre los 3 grupos&#44; es posible que variables no identificadas puedan haber participado&#44; al menos parcialmente&#44; de los resultados observados en supervivencia al a&#241;o&#46; Tercera&#44; el estudio excluy&#243; a paciente sin FEVI documentada&#44; lo cual supuso un 54&#37; de la muestra&#46; Cuarta&#44; en los pacientes incluidos la determinaci&#243;n de la FEVI se realiz&#243; durante un per&#237;odo variable de 6 meses&#44; que no queda recogido en el Registro&#46; Probablemente disponer de una ecograf&#237;a en fase de estabilidad posterior al episodio de ICA hubiese podido mejorar la estimaci&#243;n de la FEVI&#44; ya sea porque hubiese cambiado desde la realizaci&#243;n hasta el episodio &#237;ndice &#40;si la ecocardiograf&#237;a era previa&#41; o porque durante dicho episodio &#237;ndice&#44; en fase de inestabilidad&#44; haya podido resultar infraestimada&#46; Ello hace posible que alg&#250;n paciente pueda haber estado mal clasificado&#44; aunque el error puede haberse realizado en ambos sentidos&#46; Por &#250;ltimo&#44; no se recogi&#243; el m&#233;todo utilizado para la determinaci&#243;n de la FEVI&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">Con todo&#44; podemos concluir que el estudio muestra que los pacientes con ICFEi presentan unas caracter&#237;sticas cl&#237;nicas intermedias entre los pacientes con ICFEc y con ICFEd&#46; No obstante&#44; cuando presentan una descompensaci&#243;n aguda&#44; su tratamiento en Urgencias no difiere significativamente del de los otros 2 grupos&#44; ni tampoco su mortalidad posterior&#44; tanto si esta se analiza globalmente como si se eval&#250;a en funci&#243;n de los diferentes perfiles de los pacientes seg&#250;n los principales destinos tras su atenci&#243;n en Urgencias&#46; El pron&#243;stico a corto y largo plazo es similar entre los 3 grupos&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Financiaci&#243;n</span><p id="par0095" class="elsevierStylePara elsevierViewall">El presente estudio ha sido posible en parte gracias a las becas PI15&#47;01019&#44; PI15&#47;00773&#44; PI11&#47;01021 y PI10&#47;01918&#44; del Instituto de Salud Carlos <span class="elsevierStyleSmallCaps">III&#44;</span> procedentes de fondos del Ministerio de Sanidad&#44; Servicios Sociales e Igualdad &#40;MSSSI&#41; y el Fondo Europeo de Desarrollo Regional &#40;FEDER&#41;&#59; a las becas de la Generalitat de Catalunya para Grupos de Investigaci&#243;n Consolidados &#40;GRC 2009&#47;1385 and 2014&#47;0313&#41;&#59; y a la beca Fundaci&#243; La Marat&#243; de TV3 &#40;2015&#47;2510&#41;&#46; El grupo ICA-SEMES ha recibido ayudas no condicionadas de Orion Pharma&#44; Otsuka y Novartis Espa&#241;a&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Autor&#237;a</span><p id="par0100" class="elsevierStylePara elsevierViewall">&#210;scar Mir&#243; y Patricia Javaloyes han contribuido de forma igualitaria para ser considerados como primer autor&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Conflicto de intereses</span><p id="par0105" class="elsevierStylePara elsevierViewall">Los autores declaran no tener ning&#250;n conflicto de intereses&#46;</p></span></span>"
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            0 => array:2 [
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            1 => array:2 [
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              "titulo" => "Pacientes y m&#233;todo"
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            2 => array:2 [
              "identificador" => "abst0015"
              "titulo" => "Resultados"
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          "titulo" => "Palabras clave"
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        2 => array:3 [
          "identificador" => "xres1080404"
          "titulo" => "Abstract"
          "secciones" => array:4 [
            0 => array:2 [
              "identificador" => "abst0025"
              "titulo" => "Background and objective"
            ]
            1 => array:2 [
              "identificador" => "abst0030"
              "titulo" => "Patients and method"
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              "identificador" => "abst0035"
              "titulo" => "Results"
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              "titulo" => "Conclusion"
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          "identificador" => "xpalclavsec1025662"
          "titulo" => "Keywords"
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        4 => array:2 [
          "identificador" => "sec0005"
          "titulo" => "Introducci&#243;n"
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        5 => array:2 [
          "identificador" => "sec0010"
          "titulo" => "M&#233;todo"
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        6 => array:2 [
          "identificador" => "sec0015"
          "titulo" => "Resultados"
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        7 => array:2 [
          "identificador" => "sec0020"
          "titulo" => "Discusi&#243;n"
        ]
        8 => array:2 [
          "identificador" => "sec0025"
          "titulo" => "Financiaci&#243;n"
        ]
        9 => array:2 [
          "identificador" => "sec0030"
          "titulo" => "Autor&#237;a"
        ]
        10 => array:2 [
          "identificador" => "sec0035"
          "titulo" => "Conflicto de intereses"
        ]
        11 => array:1 [
          "titulo" => "Bibliograf&#237;a"
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    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2017-08-22"
    "fechaAceptado" => "2017-11-02"
    "PalabrasClave" => array:2 [
      "es" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palabras clave"
          "identificador" => "xpalclavsec1025663"
          "palabras" => array:5 [
            0 => "Insuficiencia cardiaca"
            1 => "Mortalidad"
            2 => "Ingreso"
            3 => "Urgencias"
            4 => "Fracci&#243;n de eyecci&#243;n del ventr&#237;culo izquierdo intermedia"
          ]
        ]
      ]
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec1025662"
          "palabras" => array:5 [
            0 => "Heart failure"
            1 => "Mortality"
            2 => "Admission"
            3 => "Emergency department"
            4 => "Mid-range left ventricular ejection fraction"
          ]
        ]
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    "tieneResumen" => true
    "resumen" => array:2 [
      "es" => array:3 [
        "titulo" => "Resumen"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Fundamento y objetivo</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Comparar la evoluci&#243;n tras una descompensaci&#243;n aguda de los pacientes con insuficiencia cardiaca &#40;ICA&#41; con fracci&#243;n de eyecci&#243;n del ventr&#237;culo izquierdo intermedia &#40;ICFEi&#41; respecto a los que la tienen deprimida &#40;ICFEd&#41; o conservada &#40;ICFEc&#41;&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Pacientes y m&#233;todo</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Estudio observacional prospectivo&#44; de inclusi&#243;n consecutiva de pacientes diagnosticados de ICA en 41 servicios de urgencias&#46; Se formaron 3 grupos&#58; ICFEd<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>40&#37;&#44; ICFEi 40-49&#37; e ICFEc<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>50&#37;&#46; Se recogieron 38 variables independientes y se compar&#243; la mortalidad por cualquier causa al a&#241;o en el grupo de ICFEi&#44; bruta y ajustada&#44; respecto a los de ICFEd e ICFEc&#46; Se estratific&#243; este an&#225;lisis seg&#250;n el destino del paciente tras la asistencia urgente&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Se incluyeron 3&#46;958 pacientes&#58; 580 ICFEi &#40;14&#44;6&#37;&#41;&#44; 929 ICFEd &#40;23&#44;5&#37;&#41; y 2&#46;449 ICFEc &#40;61&#44;9&#37;&#41;&#46; La mortalidad global al a&#241;o fue del 28&#44;5&#37;&#46; La mortalidad bruta en la ICFEi fue similar a la ICFEc &#40;HR 1&#44;009&#59; IC 95&#37; 0&#44;819-1&#44;243&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;933&#41; y menor que la ICFEd &#40;HR 0&#44;800&#59; IC 95&#37; 0&#44;635-1&#44;008&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;058&#41;&#44; pero tras el ajuste por las caracter&#237;sticas basales discordantes entre grupos&#44; la mortalidad de la ICFEi no difiri&#243; de la ICFEc &#40;HRa 1&#44;025&#59; IC 95&#37; 0&#44;825-1&#44;275&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;821&#41; ni de la ICFEd &#40;HRa 0&#44;924&#59; IC 95&#37; 0&#44;720-1&#44;186&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;535&#41;&#46; El an&#225;lisis estratificado seg&#250;n el destino del ingreso o alta directa desde Urgencias tampoco mostr&#243; diferencias significativas entre la ICFEi y los otros 2 grupos&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusi&#243;n</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">La mortalidad a un a&#241;o tras un episodio de ICA en pacientes con ICFEi no difiere de la de los pacientes con ICFEc o ICFEd&#44; ni globalmente ni para ninguno de los principales destinos tras la asistencia en Urgencias&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0005"
            "titulo" => "Fundamento y objetivo"
          ]
          1 => array:2 [
            "identificador" => "abst0010"
            "titulo" => "Pacientes y m&#233;todo"
          ]
          2 => array:2 [
            "identificador" => "abst0015"
            "titulo" => "Resultados"
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          3 => array:2 [
            "identificador" => "abst0020"
            "titulo" => "Conclusi&#243;n"
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      "en" => array:3 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Background and objective</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">To compare the outcome of patients with acute heart failure &#40;AHF&#41; with a mid-range left ventricular ejection fraction &#40;HFmrEF&#41; with patients with a reduced &#40;HFrEF&#41; or preserved &#40;HFpEF&#41; left ventricular ejection fraction&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Patients and method</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">A prospective observational study included patients diagnosed with AHF in 41 emergency departments&#46; Patients were divided into 3 groups&#58; HFrEF<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>40&#37;&#44; HFmrEF 40-49&#37; and HFpEF<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>50&#37;&#46; We collected 38 independent variables and the adjusted and crude all-cause mortality at one-year in the HFmrEF group was compared with that of the HFrEF and HFpEF groups&#46; The analysis was stratified according to patient destination following ED care&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Three thousand nine hundred and fifty-eight patients were included&#58; 580 HFmrEF &#40;14&#46;6&#37;&#41;&#44; 929 HFrEF &#40;23&#46;5&#37;&#41; and 2&#44;449 HFpEF &#40;61&#46;9&#37;&#41;&#46; Global mortality at one year was 28&#46;5&#37;&#46; The crude mortality of the HFmrEF group was similar to that of the HFpEF group &#40;HR 1&#46;009&#59; 95&#37; CI 0&#46;819-1&#46;243&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;933&#41; and lower than the HFrEF group &#40;HR 0&#46;800&#59; 95&#37; CI 0&#46;635-1&#46;008&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;058&#41;&#44; but after adjustment for discordant basal characteristics among groups&#44; the mortality of the HFmrEF group did not differ from that of the HFpEF &#40;HRa 1&#46;025&#59; 95&#37; CI 0&#46;825-1&#46;275&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;821&#41; or HFrEF group &#40;HRa 0&#46;924&#59; 95&#37; CI 0&#46;720-1&#46;186&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;535&#41;&#46; Neither were significant differences found between the HFmrEF group and the other 2 groups in the analysis stratified according to admission or discharge direct from the emergency department&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusion</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Mortality at one-year after an AHF episode in patients with HFmrEF does not differ from that of patients with HFpEF or HfrEF&#44; either globally or based on the main destinations after emergency department care&#46;</p></span>"
        "secciones" => array:4 [
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            "titulo" => "Background and objective"
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            "titulo" => "Patients and method"
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          2 => array:2 [
            "identificador" => "abst0035"
            "titulo" => "Results"
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          3 => array:2 [
            "identificador" => "abst0040"
            "titulo" => "Conclusion"
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        "etiqueta" => "&#9674;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">En el <a class="elsevierStyleCrossRef" href="#sec0045">anexo</a> se relacionan los nombres de todos los autores del Grupo de Trabajo de Insuficiencia Cardiaca Aguda de la Sociedad Espa&#241;ola de Urgencias y Emergencias &#40;grupo ICA-SEMES&#41;&#46;</p>"
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          0 => array:4 [
            "apendice" => "<p id="par0115" class="elsevierStylePara elsevierViewall">Marta Fuentes&#44; Cristina Gil &#40;Hospital Universitario de Salamanca&#41;&#46;</p> <p id="par0120" class="elsevierStylePara elsevierViewall">Manuel Garrido &#40;Hospital Virgen Macarena&#44; Sevilla&#41;&#46;</p> <p id="par0125" class="elsevierStylePara elsevierViewall">Pablo Garmila &#40;Hospital Marqu&#233;s de Valdecilla&#44; Santander&#41;&#46;</p> <p id="par0130" class="elsevierStylePara elsevierViewall">Esther Rodr&#237;guez Adrada&#46; Guillermo Llopis Garcia &#40;Hospital Cl&#237;nico San Carlos&#44; Madrid&#41;&#46;</p> <p id="par0135" class="elsevierStylePara elsevierViewall">Rosa Escoda&#44; Carolina Xipell&#44; Carolina S&#225;nchez&#44; Josep M&#46; Gaytan &#40;Hospital Cl&#237;nic de Barcelona&#41;&#46;</p> <p id="par0140" class="elsevierStylePara elsevierViewall">Mar&#237;a Jos&#233; P&#233;rez-Dur&#225; &#40;Hospital La Fe de Valencia&#41;&#46;</p> <p id="par0145" class="elsevierStylePara elsevierViewall">Jos&#233; Pav&#243;n &#40;Hospital Dr&#46; Negr&#237;n de Las Palmas de Gran Canaria&#41;&#46;</p> <p id="par0150" class="elsevierStylePara elsevierViewall">Antonio Noval &#40;Hospital Insular de Las Palmas de Gran Canaria&#41;&#46;</p> <p id="par0155" class="elsevierStylePara elsevierViewall">Jos&#233; M&#46; Torres &#40;Hospital Reina Sof&#237;a de C&#243;rdoba&#41;&#46;</p> <p id="par0160" class="elsevierStylePara elsevierViewall">Mar&#237;a Luisa L&#243;pez-Grima&#44; Amparo Valero &#40;Hospital Dr&#46; Peset de Valencia&#41;&#46;</p> <p id="par0165" class="elsevierStylePara elsevierViewall">Alfons Aguirre&#44; Maria &#192;ngels Pedragosa &#40;Hospital del Mar de Barcelona&#41;&#46;</p> <p id="par0170" class="elsevierStylePara elsevierViewall">Maria Isabel Alonso&#44; Francisco Ruiz &#40;Hospital de Valme de Sevilla&#41;&#46;</p> <p id="par0175" class="elsevierStylePara elsevierViewall">Jos&#233; Miguel Franco &#40;Hospital Miguel Servet de Zaragoza&#41;&#46;</p> <p id="par0180" class="elsevierStylePara elsevierViewall">Elena Diaz &#40;Hospital San Juan de Alicante&#41;&#46;</p> <p id="par0185" class="elsevierStylePara elsevierViewall">Ana Bel&#233;n Mecina &#40;Hospital de Alcorc&#243;n&#41;&#46;</p> <p id="par0190" class="elsevierStylePara elsevierViewall">Josep Tost &#40;Consorci Sanitari de Terrassa&#41;&#46;</p> <p id="par0195" class="elsevierStylePara elsevierViewall">Susana S&#225;nchez &#40;Hospital R&#237;o Ortega de Valladolid&#41;&#46;</p> <p id="par0200" class="elsevierStylePara elsevierViewall">Pascual Pi&#241;era &#40;Hospital Reina Sof&#237;a de Murcia&#41;&#46;</p> <p id="par0205" class="elsevierStylePara elsevierViewall">Raquel Torres Garate &#40;Hospital Severo Ochoa&#44; Madrid&#41;&#46;</p> <p id="par0210" class="elsevierStylePara elsevierViewall">Aitor Alquezar&#44; Miguel Alberto Rizzi&#44; Sergio Herrera &#40;Hospital de la Santa Creu i Sant Pau de Barcelona&#41;&#46;</p> <p id="par0215" class="elsevierStylePara elsevierViewall">Irene Cabello &#40;Hospital Universitari de Bellvitge&#44; Barcelona&#41;&#46;</p> <p id="par0220" class="elsevierStylePara elsevierViewall">Fernando Richard&#44; Jos&#233; Mar&#237;a &#193;lvarez P&#233;rez&#44; Maria Pilar L&#243;pez Diez &#40;Hospital Universitario de Burgos&#41;&#46;</p> <p id="par0225" class="elsevierStylePara elsevierViewall">Javier Lucas &#40;Hospital General de Albacete&#41;&#46;</p> <p id="par0230" class="elsevierStylePara elsevierViewall">Joaquin V&#225;zquez Alvarez&#44; Marta S&#225;nchez Gonzalez&#44; Jose Juan Gil Rom&#225;n &#40;Hospital Universitario Central de Asturias&#44; Oviedo&#41;&#46;</p> <p id="par0235" class="elsevierStylePara elsevierViewall">V&#237;ctor Marquina&#44; Inmaculada Jim&#233;nez&#44; N&#233;stor Hern&#225;ndez&#44; Ana L&#243;pez &#40;Hospital General de Alicante&#41;&#46;</p> <p id="par0240" class="elsevierStylePara elsevierViewall">Juan Antonio Andueza &#40;Hospital General Universitario Gregorio Mara&#241;&#243;n de Madrid&#41;&#46;</p> <p id="par0245" class="elsevierStylePara elsevierViewall">Rodolfo Romero &#40;Hospital de Getafe&#44; Madrid&#41;&#46;</p> <p id="par0250" class="elsevierStylePara elsevierViewall">Roberto Calvache &#40;Hospital del Henares&#44; Coslada&#44; Madrid&#41;&#46;</p> <p id="par0255" class="elsevierStylePara elsevierViewall">Maria Teresa Lorca&#44; Luis Calder&#243;n &#40;Hospital del Tajo&#44; Aranjuez&#44; Madrid&#41;&#46;</p> <p id="par0260" class="elsevierStylePara elsevierViewall">Beatriz Amores Arriaga&#44; Beatriz Sierra &#40;Hospital Cl&#237;nico Lozano Blesa de Zaragoza&#41;&#46;</p> <p id="par0265" class="elsevierStylePara elsevierViewall">Enrique Mart&#237;n Mojarro &#40;Hospital Sant Pau i Santa Tecla de Tarragona&#41;&#46;</p> <p id="par0270" class="elsevierStylePara elsevierViewall">Lisette Traver&#237;a B&#233;cquer &#40;Hospital Universitario de Canarias&#44; Tenerife&#41;&#46;</p> <p id="par0275" class="elsevierStylePara elsevierViewall">Llu&#237;s Llauger Garcia&#44; Gerard Corominas Lasalle &#40;Hospital Universitari de Vic&#44; Barcelona&#41;&#46;</p> <p id="par0280" class="elsevierStylePara elsevierViewall">Carmen Ag&#252;era Urbano &#40;Hospital Costa del Sol de Marbella&#44; M&#225;laga&#41;&#46;</p> <p id="par0285" class="elsevierStylePara elsevierViewall">Ester Soy Ferrer &#40;Hospital Josep Trueta de Girona&#41;&#46;</p>"
            "etiqueta" => "ANEXO"
            "titulo" => "Resto de investigadores participantes en el estudio del Grupo de Trabajo de Insuficiencia Cardiaca Aguda de la Sociedad Espa&#241;ola de Urgencias y Emergencias &#40;grupo ICA-SEMES&#41;&#58;"
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          "es" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Supervivencia a un a&#241;o en funci&#243;n de la fracci&#243;n de eyecci&#243;n del ventr&#237;culo izquierdo&#46; An&#225;lisis bruto &#40;izquierda&#41; y ajustado por 30 covariables &#40;derecha&#41;&#46;</p> <p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">HR&#58; <span class="elsevierStyleItalic">hazard ratio&#59;</span> ICFEc&#58; insuficiencia cardiaca con fracci&#243;n de eyecci&#243;n conservada&#59; ICFEd&#58; insuficiencia cardiaca con fracci&#243;n de eyecci&#243;n deprimida&#59; ICFEi&#58; insuficiencia cardiaca con fracci&#243;n de eyecci&#243;n intermedia&#46;</p>"
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          "es" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">Hazard ratio</span> brutas y ajustadas para la mortalidad a un a&#241;o de los pacientes con insuficiencia cardiaca aguda y fracci&#243;n de eyecci&#243;n moderadamente reducida en relaci&#243;n con los pacientes con fracci&#243;n de eyecci&#243;n reducida &#40;parte superior&#41; y preservada &#40;parte inferior&#41;&#44; analizadas tanto para la poblaci&#243;n total estudiada como en funci&#243;n del servicio en el cual ingres&#243; durante el episodio &#237;ndice&#46;</p> <p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">HR&#58; <span class="elsevierStyleItalic">hazard ratio&#59;</span> IC 95&#37;&#58; intervalo de confianza del 95&#37;&#59; LI&#58; l&#237;mite inferior del intervalo de confianza del 95&#37;&#59; LS&#58; l&#237;mite superior del intervalo de confianza del 95&#37;&#46;</p>"
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          "leyenda" => "<p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">ARA-<span class="elsevierStyleSmallCaps">II</span>&#58; antagonista del receptor de la angiotensina <span class="elsevierStyleSmallCaps">ii</span>&#59; BiPAP&#58; <span class="elsevierStyleItalic">bilevel positive airway pressure</span> &#40;&#171;presi&#243;n positiva de la v&#237;a a&#233;rea de 2 niveles&#187;&#41;&#59; BNP&#58; <span class="elsevierStyleItalic">brain natriuretic peptide</span> &#40;&#171;p&#233;ptido natriur&#233;tico cerebral&#187;&#41;&#59; BRA&#58; bloqueante del receptor de aldosterona&#59; CPAP&#58; <span class="elsevierStyleItalic">continuous positive airway pressure</span> &#40;&#171;presi&#243;n positiva continua de las v&#237;as respiratorias&#187;&#41;&#59; DE&#58; desviaci&#243;n est&#225;ndar&#59; EPOC&#58; enfermedad pulmonar obstructiva cr&#243;nica&#59; FEVI&#58; fracci&#243;n de eyecci&#243;n del ventr&#237;culo izquierdo&#59; ICA&#58; insuficiencia cardiaca aguda&#59; ICFEc&#58; insuficiencia cardiaca con fracci&#243;n de eyecci&#243;n conservada&#59; ICFEd&#58; insuficiencia cardiaca con fracci&#243;n de eyecci&#243;n deprimida&#59; ICFEi&#58; insuficiencia cardiaca con fracci&#243;n de eyecci&#243;n intermedia&#59; IECA&#58; inhibidor de la enzima conversiva de la angiotensina&#59; NT-proBNP&#58; <span class="elsevierStyleItalic">N-terminal pro brain natriuretic peptide</span> &#40;&#171;prop&#233;ptido natriur&#233;tico cerebral N-terminal&#187;&#41;&#59; NYHA&#58; <span class="elsevierStyleItalic">New York Heart Association&#59;</span> PAS&#58; presi&#243;n arterial sist&#243;lica&#59; RIC&#58; rango intercuart&#237;lico&#59; TFG&#58; tasa de filtrado glomerular&#46; &#44;</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="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Total<br>N<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>3&#46;958<br>n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">ICFEd &#40;&#60;<span class="elsevierStyleHsp" style=""></span>40&#37;&#41;<br>n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>929<br>n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">ICFEi &#40;40-49&#37;&#41;<br>n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>580<br>n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">ICFEc &#40;&#8805;<span class="elsevierStyleHsp" style=""></span>50&#37;&#41;<br>n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#46;449<br>n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">p&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " colspan="6" align="left" valign="top"><span class="elsevierStyleItalic">Variables sociodemogr&#225;ficas</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Edad &#40;a&#241;os&#41;&#44; media &#40;DE&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">79 &#40;10&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">76 &#40;11&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">78 &#40;10&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">80 &#40;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleBold">&#60;</span><span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Sexo femenino&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#46;075 &#40;52&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">315 &#40;34&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">246 &#40;42&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;514 &#40;62&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleBold">&#60;</span><span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="6" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="6" align="left" valign="top"><span class="elsevierStyleItalic">Variables de comorbilidad</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Hipertensi&#243;n arterial&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&#46;401 &#40;85&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">763 &#40;82&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">491 &#40;84&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#46;147 &#40;87&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleBold">&#60;</span><span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Diabetes mellitus&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;815 &#40;45&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">470 &#40;50&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">284 &#40;49&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;061 &#40;43&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleBold">&#60;</span><span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Dislipidemia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;917 &#40;48&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">481 &#40;51&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">287 &#40;49&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;149 &#40;46&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;037&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Cardiopat&#237;a isqu&#233;mica&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;517 &#40;38&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">518 &#40;55&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">271 &#40;46&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">728 &#40;28&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleBold">&#60;</span><span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Valvulopat&#237;a&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;520 &#40;38&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">287 &#40;30&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">217 &#40;37&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;016 &#40;41&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleBold">&#60;</span><span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Fibrilaci&#243;n auricular&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&#46;956 &#40;53&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">376 &#40;40&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">312 &#40;53&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;416 &#40;57&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleBold">&#60;</span><span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Enfermedad renal cr&#243;nica&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;108 &#40;28&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">284 &#40;30&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">159 &#40;27&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">665 &#40;27&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;134&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Enfermedad cerebrovascular&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">548 &#40;13&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">143 &#40;15&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">80 &#40;13&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">325 &#40;13&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;282&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>EPOC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;091 &#40;27&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">254 &#40;27&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">155 &#40;26&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">682 &#40;27&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;875&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Arteriopat&#237;a perif&#233;rica&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">414 &#40;10&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">125 &#40;13&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">67 &#40;11&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">222 &#40;9&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Demencia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">368 &#40;11&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">58 &#40;7&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">50 &#40;10&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">260 &#40;12&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;009&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Episodio previo de ICA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#46;903 &#40;74&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">737 &#40;80&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">453 &#40;79&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;713 &#40;70&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleBold">&#60;</span><span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="6" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="6" align="left" valign="top"><span class="elsevierStyleItalic">Situaci&#243;n basal</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>NYHA <span class="elsevierStyleSmallCaps">III</span>-<span class="elsevierStyleSmallCaps">IV</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">980 &#40;26&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">293 &#40;33&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">118 &#40;21&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">569 &#40;25&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleBold">&#60;</span><span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>&#205;ndice de Barthel &#40;puntos&#41;&#44; media &#40;DE&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">81 &#40;22&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">83 &#40;22&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">83 &#40;22&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">137 &#40;5&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">188 &#40;8&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;004&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="6" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="6" align="left" valign="top"><span class="elsevierStyleItalic">Tratamiento en Urgencias</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Diur&#233;ticos intravenosos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#46;076 &#40;86&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">810 &#40;88&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">512 &#40;90&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#46;076 &#40;86&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;015&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Nitroglicerina intravenosa&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">723 &#40;18&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">179 &#40;19&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">120 &#40;21&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">424 &#40;17&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;101&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Inotropos&#47;vasopresores&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">104 &#40;2&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">51 &#40;5&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">15 &#40;2&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">38 &#40;1&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleBold">&#60;</span><span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Ventilaci&#243;n no invasiva &#40;CPAP&#47;BiPAP&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">289 &#40;7&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">82 &#40;9&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">41 &#40;7&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">166 &#40;6&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;117&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
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        "descripcion" => array:1 [
          "es" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Caracter&#237;sticas de los pacientes incluidos en el estudio y comparaci&#243;n en funci&#243;n del grupo de fracci&#243;n de eyecci&#243;n del ventr&#237;culo izquierdo</p>"
        ]
      ]
      4 => array:8 [
        "identificador" => "tbl0010"
        "etiqueta" => "Tabla 2"
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          "leyenda" => "<p id="spar0090" class="elsevierStyleSimplePara elsevierViewall">ICFEc&#58; insuficiencia cardiaca con fracci&#243;n de eyecci&#243;n conservada&#59; ICFEd&#58; insuficiencia cardiaca con fracci&#243;n de eyecci&#243;n deprimida&#59; ICFEi&#58; insuficiencia cardiaca con fracci&#243;n de eyecci&#243;n intermedia&#46;</p>"
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              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Destino tras la asistencia en Urgencias&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Total<br>N<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>3&#46;958<br>n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">ICFEd &#40;&#60;<span class="elsevierStyleHsp" style=""></span>40&#37;&#41;<br>n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>929<br>n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">ICFEi &#40;40-49&#37;&#41;<br>n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>580<br>n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">ICFEc &#40;&#8805;<span class="elsevierStyleHsp" style=""></span>50&#37;&#41;<br>n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#46;449<br>n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">p&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Ingreso en Medicina Interna&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;225 &#40;31&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">271 &#40;29&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">189 &#40;32&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">765 &#40;31&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;333&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Ingreso en Cardiolog&#237;a&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">794 &#40;20&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">251 &#40;27&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">110 &#40;19&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">433 &#40;17&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleBold">&#60;</span><span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Ingreso en Unidad de Corta Estancia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">489 &#40;12&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">107 &#40;11&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">67 &#40;11&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">315 &#40;12&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;465&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Ingreso en Geriatr&#237;a&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">233 &#40;5&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">43 &#40;4&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">21 &#40;3&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">169 &#40;6&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;002&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Ingreso en Unidad de Cuidados Intensivos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">39 &#40;1&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">12 &#40;1&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10 &#40;1&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">17 &#40;0&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;044&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Ingreso en otros servicios&#47;unidades&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">253 &#40;6&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">52 &#40;5&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">49 &#40;8&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">152 &#40;6&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;074&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">No ingreso &#40;alta desde Urgencias&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">923 &#40;23&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">193 &#40;20&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">133 &#40;23&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">597 &#40;24&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;084&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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          "es" => "<p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">Principales destinos de los pacientes con insuficiencia cardiaca aguda tras su atenci&#243;n en el Servicio de Urgencias</p>"
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      5 => array:8 [
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            "identificador" => "at3"
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        "tabla" => array:2 [
          "leyenda" => "<p id="spar0100" class="elsevierStyleSimplePara elsevierViewall">ARA-<span class="elsevierStyleSmallCaps">II</span>&#58; antagonista del receptor de la angiotensina <span class="elsevierStyleSmallCaps">ii</span>&#59; BiPAP&#58; <span class="elsevierStyleItalic">bilevel positive airway pressure</span> &#40;&#171;presi&#243;n positiva de la v&#237;a a&#233;rea de 2 niveles&#187;&#41;&#59; BNP&#58; <span class="elsevierStyleItalic">brain natriuretic peptide</span> &#40;&#171;p&#233;ptido natriur&#233;tico cerebral&#187;&#41;&#59; BRA&#58; bloqueante del receptor de aldosterona&#59; CPAP&#58; <span class="elsevierStyleItalic">continuous positive airway pressure</span> &#40;&#171;presi&#243;n positiva continua de las v&#237;as respiratorias&#187;&#41;&#59; DE&#58; desviaci&#243;n est&#225;ndar&#59; EPOC&#58; enfermedad pulmonar obstructiva cr&#243;nica&#59; FEVI&#58; fracci&#243;n de eyecci&#243;n del ventr&#237;culo izquierdo&#59; ICA&#58; insuficiencia cardiaca aguda&#59; IECA&#58; inhibidor de la enzima conversiva de la angiotensina&#59; NT-proBNP&#58; <span class="elsevierStyleItalic">N-terminal pro brain natriuretic peptide</span> &#40;&#171;prop&#233;ptido natriur&#233;tico cerebral N-terminal&#187;&#41;&#59; NYHA&#58; <span class="elsevierStyleItalic">New York Heart Association&#59;</span> PAS&#58; presi&#243;n arterial sist&#243;lica&#59; RIC&#58; rango intercuart&#237;lico&#59; TFG&#58; tasa de filtrado glomerular&#46;</p>"
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              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Medicina Interna<br>n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#46;225<br>n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Cardiolog&#237;a<br>n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>794<br>n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Unidad de Corta Estancia<br>n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>489<br>n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Alta directa desde Urgencias<br>n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>923<br>n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">p&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " colspan="6" align="left" valign="top"><span class="elsevierStyleItalic">Variables sociodemogr&#225;ficas</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Edad &#40;a&#241;os&#41;&#44; media &#40;DE&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">81 &#40;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">74 &#40;11&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">80 &#40;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">78 &#40;10&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Sexo femenino&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">660 &#40;54&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">365 &#40;46&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">278 &#40;56&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">469 &#40;51&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="6" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="6" align="left" valign="top"><span class="elsevierStyleItalic">Variables de comorbilidad</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Hipertensi&#243;n arterial&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;070 &#40;87&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">645 &#40;81&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">430 &#40;87&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">799 &#40;86&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Diabetes mellitus&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">578 &#40;47&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">371 &#40;46&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">225 &#40;46&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">423 &#40;45&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;931&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Dislipidemia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">569 &#40;46&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">408 &#40;51&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">245 &#40;50&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">453 &#40;49&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;157&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Cardiopat&#237;a isqu&#233;mica&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">450 &#40;36&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">313 &#40;39&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">169 &#40;34&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">398 &#40;43&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;004&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Valvulopat&#237;a&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">417 &#40;34&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">363 &#40;45&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">193 &#40;39&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">352 &#40;38&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Fibrilaci&#243;n auricular&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">693 &#40;56&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">376 &#40;47&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">292 &#40;59&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">457 &#40;49&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Enfermedad renal cr&#243;nica&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">371 &#40;30&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">180 &#40;22&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">144 &#40;29&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">235 &#40;25&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Enfermedad cerebrovascular&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">186 &#40;15&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">100 &#40;12&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">68 &#40;13&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">106 &#40;11&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;078&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>EPOC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">393 &#40;32&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">174 &#40;22&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">137 &#40;28&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">234 &#40;25&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Arteriopat&#237;a perif&#233;rica&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">133 &#40;10&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">83 &#40;10&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">60 &#40;12&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">80 &#40;8&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;165&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Demencia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">157 &#40;15&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">32 &#40;4&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">36 &#40;8&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">67 &#40;8&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Episodio previo de ICA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">923 &#40;76&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">555 &#40;71&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">371 &#40;78&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">643 &#40;70&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="6" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="6" align="left" valign="top"><span class="elsevierStyleItalic">Situaci&#243;n basal</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>NYHA <span class="elsevierStyleSmallCaps">III</span>-<span class="elsevierStyleSmallCaps">IV</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">186 &#40;30&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">109 &#40;24&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">68 &#40;23&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">90 &#40;22&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;012&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>&#205;ndice de Barthel &#40;puntos&#41;&#44; media &#40;DE&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">75 &#40;24&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">88 &#40;18&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">82 &#40;21&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">86 &#40;19&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="6" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="6" align="left" valign="top"><span class="elsevierStyleItalic">Tratamiento cr&#243;nico</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Diur&#233;ticos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">960 &#40;82&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">586 &#40;76&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">407 &#40;83&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">673 &#40;82&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;002&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>IECA-ARA-<span class="elsevierStyleSmallCaps">II</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Betabloqueantes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">488 &#40;41&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">410 &#40;53&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">233 &#40;47&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">423 &#40;51&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>BRA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">268 &#40;22&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">196 &#40;25&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">117 &#40;24&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">185 &#40;22&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;507&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Digoxina&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">247 &#40;21&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">115 &#40;15&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">108 &#40;22&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">172 &#40;21&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;002&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="6" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="6" align="left" valign="top"><span class="elsevierStyleItalic">Situaci&#243;n en Urgencias</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>PAS &#40;mmHg&#41;&#44; media &#40;DE&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">140 &#40;28&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">139 &#40;30&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">142 &#40;27&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">141 &#40;26&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;263&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Frecuencia cardiaca &#40;lpm&#41;&#44; media &#40;DE&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">89 &#40;23&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">91 &#40;26&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">86 &#40;23&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">83 &#40;22&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Saturaci&#243;n de ox&#237;geno &#40;&#37;&#41;&#44; media &#40;DE&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">91 &#40;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">92 &#40;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">93 &#40;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">94 &#40;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="6" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="6" align="left" valign="top"><span class="elsevierStyleItalic">Anal&#237;tica en Urgencias</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Hemoglobina &#40;g&#47;l&#41;&#44; media &#40;DE&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">118 &#40;21&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">121 &#40;21&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">118 &#40;18&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">121 &#40;19&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>TFG &#40;ml&#47;min&#47;1&#44;73<span class="elsevierStyleHsp" style=""></span>m<span class="elsevierStyleSup">2</span>&#41;&#44; media &#40;DE&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">55 &#40;26&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">59 &#40;28&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">57 &#40;26&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">62 &#40;28&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Sodio &#40;mmol&#47;dl&#41;&#44; media &#40;DE&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">137 &#40;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">137 &#40;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">138 &#40;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">138 &#40;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Potasio &#40;mmol&#47;l&#41;&#44; media &#40;DE&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&#44;45 &#40;0&#44;72&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&#44;40 &#40;0&#44;70&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&#44;33 &#40;0&#44;59&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&#44;35 &#40;0&#44;66&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Troponina elevada&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">371 &#40;48&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">251 &#40;45&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">127 &#40;57&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">188 &#40;42&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;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="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>NT-proBNP &#40;pmol&#47;l&#41;&#44; mediana &#40;RIC&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#46;100 &#40;8&#46;198&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&#46;732 &#40;7&#46;242&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&#46;519 &#40;5&#46;403&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&#46;114 &#40;5&#46;572&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>BNP &#40;pmol&#47;l&#41;&#44; mediana &#40;RIC&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">750 &#40;933&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">808 &#40;1&#46;049&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">595 &#40;977&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">361 &#40;420&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;046&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="6" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="6" align="left" valign="top"><span class="elsevierStyleItalic">Electrocardiograma en Urgencias</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Fibrilaci&#243;n auricular&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">626 &#40;52&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">349 &#40;45&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">272 &#40;57&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">396 &#40;44&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Bloqueo completo de rama izquierda&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">52 &#40;4&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">52 &#40;6&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">14 &#40;2&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">33 &#40;3&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;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="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Hipertrofia ventricular izquierda&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">125 &#40;10&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">124 &#40;16&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">46 &#40;9&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">113 &#40;12&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="6" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="6" align="left" valign="top"><span class="elsevierStyleItalic">Tratamiento en Urgencias</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Diur&#233;ticos intravenosos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;072 &#40;88&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">720 &#40;91&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">458 &#40;94&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">688 &#40;76&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Nitroglicerina intravenosa&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">206 &#40;17&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">181 &#40;23&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">126 &#40;25&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">109 &#40;12&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Inotropos&#47;vasopresores&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">36 &#40;3&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">34 &#40;4&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5 &#40;1&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7 &#40;0&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Ventilaci&#243;n no invasiva &#40;CPAP&#47;BiPAP&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">104 &#40;8&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">89 &#40;11&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">32 &#40;6&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">11 &#40;1&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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          "es" => "<p id="spar0095" class="elsevierStyleSimplePara elsevierViewall">Caracter&#237;sticas de los pacientes incluidos en el estudio y comparaci&#243;n en funci&#243;n del destino</p>"
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      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "Bibliograf&#237;a"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0015"
          "bibliografiaReferencia" => array:31 [
            0 => array:3 [
              "identificador" => "bib0160"
              "etiqueta" => "1"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "ESC guidelines for the diagnosis and treatment of acute and chronic heart failure 2012&#58; The Task Force for the diagnosis and treatment of acute and chronic heart failure 2012 of the European Society of Cardiology&#46; Developed in collaboration with the Heart Failure Association &#40;HFA&#41; of the ESC"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46;J&#46; McMurray"
                            1 => "S&#46; Adamopoulos"
                            2 => "S&#46;D&#46; Anker"
                            3 => "A&#46; Auricchio"
                            4 => "M&#46; B&#246;hm"
                            5 => "K&#46; Dickstein"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
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Información del artículo
ISSN: 00257753
Idioma original: Español
DOI:10.1016/j.medcli.2017.11.025
Datos actualizados diariamente
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2023 Marzo 7 4 11
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2018 Octubre 1 0 1
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2017 Diciembre 0 2 2

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