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Mortalidad tras fractura de cadera: modelos predictivos
Hip fracture mortality: Predictive models
Beatriz Pallardo Rodila, Javier Gómez Pavóna,
Autor para correspondencia
fgomez@salud.madrid.org

Autor para correspondencia.
, Pablo Menéndez Martínezb
a Unidad de Ortogeriatría, Servicio de Geriatría, Hospital Central de la Cruz Roja San José y Santa Adela, Madrid, España
b Unidad de Ortogeriatría, Servicio de Traumatología Hospital Central de la Cruz Roja San José y Santa Adela, Madrid, España
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no igual&#225;ndose el riesgo en ambos grupos hasta pasados 5 e incluso 10 a&#241;os<a class="elsevierStyleCrossRefs" href="#bib0315"><span class="elsevierStyleSup">3&#44;4</span></a>&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">En los &#250;ltimos 10-20 a&#241;os se ha descrito&#44; en estudios llevados a cabo en distintos pa&#237;ses desarrollados como EE&#46; UU&#46;&#44; Inglaterra o Francia&#44; una disminuci&#243;n de la mortalidad intrahospitalaria<a class="elsevierStyleCrossRef" href="#bib0325"><span class="elsevierStyleSup">5</span></a>&#46; Cabe mencionar como avances que han contribuido a la mejor&#237;a de la supervivencia durante el ingreso la profilaxis de enfermedad tromboemb&#243;lica&#44; la reducci&#243;n del tiempo previo a la cirug&#237;a o el manejo perioperatorio de estos pacientes por un equipo multidisciplinario &#40;traumat&#243;logo&#44; anestesista&#44; ortogeriatra&#41;&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">La edad avanzada y el sexo masculino son los factores de riesgo m&#225;s com&#250;nmente estudiados y asociados a mortalidad tras una fractura de cadera en la literatura&#46; La comorbilidad&#44; la situaci&#243;n basal funcional y cognitiva&#44; las complicaciones m&#233;dicas&#44; la institucionalizaci&#243;n previa en residencia&#44; la deambulaci&#243;n precoz tras cirug&#237;a y la demora quir&#250;rgica tambi&#233;n han sido ampliamente investigadas y aceptadas como predictores de mortalidad&#46; Salvo el tiempo previo a la cirug&#237;a y la recuperaci&#243;n funcional temprana&#44; se trata de factores no modificables&#46; Gracias a los avances en las t&#233;cnicas quir&#250;rgicas y anest&#233;sicas y a la mejor&#237;a de la atenci&#243;n m&#233;dica durante el ingreso&#44; las tasas de mortalidad a los 30 d&#237;as y al a&#241;o no se han incrementado considerablemente en los &#250;ltimos 20-30 a&#241;os&#44; pese al aumento de edad de los pacientes y a una mayor prevalencia de comorbilidades&#44; como enfermedad cardiaca&#44; enfermedad pulmonar obstructiva cr&#243;nica&#44; insuficiencia renal o demencia<a class="elsevierStyleCrossRef" href="#bib0325"><span class="elsevierStyleSup">5</span></a>&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">Variables como tipo de anestesia o pol&#237;tica transfusional perioperatoria no han demostrado&#44; salvo en estudios aislados&#44; influir en la mortalidad tras una fractura de cadera&#46; Tampoco el tratamiento anticoagulante previo a la cirug&#237;a&#44; cada vez m&#225;s frecuente en esta poblaci&#243;n&#44; el cual s&#237; se ha relacionado con un alargamiento del tiempo preoperatorio&#44; aunque se necesitan m&#225;s evidencias al respecto&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">No son muchos los estudios que analizan la influencia del tipo de fractura y de cirug&#237;a en la supervivencia&#46; La relaci&#243;n entre tipo de fractura y mortalidad es motivo de controversia&#46; Hay autores que no han demostrado diferencias significativas&#44; si bien una discreta mayor&#237;a de ellos ha observado mediante an&#225;lisis multivariante un incremento de la mortalidad tras las fracturas extracapsulares &#40;pertrocant&#233;reas y subtrocant&#233;reas&#41; con respecto a las intracapsulares &#40;subcapitales&#41;&#46; El mecanismo que explicar&#237;a este hecho est&#225; pendiente de ser identificado en futuras investigaciones&#46; Tambi&#233;n hay discrepancias con respecto al tipo de cirug&#237;a&#46; Aunque algunos no han encontrado relaci&#243;n entre esta variable y la mortalidad&#44; otros han observado un peor pron&#243;stico con la hemiartroplastia &#40;cirug&#237;a habitual de las fracturas subcapitales&#41; que con la osteos&#237;ntesis empleada para fracturas extracapsulares&#46; Quiz&#225; esto &#250;ltimo por tratarse de un procedimiento m&#225;s complejo y agresivo&#44; con un mayor tiempo quir&#250;rgico&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Algunos autores han realizado estudios con el prop&#243;sito de determinar factores predictivos de mortalidad tras fractura de cadera&#46; Otros&#44; m&#225;s all&#225; de enumerar distintas variables&#44; han dise&#241;ado modelos predictivos de estratificaci&#243;n del riesgo de mortalidad a corto y largo plazo&#46; En este sentido se ha realizado un estudio de revisi&#243;n bibliogr&#225;fica narrativa exhaustiva de los modelos predictivos de mortalidad tras fractura de cadera dise&#241;ados hasta la actualidad con el objetivo de analizar cual o cuales han demostrado un mejor rendimiento&#44; as&#237; como de determinar aspectos susceptibles de mejora en el futuro&#46; Llevamos a cabo una b&#250;squeda bibliogr&#225;fica utilizando las bases de datos PubMed&#44; Cochrane Library&#44; Embase&#44; ibecs y Medes&#44; sin establecer l&#237;mites por fecha de publicaci&#243;n o criterios de exclusi&#243;n respecto al tipo de publicaci&#243;n&#44; tama&#241;o muestral o poblaci&#243;n diana&#46; Se incluyeron los art&#237;culos publicados en espa&#241;ol e ingl&#233;s&#46; Las palabras clave utilizadas para la b&#250;squeda fueron&#58; &#171;hip fracture&#187;&#44; &#171;mortality&#187;&#44; &#171;risk factors&#187;&#44; &#171;prognosis&#187;&#44; &#171;score&#187; y &#171;predictive model&#187;&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Descripci&#243;n de los modelos</span><p id="par0040" class="elsevierStylePara elsevierViewall">Se han creado modelos predictores de mortalidad para pacientes con fractura de cadera&#44; mientras que otros fueron inicialmente dise&#241;ados y validados para pacientes quir&#250;rgicos en general&#46; Algunos son modelos aplicables de forma preoperatoria&#44; mientras otros utilizan variables intraoperatorias o postoperatorias&#46;</p><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Modelos espec&#237;ficos</span><p id="par0045" class="elsevierStylePara elsevierViewall">Wallace et al&#46;&#44; en 1986<a class="elsevierStyleCrossRef" href="#bib0330"><span class="elsevierStyleSup">6</span></a>&#44; e Ions y Stevens&#44; en 1987<a class="elsevierStyleCrossRef" href="#bib0335"><span class="elsevierStyleSup">7</span></a>&#44; elaboran sencillos sistemas de puntuaci&#243;n para establecer el pron&#243;stico tras una fractura de cadera&#44; basados en el estado de salud y situaci&#243;n social <span class="elsevierStyleItalic">&#40;Belfast score&#41;&#44;</span> y en edad&#44; estado mental y comorbilidad previas <span class="elsevierStyleItalic">&#40;Newcastle score&#41;&#44;</span> respectivamente&#46; Posteriormente&#44; Thomas y Eastwood<a class="elsevierStyleCrossRef" href="#bib0340"><span class="elsevierStyleSup">8</span></a> mostraron que una mayor puntuaci&#243;n en ambos <span class="elsevierStyleItalic">scores</span> se asocia a una mayor mortalidad&#46; Sin embargo&#44; ninguno de los 2<span class="elsevierStyleHsp" style=""></span>ofrece cifras de mortalidad esperada con la que poder comparar la mortalidad observada&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Nottingham Hip Fracture Score &#40;NHFS&#41;</span> &#40;<a class="elsevierStyleCrossRefs" href="#tbl0005">tablas 1 y 2</a>&#41;&#58; Maxwell et al&#46;<a class="elsevierStyleCrossRef" href="#bib0345"><span class="elsevierStyleSup">9</span></a> publicaron en 2008 un estudio de cohorte en el que se recogen de forma prospectiva datos cl&#237;nicos y quir&#250;rgicos de 4&#46;967 pacientes de 65 a&#241;os o m&#225;s de edad intervenidos por fractura de cadera en el Queen&#39;s Medical Centre &#40;Nottingham&#44; Reino Unido&#41;&#46; En una mitad de la cohorte se identificaron las diferentes variables asociadas a mortalidad a los 30 d&#237;as&#44; que constituyeron el modelo predictivo que posteriormente fue validado en la otra mitad de la cohorte&#46; El n&#250;mero de muertes observadas frente a las pronosticadas indican una buena calibraci&#243;n &#40;prueba de la chi al cuadrado &#40;&#967;<span class="elsevierStyleSup">2</span>&#41;&#44; p &#61; 0&#44;79&#41; y un &#225;rea bajo la curva &#40;AUC&#41; <span class="elsevierStyleItalic">receiver operating characteristic</span> &#40;ROC&#41; de 0&#44;719 demuestra una razonable capacidad discriminante&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0055" class="elsevierStylePara elsevierViewall">Wiles et al&#46;<a class="elsevierStyleCrossRef" href="#bib0350"><span class="elsevierStyleSup">10</span></a> demostraron&#44; a partir de un estudio retrospectivo en el mismo centro&#44; que el NHFS tambi&#233;n estratifica el riesgo de mortalidad al a&#241;o de la cirug&#237;a por fractura de cadera&#46; Rushton et al&#46;<a class="elsevierStyleCrossRef" href="#bib0355"><span class="elsevierStyleSup">11</span></a> realizaron la primera validaci&#243;n independiente del NHFS en el Reino Unido&#44; aplicando esta escala de forma retrospectiva en 2<span class="elsevierStyleHsp" style=""></span>hospitales del condado de Northumberland&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">El NHFS es f&#225;cil de aplicar&#44; los datos que utiliza son generalmente recogidos de forma rutinaria en las historias m&#233;dica y de enfermer&#237;a&#44; y pueden ser registrados por el personal administrativo&#44; lo que facilita notablemente su uso como sistema de puntuaci&#243;n&#46; No incluye datos acerca del acto quir&#250;rgico ni del tipo de anestesia&#44; que Maxwell cree que pueden estar influidos en mayor o menor grado por factores preoperatorios&#44; por lo que puede ser calculado a su llegada a Urgencias<a class="elsevierStyleCrossRef" href="#bib0345"><span class="elsevierStyleSup">9</span></a>&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">En 2014 m&#225;s de la mitad &#40;51&#44;7&#37;&#41; de los hospitales en Inglaterra&#44; Gales e Irlanda del Norte reportaron el uso ocasional o rutinario de esta herramienta<a class="elsevierStyleCrossRef" href="#bib0360"><span class="elsevierStyleSup">12</span></a>&#46; No obstante&#44; la validaci&#243;n externa del modelo fuera del Reino Unido es hasta el momento muy limitada<a class="elsevierStyleCrossRefs" href="#bib0325"><span class="elsevierStyleSup">5&#44;13-15</span></a>&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">Recientemente&#44; de Jong et al&#46;<a class="elsevierStyleCrossRef" href="#bib0375"><span class="elsevierStyleSup">15</span></a> han llevado a cabo en Holanda un estudio de validaci&#243;n del NHFS en pacientes con fractura intracapsular tratados con hemiartroplastia&#44; demostrando una mortalidad significativamente superior a la esperada en esta poblaci&#243;n&#46; Refiere el autor que&#44; de confirmarse estos resultados en futuras investigaciones&#44; ser&#237;a precisa una recalibraci&#243;n de este modelo para este subgrupo&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">Otros autores han propuesto distintos modelos predictivos de mortalidad tras fractura de cadera a partir de variables preoperatorias &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">tablas 2 y 3</a>&#41;&#44; pero&#44; salvo excepciones como el Cumulated Ambulation Score<a class="elsevierStyleCrossRefs" href="#bib0380"><span class="elsevierStyleSup">16&#44;17</span></a> o The Sernbo score<a class="elsevierStyleCrossRefs" href="#bib0390"><span class="elsevierStyleSup">18&#44;19</span></a>&#44; no han sido validados posteriormente en otras poblaciones&#46; Adem&#225;s de los diversos tipos de variables que integran estos modelos &#40;datos sociodemogr&#225;ficos&#44; situaci&#243;n funcional&#44; situaci&#243;n mental&#44; comorbilidad&#44; calidad de vida o demora quir&#250;rgica entre otros&#41;&#44; se ha empezado a tomar en consideraci&#243;n en los &#250;ltimos a&#241;os el papel pron&#243;stico de ciertos marcadores inflamatorios como la amplitud de distribuci&#243;n eritrocitaria<a class="elsevierStyleCrossRef" href="#bib0305"><span class="elsevierStyleSup">1</span></a>&#44; el &#237;ndice neutr&#243;filo&#47;linfocito &#40;INL&#41;<a class="elsevierStyleCrossRef" href="#bib0400"><span class="elsevierStyleSup">20</span></a> o la relaci&#243;n prote&#237;na C reactiva&#47;&#237;ndice pron&#243;stico nutricional &#40;PCR&#47;IPN&#41;<a class="elsevierStyleCrossRef" href="#bib0405"><span class="elsevierStyleSup">21</span></a>&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Modelos generales</span><p id="par0080" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">The Orthopaedic Physiological and Operative Severity Score for enUmeration of Mortality and morbidity</span><span class="elsevierStyleItalic">&#40;O-POSSUM&#41;</span> &#40;<a class="elsevierStyleCrossRefs" href="#tbl0020">tablas 4 y 5</a>&#41;&#58; el sistema POSSUM&#44; originalmente dise&#241;ado por Copeland en 1991 como herramienta para evaluar los resultados tras cualquier cirug&#237;a&#44; urgente o electiva&#44; ten&#237;a en cuenta variables fisiol&#243;gicas preoperatorias y variables quir&#250;rgicas a partir de las cuales&#44; mediante an&#225;lisis de regresi&#243;n log&#237;stica&#44; se crearon las ecuaciones POSSUM para predicci&#243;n del riesgo de morbimortalidad&#46; Posteriormente&#44; se ha validado en distintas especialidades quir&#250;rgicas &#40;cirug&#237;a vascular&#44; tor&#225;cica y colorrectal&#44; entre otras&#41;&#46; En 2002 Mohamed et al&#46;<a class="elsevierStyleCrossRef" href="#bib0410"><span class="elsevierStyleSup">22</span></a> desarrollan y validan la variante Orthopaedic POSSUM&#44; aplic&#225;ndola a una muestra de 2326 pacientes tratados mediante cirug&#237;a ortop&#233;dica &#40;44&#37; electiva&#41; en un hospital de Warrington &#40;Reino Unido&#41; para predecir morbimortalidad a los 30 d&#237;as&#46; El sistema analiza 14 variables fisiol&#243;gicas y 6 intraoperatorias&#46; Cada una de las variables se divide en 4 categor&#237;as cuya puntuaci&#243;n aumenta exponencialmente &#40;1&#44; 2&#44; 4 y 8 puntos&#41;&#46;</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia><elsevierMultimedia ident="tbl0025"></elsevierMultimedia><p id="par0085" class="elsevierStylePara elsevierViewall">Otros autores utilizaron la escala O-POSSUM en pacientes con fractura de cadera con resultados a los 30 d&#237;as&#58; Ramanathan et al&#46;<a class="elsevierStyleCrossRef" href="#bib0415"><span class="elsevierStyleSup">23</span></a> predicen un 15&#44;6&#37; de mortalidad frente a un 10&#44;2&#37; de mortalidad observada&#44; con un pobre rendimiento &#40;AUC 0&#44;62&#41;&#44; mientras que Wright et al&#46;<a class="elsevierStyleCrossRef" href="#bib0420"><span class="elsevierStyleSup">24</span></a>&#44; por el contrario&#44; predicen de forma precisa morbimortalidad &#40;cociente casos observados&#47;esperados &#91;O&#47;E&#93; de 0&#44;95 y 1&#44;19&#44; respectivamente&#41;&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">Bonicoli et al&#46;<a class="elsevierStyleCrossRef" href="#bib0425"><span class="elsevierStyleSup">25</span></a> comparan O-POSSUM y Portsmouth-POSSUM &#40;P-POSSUM&#41; &#40;modificaci&#243;n del sistema original para solventar la sobrestimaci&#243;n de mortalidad referida por algunos autores al utilizar el sistema POSSUM&#41; en pacientes con fractura de cuello femoral tipos <span class="elsevierStyleSmallCaps">iii</span> y <span class="elsevierStyleSmallCaps">iv</span> de Garden tratados con artroplastia&#44; evidenciando que P-POSSUM infraestima la mortalidad en este grupo&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">En nuestro pa&#237;s&#44; Blay Dom&#237;nguez et al&#46; publican en 2018<a class="elsevierStyleCrossRef" href="#bib0320"><span class="elsevierStyleSup">4</span></a> los resultados de un an&#225;lisis retrospectivo con seguimiento a un a&#241;o&#44; mostrando una escasa capacidad de predicci&#243;n de mortalidad y morbilidad del O-POSSUM &#40;AUC de 0&#44;605 y 0&#44;55&#44; respectivamente&#41;&#44; por lo que se considera como un modelo no aceptable para su utilizaci&#243;n en poblaci&#243;n con fractura de cadera&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">El sistema O-POSSUM cuenta con varios inconvenientes para su utilizaci&#243;n en poblaci&#243;n con fractura de cadera<a class="elsevierStyleCrossRefs" href="#bib0355"><span class="elsevierStyleSup">11&#44;26</span></a>&#58; <span class="elsevierStyleItalic">a&#41;</span> se necesita demasiado tiempo para su aplicaci&#243;n&#44; lo cual limita su uso en la pr&#225;ctica cl&#237;nica habitual&#59; <span class="elsevierStyleItalic">b&#41;</span> utiliza datos intraoperatorios&#44; haciendo imposible su aplicaci&#243;n al ingreso&#44; y <span class="elsevierStyleItalic">c&#41;</span> debido a la homogeneidad de la cirug&#237;a en este grupo de pacientes&#44; la variabilidad en el POSSUM se debe en gran parte a cambios en las variables fisiol&#243;gicas &#40;algunos autores han probado que usando &#250;nicamente el componente fisiol&#243;gico del POSSUM el rendimiento es similar al demostrado cuando se utilizan ambas puntuaciones<a class="elsevierStyleCrossRefs" href="#bib0415"><span class="elsevierStyleSup">23&#44;27</span></a>&#41;&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">El Estimation of Physiologic Ability and Surgical Stress &#40;E-PASS&#41; score</span> fue desarrollado por el grupo japon&#233;s de Haga como herramienta pron&#243;stica de mortalidad postoperatoria tras cirug&#237;a electiva gastrointestinal&#46; Hirose et al&#46; aplicaron el E-PASS en poblaci&#243;n intervenida por fractura de cadera y encontraron una correlaci&#243;n significativa con la morbimortalidad postoperatorias intrahospitalarias<a class="elsevierStyleCrossRef" href="#bib0440"><span class="elsevierStyleSup">28</span></a>&#46; Est&#225; compuesto por una puntuaci&#243;n de riesgo preoperatorio &#40;Preoperative Risk Score&#41;&#58; edad&#44; comorbilidades&#44; Performance Status Index y clasificaci&#243;n American Society of Anesthesiologists &#91;ASA&#93;&#41; y una puntuaci&#243;n de estr&#233;s quir&#250;rgico &#40;Surgical Stress Score&#41;&#58; cantidad de sangre perdida por peso corporal&#44; tiempo de cirug&#237;a y tama&#241;o de la incisi&#243;n&#41;&#44; a partir de los cuales se calcula una puntuaci&#243;n completa de riesgo &#40;Comprehensive Risk Score&#41;&#46; Solo se han presentado &#237;ndices de casos O&#47;E&#44; sin otros an&#225;lisis estad&#237;sticos&#44; por lo que no se puede concretar el poder discriminativo y la calibraci&#243;n del E-PASS&#46; Al igual que ocurre con el O-POSSUM&#44; la inclusi&#243;n de datos intraoperatorios hace imposible su aplicaci&#243;n en el momento del ingreso y dificulta su utilizaci&#243;n en la pr&#225;ctica diaria<a class="elsevierStyleCrossRefs" href="#bib0350"><span class="elsevierStyleSup">10&#44;13</span></a>&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">La <span class="elsevierStyleItalic">clasificaci&#243;n ASA&#44;</span> focalizada en las comorbilidades del paciente a su ingreso&#44; ha demostrado un pobre-moderado poder discriminativo &#40;AUC 0&#44;60-0&#44;76&#41;<a class="elsevierStyleCrossRefs" href="#bib0345"><span class="elsevierStyleSup">9&#44;27&#44;29-33</span></a> en esta poblaci&#243;n concreta&#44; debido a que la mayor&#237;a de estos pacientes est&#225;n clasificados como ASA 3&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">La puntuaci&#243;n Donati &#40;Donati score&#41;<a class="elsevierStyleCrossRef" href="#bib0470"><span class="elsevierStyleSup">34</span></a> utiliza la edad&#44; la clasificaci&#243;n ASA&#44; la urgencia de la cirug&#237;a y la gravedad de la intervenci&#243;n&#46; La cohorte a partir de la cual se desarroll&#243; es significativamente distinta de la de los pacientes con fractura de cadera&#58; solo el 3&#37; de las cirug&#237;as eran urgentes&#44; el 15&#37; eran ASA 3&#44; el 50&#37; hombres y la edad media era de 55 a&#241;os&#46; En el caso de las fracturas de cadera&#44; al ser todas las cirug&#237;as urgentes&#44; de la misma gravedad &#40;ASA 3&#41; y con una edad generalmente superior a los 80 a&#241;os&#44; el intervalo de las puntuaciones resulta limitado y&#44; por lo tanto&#44; de baja utilidad<a class="elsevierStyleCrossRef" href="#bib0345"><span class="elsevierStyleSup">9</span></a>&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">El &#237;ndice de comorbilidad de Charlson &#40;ICCh&#41; es uno de los sistemas m&#225;s ampliamente utilizados para estratificar el riesgo quir&#250;rgico&#44; bas&#225;ndose en la comorbilidad preoperatoria&#46; Los estudios han mostrado tambi&#233;n un poder discriminativo pobre-moderado en el valor predictor tras fractura de cadera del ICCh original o de alguna de sus modificaciones&#44; con un AUC de 0&#44;62-0&#44;76 para mortalidad intrahospitalaria&#44; 0&#44;71-0&#44;79 para mortalidad a los 30 d&#237;as<a class="elsevierStyleCrossRefs" href="#bib0325"><span class="elsevierStyleSup">5&#44;35</span></a>&#44; 0&#44;59 para mortalidad a los 90 d&#237;as<a class="elsevierStyleCrossRef" href="#bib0445"><span class="elsevierStyleSup">29</span></a>&#59; 0&#44;64 a los 6 meses<a class="elsevierStyleCrossRef" href="#bib0460"><span class="elsevierStyleSup">32</span></a> y 0&#44;69-0&#44;75 al a&#241;o<a class="elsevierStyleCrossRef" href="#bib0325"><span class="elsevierStyleSup">5</span></a>&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">Las fracturas de cadera est&#225;n estrechamente vinculadas con causas y consecuencias de fragilidad&#44; como osteoporosis&#44; ca&#237;das&#44; bajo &#237;ndice de masa corporal&#44; polifarmacia y deterioro cognitivo&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">El &#237;ndice de fragilidad dise&#241;ado por Searle fue aplicado por Krishnan et al&#46;<a class="elsevierStyleCrossRef" href="#bib0480"><span class="elsevierStyleSup">36</span></a> en esta poblaci&#243;n espec&#237;fica&#46; Los pacientes se categorizan en grupos de alta&#44; intermedia y baja fragilidad&#44; comprob&#225;ndose que la mortalidad a los 30 d&#237;as es del 17&#44;2 y el 3&#44;4&#37; en los 2<span class="elsevierStyleHsp" style=""></span>primeros&#44; respectivamente&#44; y que todos los de baja fragilidad volvieron a su domicilio habitual&#46; Tambi&#233;n en los de alto riesgo el tiempo de estancia hospitalaria fue mayor y con m&#225;s frecuencia fueron institucionalizados en residencia al alta&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">La puntuaci&#243;n de fragilidad multidimensional para cadera &#40;Hip-Multidimensional Frailty Score &#91;Hip-MFS&#93;&#41;<a class="elsevierStyleCrossRef" href="#bib0465"><span class="elsevierStyleSup">33</span></a> es un modelo preoperatorio modificado de la puntuaci&#243;n multidimensional de fragilidad &#40;MFS&#41;&#44; basado en la valoraci&#243;n geri&#225;trica integral&#44; que est&#225; compuesto por 8 variables&#58; alb&#250;mina s&#233;rica&#44; circunferencia media de brazo&#44; ICCh&#44; autonom&#237;a de la deambulaci&#243;n&#44; situaci&#243;n cognitiva&#44; riesgo de ca&#237;das&#44; estado nutricional y sexo&#46; Aplicado retrospectivamente en 481 pacientes con fractura de cadera predice la mortalidad a los 6 meses y al a&#241;o&#44; las complicaciones postoperatorias&#44; el tiempo de estancia hospitalaria y la institucionalizaci&#243;n&#46; El Hip-MFS &#40;AUC 0&#44;784&#41; predijo de forma significativamente m&#225;s precisa la mortalidad a los 6 meses en comparaci&#243;n con la edad &#40;0&#44;586&#41; &#40;p &#61; 0&#44;004&#41;&#44; clasificaci&#243;n ASA &#40;0&#44;661&#41; &#40;p &#61; 0&#44;002&#41; y NHFS &#40;0&#44;711&#41; &#40;p &#61; 0&#44;044&#41;&#46;</p><p id="par0140" class="elsevierStylePara elsevierViewall">En un estudio retrospectivo llevado a cabo en un hospital de Texas &#40;EE&#46; UU&#46;&#41;&#44; Patel et al&#46;<a class="elsevierStyleCrossRef" href="#bib0485"><span class="elsevierStyleSup">37</span></a> examinaron la relaci&#243;n entre la puntuaci&#243;n en un &#237;ndice de fragilidad modificado abreviado del Canadian Study of Health and Aging Frailty Index y la mortalidad al a&#241;o y a los 2<span class="elsevierStyleHsp" style=""></span>a&#241;os tras una fractura de cadera en pacientes de 60 a&#241;os o m&#225;s de edad&#46; Una puntuaci&#243;n de 4 o m&#225;s se relaciona con unas tasas de mortalidad al a&#241;o y a los 2<span class="elsevierStyleHsp" style=""></span>a&#241;os m&#225;s elevadas&#44; con AUC de 0&#44;74 y 0&#44;72&#44; respectivamente&#44; lo cual sugiere que puede tratarse de una herramienta &#250;til para pronosticar mortalidad&#46; El an&#225;lisis de regresi&#243;n log&#237;stica demostr&#243; que la limitaci&#243;n de la movilidad&#44; el deterioro cognitivo&#44; la enfermedad respiratoria&#44; renal y tiroidea&#44; y la enfermedad tumoral se asociaron de forma independiente con un aumento de mortalidad&#46;</p><p id="par0145" class="elsevierStylePara elsevierViewall">Otros sistemas han demostrado su utilidad para predecir mortalidad en poblaci&#243;n con fractura de cadera&#44; como el &#237;ndice de riesgo cardiaco de Goldman<a class="elsevierStyleCrossRef" href="#bib0490"><span class="elsevierStyleSup">38</span></a>&#44; instrumentos que miden comorbilidad &#40;el &#237;ndice de comorbilidad de Elixhauser &#91;Elixhauser Comorbidity Index&#93;&#41;<a class="elsevierStyleCrossRef" href="#bib0495"><span class="elsevierStyleSup">39</span></a>&#44; la evaluaci&#243;n de la comorbilidad del adulto de 17 puntos &#40;Adult Comorbidity Evaluation-27&#41;<a class="elsevierStyleCrossRef" href="#bib0455"><span class="elsevierStyleSup">31</span></a>&#44; la puntuaci&#243;n preoperatoria para predecir mortalidad postoperatoria &#40;Preoperative Score to Predict Postoperative Mortality &#91;POSPOM&#93;&#41;<a class="elsevierStyleCrossRef" href="#bib0460"><span class="elsevierStyleSup">32</span></a>&#44; la herramienta de riesgo evolutivo quir&#250;rgico &#40;Surgical Outcome Risk Tool&#41;<a class="elsevierStyleCrossRef" href="#bib0450"><span class="elsevierStyleSup">30</span></a>&#44; la puntuaci&#243;n para valoraci&#243;n de traumatismos en pacientes ancianos y de edad media &#40;Score for Trauma Triage in the Geriatric and Middle-Aged &#91;STTGMA&#93;&#41;<a class="elsevierStyleCrossRef" href="#bib0500"><span class="elsevierStyleSup">40</span></a> o la puntuaci&#243;n STTGMA para fragilidad &#40;STTGMA Frailty score&#41;<a class="elsevierStyleCrossRef" href="#bib0505"><span class="elsevierStyleSup">41</span></a>&#44; derivado del anterior&#46;</p></span></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Estudios de comparaci&#243;n entre modelos</span><p id="par0150" class="elsevierStylePara elsevierViewall">En algunos estudios se eval&#250;a y compara el rendimiento de varios modelos&#44; tal y como se muestra en la <a class="elsevierStyleCrossRef" href="#tbl0030">tabla 6</a>&#46;</p><elsevierMultimedia ident="tbl0030"></elsevierMultimedia><p id="par0155" class="elsevierStylePara elsevierViewall">Burgos et al&#46;<a class="elsevierStyleCrossRef" href="#bib0445"><span class="elsevierStyleSup">29</span></a> llevaron a cabo un estudio prospectivo con una serie de 232 pacientes de 65 a&#241;os o m&#225;s intervenidos por fractura de cadera&#46; Previamente a la cirug&#237;a aplicaron&#58; la clasificaci&#243;n ASA&#44; el &#237;ndice de Barthel&#44; el &#237;ndice de Goldman&#44; el sistema POSSUM&#44; el ICCh y la escala anal&#243;gica visual de riesgo &#40;&#40;Visual Analogue Scale for Risk&#41;&#46; Ninguna de las escalas fue capaz de predecir la mortalidad a los 90 d&#237;as&#46;</p><p id="par0160" class="elsevierStylePara elsevierViewall">Karres et al&#46;<a class="elsevierStyleCrossRef" href="#bib0475"><span class="elsevierStyleSup">35</span></a> compararon la capacidad de predicci&#243;n de mortalidad a los 30 d&#237;as de una cirug&#237;a de fractura de cadera de 6 modelos&#44; aplicados de forma retrospectiva en una cohorte de un hospital de &#193;msterdam entre 2004 y 2010&#46; Tres de ellos &#40;ICCh&#44; O-POSSUM y E-PASS&#41; inicialmente dise&#241;ados para poblaci&#243;n quir&#250;rgica en general&#44; frente a otros 3 &#40;modelo de Jiang&#44; NHFS y modelo de Holt&#41; creados espec&#237;ficamente para pacientes con fractura de cadera&#46; Ninguno ofreci&#243; una discriminaci&#243;n excelente &#40;AUC &#62; 0&#44;80&#41;&#44; siendo mejor la demostrada por los modelos espec&#237;ficos&#44; que&#44; sin embargo&#44; adolecen de falta de ajuste&#46;</p><p id="par0165" class="elsevierStylePara elsevierViewall">Boddaert et al&#46;<a class="elsevierStyleCrossRef" href="#bib0460"><span class="elsevierStyleSup">32</span></a> demuestran en un estudio prospectivo que los modelos espec&#237;ficos &#40;NHFS&#41; o los geri&#225;tricos &#40;Cumulative Illness Rating Scale e ICCh&#41; no son mejores que los modelos generales &#40;clasificaci&#243;n ASA&#44; POSPOM&#41; en la predicci&#243;n de la mortalidad a corto &#40;30 d&#237;as&#41; y largo plazo &#40;6 meses&#41;&#46; Todos ellos muestran una baja capacidad de discriminaci&#243;n &#40;AUC 0&#44;62-0&#44;67&#41;&#44; lo cual sugiere al autor que las variables preoperatorias pueden no ser cruciales en la determinaci&#243;n del riesgo de mortalidad en esta poblaci&#243;n&#46;</p><p id="par0170" class="elsevierStylePara elsevierViewall">Tsang et al&#46;<a class="elsevierStyleCrossRef" href="#bib0360"><span class="elsevierStyleSup">12</span></a> comparan el modelo utilizado por el National Hip Fracture Database &#40;NHFD&#41; con el NHFS&#44; analizando datos de pacientes de 94 hospitales de Reino Unido ingresados por fractura de cadera en 2013&#46; Ambos modelos ofrecieron una capacidad moderada de discriminaci&#243;n&#44; con un estad&#237;stico c de 0&#44;71 y 0&#44;70&#44; respectivamente&#46; El NHFS demostr&#243; un mejor ajuste &#40;test de Hosmer y Lemeshow&#58; p &#61; 0&#44;599&#41; que el modelo del NHFD &#40;p &#61; 0&#44;029&#41;&#44; pero ambos fueron incongruentes en sus estimaciones del riesgo de mortalidad en algunos grupos de riesgo&#46;</p><p id="par0175" class="elsevierStylePara elsevierViewall">En un estudio retrospectivo que incluye a los pacientes mayores de 65 a&#241;os ingresados por fractura de cadera en el a&#241;o 2000 &#40;90 pacientes&#41; y en el 2015 &#40;167 pacientes&#41; en el Bolognini Hospital de Seriate en Lombard&#237;a &#40;Italia&#41;&#44; el ICCh evidenci&#243; una mejor capacidad predictiva que el NHFS a los 30 d&#237;as y al a&#241;o en ambos grupos<a class="elsevierStyleCrossRef" href="#bib0325"><span class="elsevierStyleSup">5</span></a>&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Discusi&#243;n y conclusiones</span><p id="par0180" class="elsevierStylePara elsevierViewall">La estimaci&#243;n precoz del pron&#243;stico de la cirug&#237;a de la fractura de cadera es de gran utilidad tanto para la pr&#225;ctica cl&#237;nica como para el propio paciente y su entorno familiar&#58;<ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005"><span class="elsevierStyleLabel">a&#41;</span><p id="par0185" class="elsevierStylePara elsevierViewall">Puede ayudar al m&#233;dico a planificar los cuidados perioperatorios<a class="elsevierStyleCrossRefs" href="#bib0390"><span class="elsevierStyleSup">18&#44;42&#44;43</span></a>&#46; As&#237;&#44; ayuda al anestesista a decidir el momento apropiado para la cirug&#237;a y tipo de anestesia<a class="elsevierStyleCrossRef" href="#bib0345"><span class="elsevierStyleSup">9</span></a> y al traumat&#243;logo a elegir el tipo de cirug&#237;a m&#225;s adecuado<a class="elsevierStyleCrossRef" href="#bib0395"><span class="elsevierStyleSup">19</span></a>&#44; lo cual no es &#243;bice para que las decisiones que se tomen en cada momento est&#233;n fundamentadas en la experiencia de los distintos profesionales implicados y de las circunstancias cl&#237;nicas espec&#237;ficas de cada paciente en cada momento&#46; Orienta en la decisi&#243;n de ubicar a los pacientes en un &#225;rea de optimizaci&#243;n preoperatoria con atenci&#243;n multidisciplinaria &#40;traumat&#243;logo&#44; anestesista&#44; ortogeriatra&#44; etc&#46;&#41;&#44; que permitir&#225; una cuidadosa planificaci&#243;n quir&#250;rgica o bien&#44; en los casos de bajo riesgo&#44; en una sala ortop&#233;dica convencional&#46; En los casos con una expectativa de vida limitada&#44; guiar&#237;a a los cl&#237;nicos a priorizar los cuidados paliativos y necesidades del cuidador<a class="elsevierStyleCrossRef" href="#bib0520"><span class="elsevierStyleSup">44</span></a>&#46;</p></li><li class="elsevierStyleListItem" id="lsti0010"><span class="elsevierStyleLabel">b&#41;</span><p id="par0190" class="elsevierStylePara elsevierViewall">Asiste a paciente y familiares en el proceso de consentimiento informado y les ayuda a elaborar unas expectativas realistas acerca de los resultados que se pueden esperar tanto desde el punto de vista funcional como de morbimortalidad<a class="elsevierStyleCrossRefs" href="#bib0345"><span class="elsevierStyleSup">9&#44;17&#44;22&#44;43</span></a>&#46;</p></li><li class="elsevierStyleListItem" id="lsti0015"><span class="elsevierStyleLabel">c&#41;</span><p id="par0195" class="elsevierStylePara elsevierViewall">Permite establecer comparaciones entre los posibles factores de riesgo de mortalidad en distintas localizaciones geogr&#225;ficas&#44; o entre distintas unidades&#44; o incluso dentro de una misma unidad en diferentes periodos<a class="elsevierStyleCrossRefs" href="#bib0345"><span class="elsevierStyleSup">9&#44;10&#44;23&#44;42</span></a>&#46; Todo esto constituye un punto de partida para la detecci&#243;n de aspectos de la atenci&#243;n de este proceso susceptibles de mejora&#44; promover futuras investigaciones y para la realizaci&#243;n de auditor&#237;as internas&#44; con una consiguiente mejor&#237;a de la calidad asistencial<a class="elsevierStyleCrossRefs" href="#bib0350"><span class="elsevierStyleSup">10&#44;45</span></a>&#46;</p></li></ul></p><p id="par0200" class="elsevierStylePara elsevierViewall">El modelo predictivo ideal ha de ser preciso&#44; f&#225;cil y r&#225;pido de aplicar&#44; y basarse en informaci&#243;n disponible antes de la cirug&#237;a &#40;preferiblemente&#44; en el momento del ingreso&#44; antes de la cirug&#237;a&#41;&#46; El modelo predictivo de mortalidad ideal tras fractura de cadera no existe&#46; La clasificaci&#243;n ASA&#44; el ICCh&#44; E-PASS&#44; NHFS y O-POSSUM han sido los m&#225;s utilizados hasta la fecha&#46; El ICCh es una herramienta moderadamente discriminante&#44; cuya calibraci&#243;n no est&#225; bien descrita&#44; y que adem&#225;s no es espec&#237;fico para cirug&#237;a&#44; por lo cual no tiene en consideraci&#243;n la gravedad del proceso quir&#250;rgico ni otras variables quir&#250;rgicas&#46; La clasificaci&#243;n ASA&#44; que como el ICCh incluye variables subjetivas&#44; presenta una discreta capacidad discriminante&#46; Parece dif&#237;cil generalizar el uso de modelos como el POSSUM o E-PASS&#44; por la complejidad que supone su aplicaci&#243;n dadas las variables intraoperatorias que incluyen&#44; no f&#225;cilmente disponibles en la pr&#225;ctica diaria<a class="elsevierStyleCrossRefs" href="#bib0310"><span class="elsevierStyleSup">2&#44;14&#44;34</span></a>&#46;</p><p id="par0205" class="elsevierStylePara elsevierViewall">El NHFS ha demostrado su valor pron&#243;stico a corto y a largo plazo&#44; con una moderada capacidad discriminante y aceptable calibraci&#243;n&#44; es f&#225;cil y r&#225;pido de aplicar por el personal sanitario desde el mismo momento de su ingreso hospitalario&#44; al no incluir variables quir&#250;rgicas&#46; Ha sido validado principalmente en centros de Reino Unido&#44; pero tambi&#233;n en otros pa&#237;ses<a class="elsevierStyleCrossRef" href="#bib0370"><span class="elsevierStyleSup">14</span></a>&#46; No hemos encontrado en la literatura revisada validaci&#243;n de este modelo en Espa&#241;a&#46;</p><p id="par0210" class="elsevierStylePara elsevierViewall">Ser&#237;an necesarios nuevos estudios para clarificar la importancia de ciertas variables preoperatorias cl&#237;nicas &#40;f&#225;rmacos&#44; tipo de fractura&#44; etc&#46;&#41; y anal&#237;ticas &#40;PCR&#44; INL&#44; etc&#46;&#41; como predictores de mortalidad tras una fractura de cadera&#44; y as&#237; poder contar con ellas para la elaboraci&#243;n de nuevos modelos predictivos o modificar de los ya existentes con objeto de mejorar su rendimiento&#46;</p><p id="par0215" class="elsevierStylePara elsevierViewall">Hay que rese&#241;ar que pese a la importancia de establecer el riesgo de mortalidad lo antes posible&#44; circunstancias intraoperatorias y del postoperatorio &#40;ciertos procedimientos quir&#250;rgicos&#44; duraci&#243;n de la cirug&#237;a&#44; transfusiones intraoperatorias&#44; hipotensi&#243;n perioperatoria o complicaciones mayores como embolia pulmonar y eventos cardiovasculares&#41; van a poder modificar ese riesgo<a class="elsevierStyleCrossRefs" href="#bib0315"><span class="elsevierStyleSup">3&#44;46&#44;47</span></a>&#46; As&#237;&#44; aspectos como el acortamiento del tiempo a la cirug&#237;a o un seguimiento en el perioperatorio por un equipo multidisciplinar con la participaci&#243;n de un ortogeriatra van a influir en la mortalidad de estos pacientes<a class="elsevierStyleCrossRef" href="#bib0360"><span class="elsevierStyleSup">12</span></a>&#46; La no inclusi&#243;n de variables intraoperatorias o postoperatorias en los modelos predictivos puede ayudar a explicar el hecho de que&#44; salvo excepciones&#44; no hayan demostrado una excelente discriminaci&#243;n&#46;</p><p id="par0220" class="elsevierStylePara elsevierViewall">Los estudios realizados hasta ahora&#44; tanto para definir factores de riesgo de mortalidad como para desarrollar o validar modelos predictivos&#44; muestran una gran heterogeneidad en distintos aspectos&#44; lo cual hace dif&#237;cil realizar comparaciones entre ellos y establecer conclusiones&#58; <span class="elsevierStyleItalic">a&#41;</span> criterios de exclusi&#243;n aplicados al elegir la muestra &#40;edad m&#237;nima&#44; lugar de residencia previo&#44; tipo de fractura o tipo de tratamiento&#44; por ejemplo&#41;&#59; <span class="elsevierStyleItalic">b&#41;</span> distintas variables recogidas&#44; as&#237; como la subjetividad de las mismas en ocasiones y la variabilidad en las escalas empleadas para medir algunas de estas variables &#40;situaci&#243;n funcional&#44; situaci&#243;n mental&#44; entre otras&#41;<a class="elsevierStyleCrossRef" href="#bib0530"><span class="elsevierStyleSup">46</span></a>&#59; <span class="elsevierStyleItalic">c&#41;</span> periodo de seguimiento &#40;intrahospitalario&#44; 30 d&#237;as&#44; 1 a&#241;o u otro&#41;&#59; <span class="elsevierStyleItalic">d&#41;</span> dise&#241;o de investigaci&#243;n empleado &#40;estudio longitudinal retrospectivo&#47;prospectivo&#44; revisi&#243;n sistem&#225;tica&#44; metaan&#225;lisis&#41;&#59; <span class="elsevierStyleItalic">e&#41;</span> fuente de datos utilizada &#40;un &#250;nico hospital&#44; multic&#233;ntrico&#44; base de datos nacional&#41;&#44; y <span class="elsevierStyleItalic">f&#41;</span> metodolog&#237;a de an&#225;lisis y medidas estad&#237;sticas empleadas&#46;</p><p id="par0225" class="elsevierStylePara elsevierViewall">La mortalidad es el resultado m&#225;s com&#250;nmente empleado para la valoraci&#243;n de la atenci&#243;n de pacientes con fractura de cadera&#46; Pero no hay que olvidar otros que aportan informaci&#243;n tan relevante o m&#225;s para pacientes&#44; familiares&#44; proveedores de cuidados y responsables pol&#237;ticos&#58; grado de independencia funcional &#40;incluida deambulaci&#243;n&#41; o la calidad de vida alcanzadas a medio plazo&#44; institucionalizaci&#243;n &#40;par&#225;metro indirecto de dependencia f&#237;sica&#41;&#44; dolor postoperatorio o costes econ&#243;micos<a class="elsevierStyleCrossRefs" href="#bib0315"><span class="elsevierStyleSup">3&#44;12&#44;45&#44;48</span></a>&#46; Ser&#237;a interesante y &#250;til dise&#241;ar modelos predictivos que atendieran a estos otros resultados o que utilizaran no tanto variables demogr&#225;ficas o cl&#237;nicas&#44; sino otras que hagan referencia a aspectos psicol&#243;gicos&#44; funcionales o sociales<a class="elsevierStyleCrossRef" href="#bib0530"><span class="elsevierStyleSup">46</span></a>&#46;</p><p id="par0230" class="elsevierStylePara elsevierViewall">En resumen&#44; el empleo de modelos predictores de riesgo de mortalidad tras una fractura de cadera podr&#237;a resultar de gran ayuda en la pr&#225;ctica diaria para la toma de decisiones por parte de los profesionales en la pr&#225;ctica diaria&#44; para optimizar e individualizar los recursos disponibles y como apoyo en procesos de auditor&#237;a destinados a la mejor&#237;a de la calidad asistencial&#46; Ninguno de los modelos descritos hasta ahora muestran una capacidad predictiva &#243;ptima y la gran mayor&#237;a est&#225; pendiente de validaci&#243;n externa en poblaciones diferentes de aquellas en las que se propusieron originalmente&#46; El NHFS y el POSSUM han sido los m&#225;s utilizados hasta el momento&#44; si bien el primero es m&#225;s sencillo y r&#225;pido de aplicar&#44; y al no incluir variables intraoperatorias se puede emplear en el momento del ingreso&#46; Adem&#225;s&#44; los trabajos realizados muestran una gran heterogeneidad en cuanto a las caracter&#237;sticas de la poblaci&#243;n incluida en los mismos&#44; variables estudiadas&#44; tiempo de seguimiento y m&#233;todos estad&#237;sticos empleados que hace dif&#237;cil establecer comparaciones&#46; Se requieren&#44; por tanto&#44; nuevos estudios prospectivos&#44; de gran tama&#241;o muestral y que muestren una mayor homogeneidad para poder emitir conclusiones&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Conflicto de intereses</span><p id="par0235" class="elsevierStylePara elsevierViewall">Los autores declaran no tener conflicto de intereses&#46;</p></span></span>"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">La estimaci&#243;n preoperatoria del riesgo de mortalidad tras una fractura de cadera es de gran utilidad para planificar el momento de la cirug&#237;a y los cuidados perioperatorios&#44; informar al paciente y familiares acerca del pron&#243;stico&#44; y establecer comparaciones entre distintas unidades&#46; Se han desarrollado varios modelos para estratificar el riesgo de mortalidad&#44; pero muestran heterogeneidad en cuanto a tipo de poblaci&#243;n&#44; variables incluidas&#44; tiempo de seguimiento y m&#233;todos estad&#237;sticos empleados&#44; lo que hace dif&#237;cil establecer comparaciones entre ellos&#46; La gran mayor&#237;a est&#225; pendiente de validaci&#243;n externa en poblaciones diferentes de aquellas en las que se propusieron originalmente&#46; El Nottingham Hip Fracture Score &#40;NHFS&#41; y el Orthopaedic Physiologic and Operative Severity Score for the enUmeration of Mortality and Morbidity &#40;O-POSSUM&#41; son los modelos m&#225;s utilizados hasta el momento&#46; El NHFS es m&#225;s sencillo y r&#225;pido de aplicar&#44; y al no incluir variables intraoperatorias se puede emplear en el momento del ingreso&#46;</p></span>"
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        "resumen" => "<span id="abst0010" class="elsevierStyleSection elsevierViewall"><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">The preoperative estimation of the risk of mortality after a hip fracture is very useful to plan time of surgery and perioperative care&#44; inform patients and families about the prognosis and allows comparisons between different units&#46; Different models have been developed to stratify mortality risk&#44; but they show heterogeneity in terms of type of population and variables included&#44; monitoring the time and statistical methods used&#44; which makes it difficult to establish comparisons between them&#46; The vast majority of them are awaiting external validation in populations different from those in which they were originally proposed&#46; So far&#44; the Nottingham Hip Fracture Score &#40;NHFS&#41; and the Orthopaedic Physiological and Operative Severity Score for the enUmeration of Mortality and Morbidity &#40;O-POSSUM&#41; are the most commonly used models&#46; The NHFS is simpler and faster to apply&#44; and by not including intraoperative variables can be used at the time of admission&#46;</p></span>"
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                  \t\t\t\t">Sexo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">HombreMujer&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hemoglobina al ingreso&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60; 10g&#47;dl&#62; 10g&#47;dl&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">MMTS al ingreso&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8804; 6 &#47;10&#62; 6 &#47;10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Institucionalizado&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">S&#237;No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">N&#250;mero de comorbilidades &#40;enfermedad cardiovascular&#44; cerebrovascular&#44; respiratoria&#44; renal&#44; diabetes&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0-1&#8805; 2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">01&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Malignidad&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">S&#237;No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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          "leyenda" => "<p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">AUC&#58; &#225;rea bajo la curva&#59; CAS&#58; Cumulated Ambulation Score&#59; NHFS&#58; Nottingham Hip Fracture Score&#59; Test HL&#58; prueba de Hosmer y Lemeshow&#59; &#967;<span class="elsevierStyleSup">2</span>&#58; chi al cuadrado&#46;</p>"
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                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Estudio &#40;autor&#44; a&#241;o&#44; pa&#237;s&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Tipo de estudio&#47;descripci&#243;n de la muestra&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Mortalidad observada&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Discriminaci&#243;n&#47;c calibraci&#243;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">NHFS</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Maxwell et al&#46;&#44; 2008<a class="elsevierStyleCrossRef" href="#bib0345"><span class="elsevierStyleSup">9</span></a>&#44;Nottingham &#40;Inglaterra&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Prospectivo&#59; muestras de derivaci&#243;n &#40;n&#58; 2&#46;492&#41; y validaci&#243;n &#40;2&#46;475&#41;Cirug&#237;a fractura de cadera&#46; Edad media&#58; 79&#44;9&#47;80&#44;1 a&#241;os&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">30 d&#237;as&#58; 7&#44;8&#37; &#40;8&#44;0&#37;&#47;7&#44;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">AUC 0&#44;719Test HL&#58; p &#61; 0&#44;79&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Wiles et al&#46;&#44; 2011<a class="elsevierStyleCrossRef" href="#bib0350"><span class="elsevierStyleSup">10</span></a>&#44;Nottingham &#40;Inglaterra&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Retrospectivo&#44; n&#58; 6&#46;202Bajo riesgo&#58; NHFS &#8804; 4&#47;alto riesgo&#58; NHFS &#8805; 5Cirug&#237;a fractura de cuello femoral&#46; Edad mediana&#58; 82 a&#241;os &#40;79&#47;87&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">30 d&#237;as&#58; 8&#44;3&#37; &#40;3&#44;5&#37;&#47;13&#44;7&#37;&#41;&#59;1 a&#241;o&#58; 29&#44;3&#37; &#40;15&#44;9&#37; &#47; 45&#44;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Moppett et al&#46;&#44; 2012<a class="elsevierStyleCrossRef" href="#bib0540"><span class="elsevierStyleSup">48</span></a>&#44;Peterborough&#44; Brighton&#44;Nottingham &#40;Inglaterra&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Retrospectivo &#40;3 hospitales&#41;&#59; muestras de derivaci&#243;n &#40;n&#58; 3&#46;623&#41; y validaci&#243;n &#40;3&#46;667&#41;Cirug&#237;a fractura de cadera &#8805; 60 a&#241;os&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">30 d&#237;as&#58; 6&#44;6&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Test HL&#58; p &#62; 0&#44;1 para muestras de derivaci&#243;n y validaci&#243;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Kau al&#46;&#44; 2014<a class="elsevierStyleCrossRef" href="#bib0305"><span class="elsevierStyleSup">1</span></a>&#41;&#44;Singapur&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Prospectivo&#44; n&#58; 138Cirug&#237;a fractura de cadera &#62; 60 a&#241;os&#46; Edad media&#58; 78&#44;78 a&#241;os&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">30 d&#237;as&#58; 7&#44;3&#37;&#59;1 a&#241;o&#58;14&#44;6&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">AUC 30 d&#237;as&#58; 0&#44;800&#59; 3 meses&#58; 0&#44;600&#59; 1 a&#241;o&#58; 0&#44;607&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Rushton et al&#46;&#44; 2015<a class="elsevierStyleCrossRef" href="#bib0355"><span class="elsevierStyleSup">11</span></a>&#44;Northumberland &#40;Inglaterra&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Retrospectivo &#40;2 hospitales&#41;&#44; n&#58; 1&#46;079Cirug&#237;a fractura de cadera &#62; 60 a&#241;os&#46; Edad media&#58; 83 a&#241;os&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">30 d&#237;as&#58; 7&#44;3&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Test HL&#58; p &#61; 0&#44;37&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Tilkeridis et al&#46;&#44; 2018<a class="elsevierStyleCrossRef" href="#bib0370"><span class="elsevierStyleSup">14</span></a>&#44;Alejandr&#243;polis &#40;Grecia&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Prospectivo&#44; n&#58; 349NHFS original&#47;NHFS modificado &#40;sustituye institucionalizaci&#243;n por New Mobility Score&#41;Cirug&#237;a fractura de cadera&#46; Edad media&#58; 80&#44;82 a&#241;os&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">30 d&#237;as&#58; 9&#44;45&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">AUC&#58; 0&#44;83&#47;0&#44;84Test HL&#58; p &#61; 0&#44;31&#47;0&#44;11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>De Jong et al&#46;&#44; 2019<a class="elsevierStyleCrossRef" href="#bib0375"><span class="elsevierStyleSup">15</span></a>&#44;R&#243;terdam &#40;Holanda&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Retrospectivo &#40;2 hospitales&#41;&#44; n&#58; 901Hemiartroplastias en fracturas intracapsulares &#62; 70 a&#241;os&#46; Edad media&#58; 83 a&#241;os&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">30 d&#237;as&#58; 9&#44;5&#37;&#59;1 a&#241;o&#58; 28&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">AUC 30 d&#237;as&#58; 0&#44;739Prueba &#967;<span class="elsevierStyleSup">2</span> de Pearson&#58; &#967;<span class="elsevierStyleSup">2</span> &#61; 20&#44;83&#44; df &#61; 10&#44; p &#61; 0&#44;022&#46; Estad&#237;stico U &#40;p &#60; 0&#44;001&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">CAS &#40;transferencia supino &#8596; sedestaci&#243;n&#44; sedestaci&#243;n &#8596; bipedestaci&#243;n &#91;desde sill&#243;n&#93;&#44; deambulaci&#243;n con la ayuda t&#233;cnica apropiada&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Foss et al&#46;&#44; 2006<a class="elsevierStyleCrossRef" href="#bib0380"><span class="elsevierStyleSup">16</span></a>&#44;Copenague &#40;Dinamarca&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Prospectivo&#44; n&#58; 426CAS los 3 primeros d&#237;as postoperatorios &#40;0-3&#47;4-6&#47;7-9&#47;&#8805; 10&#41;Cirug&#237;a fractura de cadera&#46; Edad media&#58; 82 a&#241;os&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">30 d&#237;as&#58; 10&#44;3&#37;&#40;36&#37;&#47;7&#37; &#47;10&#37; &#47;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Kristensen et al&#46;&#44; 2017<a class="elsevierStyleCrossRef" href="#bib0385"><span class="elsevierStyleSup">17</span></a>&#44;Copenague &#40;Dinamarca&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Prospectivo&#44; n&#58;444CAS al alta &#40;&#60; 6&#47;&#61; 6&#41;Cirug&#237;a fractura de cadera &#8805; 60 a&#241;os&#46; Edad media&#58; 81&#44;4 a&#241;os&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 a&#241;o&#58; 16&#37; &#40;30&#37;&#47;12&#37;&#41;&#59;5 a&#241;os&#58; 57&#37; &#40;78&#37;&#47;50&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">The SERNBO Score &#40;edad&#44; situaci&#243;n social&#44; movilidad&#44; situaci&#243;n mental&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Dawe et al&#46;&#44; 2013<a class="elsevierStyleCrossRef" href="#bib0390"><span class="elsevierStyleSup">18</span></a>&#44;Brighton &#40;Inglaterra&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Prospectivo&#44; n&#58; 259Fracturas intracapsulares desplazadas &#62; 65 a&#241;os&#46; Edad media&#58; 85 a&#241;os&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">30 d&#237;as&#58; 1&#37;&#47;11&#37;&#59;1 a&#241;o&#58; 8&#37;&#47;35&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">AUC 30 d&#237;as&#58; 0&#44;71&#59; 1 a&#241;o&#58; 0&#44;68&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Mellner et al&#46;&#44; 2017<a class="elsevierStyleCrossRef" href="#bib0395"><span class="elsevierStyleSup">19</span></a>&#44;Sundswall &#40;Suecia&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Prospectivo&#59; n&#58; 292Cirug&#237;a fractura subcapital desplazada &#8805; 65 a&#241;os&#46; Edad media&#58; 83 a&#241;os&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 a&#241;o&#58; 24&#37; &#40;5&#37;&#47;22&#37;&#47;51&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">AUC&#58; 0&#44;79 &#40;edad&#58; 0&#44;65&#59; situaci&#243;n social&#58; 0&#44;68&#59; movilidad&#58; 0&#44;67&#59; situaci&#243;n mental&#58; 0&#44;60&#41;Test HL&#58; &#967;<span class="elsevierStyleSup">2</span> &#61; 4&#44;8&#59; p &#61; 0&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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          "es" => "<p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Estudios de los principales modelos espec&#237;ficos validados predictivos de mortalidad tras fractura de cadera</p>"
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          "leyenda" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">ACS&#58; American College of Surgeons&#59; ADE&#58; amplitud de distribuci&#243;n eritrocitaria&#59; AHFS&#58; The Almelo Hip Fracture Score&#59; ASA&#58; American Society of Anesthesiologists&#59; AUC&#58; &#225;rea bajo la curva&#59; CEU 17&#58; The Clinical Effectiveness Unit model 17&#59; EPOC&#58; enfermedad pulmonar obstructiva cr&#243;nica&#59; EQ-5D&#58; European Quality of Life-5 Dimensions&#59; HEMA&#58; Hip fracture Estimator of Mortlity Amsterdam&#59; HRS&#58; Health and Retirement Study&#59; HTA&#58; hipertensi&#243;n arterial&#59; IB&#58; &#237;ndice de Barthel&#59; INL&#58; &#237;ndice neutr&#243;filo&#47;linfocito&#59; IPN&#58; &#237;ndice pron&#243;stico nutricional&#59; MaRTHi&#58; Marburg Rehabilitation Tool for hip fractures&#59; MMSE&#58; Mini-Mental State Examination&#59; NHFD&#58; National Hip Fracture Database&#59; NSQIP&#58; National Surgical Quality Improvement Program&#59; PCR&#58; prote&#237;na C reactiva&#59; Rx&#58; radiograf&#237;a&#59; SPMSQ&#58; Short Portable Mental Status Questionnaire&#59; Test HL&#58; prueba de Hosmer y Lemeshow&#59; &#967;2&#58; chi al cuadrado&#46;</p>"
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Estudio &#40;autor&#44; a&#241;o&#44; pa&#237;s&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Modelo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Tipo de estudio &#47; Descripci&#243;n de la muestra&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Mortalidad observada&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Discriminaci&#243;n &#47; Calibraci&#243;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Wallace et al&#46;&#44; 1986<a class="elsevierStyleCrossRef" href="#bib0330"><span class="elsevierStyleSup">6</span></a>Belfast &#40;Irlanda del Norte&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Belfast Score&#58;situaci&#243;n m&#233;dica y social previas&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Prospectivo&#44; n&#58; 322Cirug&#237;a fractura de cadera &#62; 65 a&#241;os&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6 meses&#58; 15&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Ions y Stevens&#44; 1987<a class="elsevierStyleCrossRef" href="#bib0335"><span class="elsevierStyleSup">7</span></a>&#44;Newcastle &#40;Inglaterra&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Newcastle Score&#58;edad&#44; situaci&#243;n mental&#44; comorbilidad&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Prospectivo&#44; n&#58; 158Fractura intracapsular &#62; 55 a&#241;os&#46; Edad media&#58; 76&#44;8 a&#241;os&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6 meses&#58; 17&#37; &#40;cirug&#237;a&#58; 9&#44;6&#37;&#47;tratamiento conservador&#58; 60&#44;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Thomas y Eastwood&#44; 1996<a class="elsevierStyleCrossRef" href="#bib0340"><span class="elsevierStyleSup">8</span></a>&#44;Southampton &#40;Inglaterra&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Belfast Score &#43; Newcastle Score</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Prospectivo&#44; n&#58; 250Cirug&#237;a fractura de cuello femoral &#8805; 65 a&#241;os&#46; Edad media&#58; 83 a&#241;os&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Intrahospitalaria&#58; 16&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Parker y Palmer&#44; 1993<a class="elsevierStyleCrossRef" href="#bib0545"><span class="elsevierStyleSup">49</span></a>&#44;Cambridge &#40;Inglaterra&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Puntuaci&#243;n de movilidad y prueba de estado mental&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Prospectivo&#44; n&#58;882Fractura de cadera&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 a&#241;o&#58; 35&#44;5&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Miller et al&#46;&#44; 1993<a class="elsevierStyleCrossRef" href="#bib0550"><span class="elsevierStyleSup">50</span></a>&#44;Salzburgo &#40;Austria&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Infarto de miocardio&#47;pulmonar en los &#250;ltimos 6 meses&#44; estenosis arterial grave&#44; <span class="elsevierStyleItalic">angor pectoris</span>&#44; movilidad prefractura&#44; insuficiencia cardiaca derecha&#44; arritmia&#44; extrasistolia ventricular&#44; HTA&#44; alteraci&#243;n Rx t&#243;rax&#44; potasio &#60; 3&#44;0&#44; creatinina &#62; 3&#44;0&#44; gasometr&#237;a arterial patol&#243;gica&#44; alteraci&#243;n funci&#243;n hep&#225;ticagrupo <span class="elsevierStyleSmallCaps">i</span> &#40;4-20 puntos&#41;&#44; <span class="elsevierStyleSmallCaps">ii</span> &#40;21-30&#41;&#44; <span class="elsevierStyleSmallCaps">iii</span> &#40;31-50&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Prospectivo&#44; n&#58; 317Cirug&#237;a fractura intracapsular y pertrocant&#233;rea&#46; Edad media&#58; 77&#47;83&#47;87 a&#241;os&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Intrahospitalaria&#58; 9&#44;5&#37; &#40;2&#44;5&#37;&#47;11&#44;9&#37;&#47;44&#44;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Elliot et al&#46;&#44; 2003<a class="elsevierStyleCrossRef" href="#bib0510"><span class="elsevierStyleSup">42</span></a>&#44;Belfast &#40;Irlanda del Norte&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Edad&#44; sexo&#44; MMSE abreviado&#44; IB&#44; ASA&#44; demora quir&#250;rgica&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Prospectivo&#44; n&#58; 1&#46;780Cirug&#237;a fractura de cadera&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 a&#241;o&#58; hombres&#58; 30&#44;1&#37;&#44; mujeres&#58; 19&#44;5&#37;&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-Estad&#237;stico c&#58; 0&#44;73-0&#44;80-Prueba de bondad de ajuste &#43863;<a class="elsevierStyleCrossRef" href="#bib0310"><span class="elsevierStyleSup">2</span></a>&#58; p&#61;0&#44;473&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Masuda et al&#46;&#44; 2004<a class="elsevierStyleCrossRef" href="#bib0555"><span class="elsevierStyleSup">51</span></a>&#44;Kawasaki &#40;Jap&#243;n&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Funci&#243;n pulmonar&#44; cardiopat&#237;a&#44; HTA&#44; intolerancia a la glucosa&#44; funci&#243;n renal&#44; funci&#243;n hep&#225;tica&#44; anemia&#44; hipoproteinemia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Prospectivo&#44; n&#58; 83Fractura de cadera &#8805; 75 a&#241;os&#46; Edad media&#58; 81&#44;2 a&#241;os&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">26&#37; &#40;seguimiento medio de 3 a&#241;os y 2 meses&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Jiang et al&#46;&#44; 2005<a class="elsevierStyleCrossRef" href="#bib0315"><span class="elsevierStyleSup">3</span></a>&#44;Edmonton &#40;Canad&#225;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Edad&#44; sexo&#44; institucionalizaci&#243;n&#44; comorbilidad &#40;EPOC&#44; neumon&#237;a&#44; cardiopat&#237;a isqu&#233;mica&#44; arritmias&#44; insuficiencia cardiaca&#44; insuficiencia renal&#44; alteraciones electrol&#237;ticas&#44; neoplasia&#44; malnutrici&#243;n&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Retrospectivo &#40;2 hospitales&#41;&#59; muestras de derivaci&#243;n &#40;n&#58; 2&#46;187&#41; y validaci&#243;n &#40;1&#46;794&#41;Fractura de cadera &#8805; 60 a&#241;os&#46; Edad mediana&#58; 82&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Intrahospitalaria&#58; 6&#44;3&#37;&#59; 1 a&#241;o&#58; 30&#44;8&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Estad&#237;stico c intrahospitalaria&#58; 0&#44;83&#47;0&#44;82&#59; 1 a&#241;o&#58; 0&#44;75&#47;0&#44;74Test HL &#40;intrahospitalaria&#44; muestra de derivaci&#243;n&#41;&#58; p &#62; 0&#44;50&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Holt et al&#46;&#44; 2008<a class="elsevierStyleCrossRef" href="#bib0560"><span class="elsevierStyleSup">52</span></a>&#44;Edimburgo &#40;Escocia&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Variables del paciente &#40;edad&#44; sexo&#44; ASA&#44; institucionalizaci&#243;n&#44; movilidad previa&#44; tipo de fractura&#41; y del tratamiento &#40;tiempo de fractura a cirug&#237;a&#44; tiempo de admisi&#243;n a cirug&#237;a&#44; cualificaci&#243;n de cirujano y anestesista&#44; tipo de anestesia&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Retrospectivo&#44; base de datos nacional&#58; Scottish Hip Fracture Audit&#59; n&#58; 18&#46;817Cirug&#237;a fractura de cadera&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">30 d&#237;as&#58; 7&#37;&#59;4 meses&#58; 18&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">S&#246;derqvist et al&#46; 2009<a class="elsevierStyleCrossRef" href="#bib0565"><span class="elsevierStyleSup">53</span></a>&#44;Estocolmo &#40;Suecia&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Edad&#44; sexo&#44; ASA&#44; SPMSQ&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Prospectivo&#44; n&#58; 1&#46;944Cirug&#237;a fractura de cadera &#62; 65 a&#241;os&#46; Edad media&#58; 84 a&#241;os&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Intrahospitalaria&#58; 4&#37;&#59; 4 meses&#58; 16&#37;&#59;2 a&#241;os&#58; 38&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">AUC 2 a&#241;os&#58; 0&#44;74&#40;edad&#44; sexo&#58; 0&#44;64&#44; edad&#44; sexo&#44; ASA&#58; 0&#44;71&#59; edad&#44; sexo&#44; SPMSQ&#58; 0&#59;70&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Frost et al&#46;&#44; 2011<a class="elsevierStyleCrossRef" href="#bib0515"><span class="elsevierStyleSup">43</span></a>&#44;S&#237;dney &#40;Australia&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Edad&#44; sexo&#44; insuficiencia cardiaca&#44; enfermedad cerebrovascular&#44; enfermedad hep&#225;tica&#44; enfermedad renal&#44; neoplasia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Prospectivo&#44; n&#58; 1&#46;504Fractura de cadera &#8805; 50 a&#241;os&#46; Edad media&#58;vivos&#58; 80 a&#241;os&#47; fallecidos&#58; 84 a&#241;os&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Intrahospitalaria&#58; 6&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">AUC&#58; 0&#44;76 &#40;edad &#43; sexo&#58; 0&#44;69&#41;M&#233;todo bootstrap&#58; sesgo de calibraci&#243;n m&#225;ximo de 4&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Tsang et al&#46;&#44; 2014<a class="elsevierStyleCrossRef" href="#bib0360"><span class="elsevierStyleSup">12</span></a>&#44;Reino Unido&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">CEU 17&#58;Edad&#44; sexo&#44; ASA&#44; institucionalizaci&#243;n&#44; capacidad de deambulaci&#243;n en interiores&#44; tipo de fractura&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Retrospectivo&#44; base de datos nacional &#40;NHFD&#41;&#58;n&#58; 59&#46;654Fractura de cadera osteopor&#243;tica&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">AUC &#40;30 d&#237;as&#41;&#58; 0&#44;751Gr&#225;fico de calibraci&#243;n&#58; razonablemente bien calibrado&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Pugely et al&#46;&#44; 2014<a class="elsevierStyleCrossRef" href="#bib0525"><span class="elsevierStyleSup">45</span></a>&#44;Iowa &#40;EE&#46; UU&#46;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Edad&#44; sexo&#44; situaci&#243;n funcional&#44; ASA&#44; neoplasia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Prospectivo&#59; ACS NSQIP &#40;&#62; 258 hospitales&#41;&#59; muestras de derivaci&#243;n &#40;n&#58; 3&#46;455&#41; y validaci&#243;n &#40;876&#41;Cirug&#237;a fractura de cadera&#46; Edad media&#58; muestra de derivaci&#243;n&#58; vivos&#47;fallecidos&#58; 80&#44;87 a&#241;os&#47;84&#44;15 a&#241;os&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">30 d&#237;as&#58; 5&#44;9&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Estad&#237;stico c&#58; 0&#44;777&#47;0&#44;702Test HL&#58; p &#62; 0&#44;05&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Bliemel et al&#46;&#44; 2016<a class="elsevierStyleCrossRef" href="#bib0430"><span class="elsevierStyleSup">26</span></a>&#44;Marburgo &#40;Alemania&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Sexo&#44; ASA&#44; MMSE &#237;ndice EQ-5D&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Prospectivo&#44; n&#58; 391Cirug&#237;a fractura de cadera &#8805; 60 a&#241;os&#46; Edad media 81 a&#241;os&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Intrahospitalaria&#58; 8&#37;&#59; 1 a&#241;o&#58; 28&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">AUC &#40;1 a&#241;o&#41;&#58; 0&#44;74Test HL&#58; &#40;&#967;2 &#61; 5&#44;73&#44; p &#61; 0&#44;678&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Cenzer et al&#46;&#44; 2016<a class="elsevierStyleCrossRef" href="#bib0520"><span class="elsevierStyleSup">44</span></a>&#44;EE&#46; UU&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Edad&#44; sexo&#44; insuficiencia cardiaca&#44; dificultad preparar comida&#44; capacidad para conducir&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Retrospectivo&#44; base de datos nacional &#40;HRS&#41;&#44; n&#58; 857Fractura de cadera &#8805; 65 a&#241;os&#46; Edad media&#58; 84 a&#241;os&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 a&#241;o&#58; 27&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">AUC&#58; 0&#44;73Estrecha relaci&#243;n entre mortalidad observada y esperada en todos los niveles de riesgo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Forget et al&#46;&#44; 2016<a class="elsevierStyleCrossRef" href="#bib0400"><span class="elsevierStyleSup">20</span></a>&#44;Bruselas &#40;B&#233;lgica&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Edad&#44; sexo&#44; INL&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Prospectivo&#44; n&#58; 286Cirug&#237;a fractura de cadera &#62; 64 a&#241;os&#46; Edad mediana&#58; 84 a&#241;os&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 a&#241;o&#58; 28&#44;7&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">AUC&#58; 0&#44;72&#40;edad &#43; sexo&#58; 0&#44;52&#59; PCR&#58; 0&#44;53&#59; INL&#58; 0&#44;59&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Nijmeijer et al&#46;&#44; 2016<a class="elsevierStyleCrossRef" href="#bib0535"><span class="elsevierStyleSup">47</span></a>&#44;Leiden &#40;Holanda&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">AHFS&#58;edad&#44; sexo&#44; hemoglobina al ingreso&#44; fragilidad cognitiva&#44; institucionalizaci&#243;n&#44; ASA&#44; n&#250;mero de comorbilidades&#44; neoplasia&#44; Parker Mobility Score&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Prospectivo&#44; n&#58; 850Cirug&#237;a fractura de cadera &#8805; 70 a&#241;os&#46; Edad mediana&#58; 83 a&#241;os&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">30 d&#237;as&#58; 7&#44;5&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">AUC&#58; 0&#44;82Test HL&#58; p &#62; 0&#44;05&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Yin et al&#46;&#44; 2016<a class="elsevierStyleCrossRef" href="#bib0305"><span class="elsevierStyleSup">1</span></a>&#44;Pekin &#40;China&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Edad&#44; sexo&#44; variables relacionadas con la fractura&#44; comorbilidad &#43; ASA y ADE&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Prospectivo&#44; n&#58; 1&#46;402Fracturas de cadera &#8805; 50 a&#241;os&#46; Edad mediana&#58; 76 a&#241;os&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 a&#241;os&#58; 14&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">AUC&#58; 0&#44;700 --&#62; 0&#44;723Test HL&#58; p &#61; 0&#44;461 --&#62; 0&#44;816&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Buecking et al&#46;&#44; 2017<a class="elsevierStyleCrossRef" href="#bib0570"><span class="elsevierStyleSup">54</span></a>&#44; Marburgo &#40;Alemania&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">MaRTHi&#58; edad&#44; ASA&#44; MMSE&#44; &#237;ndice EQ-5DEn no institucionalizados&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Prospectivo&#44; n&#58; 402Cirug&#237;a fractura de cadera &#8805; 60 a&#241;os&#46; Edad media 81 &#177; 8 a&#241;os&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Intrahospitalaria&#58; 8&#37;&#59;1 a&#241;o&#58; 46&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">AUC 1 a&#241;o&#58; 0&#44;756&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Ren et al&#46;&#44; 2017<a class="elsevierStyleCrossRef" href="#bib0405"><span class="elsevierStyleSup">21</span></a>&#44;Shanghai &#40;China&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Ratio PCR&#47;IPNRatio &#8804; 0&#44;10&#47;&#62;0&#44;10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Prospectivo&#44; n&#58; 80Cirug&#237;a fractura de cadera&#46; Edad media&#58; 86 a&#241;os&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 a&#241;o&#58; 7&#44;1&#37;&#47;100&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">AUC&#58; 0&#44;99&#40;PCR&#58; 0&#44;928&#59; IPN&#58; 0&#44;953&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Endo et al&#46;&#46; 2018<a class="elsevierStyleCrossRef" href="#bib0310"><span class="elsevierStyleSup">2</span></a>&#44;Boston &#40;EE&#46; UU&#46;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Demora quir&#250;rgica&#44; edad&#44; sexo&#44; insuficiencia cardiaca&#44; enfermedad vascular pulmonar&#44; insuficiencia renal&#44; p&#233;rdida de peso&#44; alteraciones electrol&#237;ticas0-5 puntos&#47;6-9&#47;10-20&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Retrospectivo&#59; base de datos nacional&#58; n&#58; 485&#46;215Cirug&#237;a fractura de cadera &#8805; 50 a&#241;os&#46; Edad media&#58; 79&#44;6 a&#241;os&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Intrahospitalaria&#58; 1&#44;8&#37; &#40;0&#44;6&#37;&#47;2&#44;5&#37;&#47;7&#44;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">AUC&#58; 0&#44;74Test HL&#58; p &#61; 0&#44;59&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Karres et al&#46;&#44; 2018<a class="elsevierStyleCrossRef" href="#bib0530"><span class="elsevierStyleSup">46</span></a>&#44;&#193;msterdam &#40;Holanda&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">HEMA<span class="elsevierStyleItalic">&#58;</span> edad&#44; fractura intrahospitalaria&#44; malnutrici&#243;n&#44; infarto de miocardio&#44; insuficiencia cardiaca congestiva&#44; neumon&#237;a&#44; insuficiencia renal&#44; neoplasia&#44; urea &#62; 9 mmol&#47;l&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Retrospectivo&#44; n&#58; 1&#46;050&#59; muestras de derivaci&#243;n&#58; &#40;n&#58; 746&#41; y validaci&#243;n &#40;304&#41;Cirug&#237;a fractura de cadera&#46; Edad media&#58; 80 a&#241;os&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">30 d&#237;as&#58; 8&#44;2&#37; &#40;8&#44;6&#37;&#47;7&#44;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">AUC&#58; 0&#44;81&#47;0&#44;79Test HL&#58; p &#61; 0&#44;343&#47;p &#61; 0&#44;211&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Sanz-Reig et al&#46;&#44; 2018<a class="elsevierStyleCrossRef" href="#bib0575"><span class="elsevierStyleSup">55</span></a>&#44;Alicante &#40;Espa&#241;a&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Edad&#44; sexo&#44; insuficiencia cardiaca&#44; asma&#44; enfermedad reumatol&#243;gica&#44; c&#225;ncer de pulm&#243;n&#44; antiagregaci&#243;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Prospectivo&#44; n&#58; 331Fractura de cadera &#8805; 65 a&#241;os&#46; Edad media&#58; 83&#44;7 a&#241;os&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Intrahospitalaria 11&#44;4&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">AUC&#58; 0&#44;77Test HL&#58; p &#61; 0&#44;93&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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          "es" => "<p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Estudios de otros modelos espec&#237;ficos predictivos de mortalidad tras fractura de cadera&#58;</p>"
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          "leyenda" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">PVY&#58; presi&#243;n venosa yugular&#59; EPOC&#58; enfermedad pulmonar obstructiva cr&#243;nica&#59; FA&#58; fibrilaci&#243;n auricular&#59; Io&#58; Tumor localizado sin met&#225;stasis ganglionares ni a distancia&#46;</p><p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Modificado y traducido al castellano de Mohamed et al&#46;<a class="elsevierStyleCrossRef" href="#bib0410"><span class="elsevierStyleSup">22</span></a>&#46;&#161;</p>"
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                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Variables fisiol&#243;gicas&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Edad &#40;a&#241;os&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60; 60&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">61-70&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8805; 71&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Signos cardiacos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Normal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">F&#225;rmacos cardiovasculares o esteroides&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">EdemasWarfarina&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">PVY elevada&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Radiograf&#237;a de t&#243;rax&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Normal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Cardiomegalia l&#237;mite&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Cardiomegalia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Signos respiratorios&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Normal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Disnea esfuerzo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Disnea peque&#241;os esfuerzos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Disnea de reposo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Radiograf&#237;a de t&#243;rax&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Normal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">EPOC leve&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">EPOC moderado&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Alg&#250;n otro cambio&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Presi&#243;n arterial sist&#243;lica &#40;mmHg&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">110-130&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">131-170&#47;100-109&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8805; 171&#47;90-99&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8804; 89&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Pulso &#40;&#47;min&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">50-80&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">81-100&#47;40-49&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">101-120&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8805; 121&#47;&#8804; 39&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Escala de coma de Glasgow&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">15&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12-14&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9-11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8804; 8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Urea &#40;mmol&#47;l&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8804; 7&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&#44;6-10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10&#44;1&#44;1-15&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8805; 15&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Sodio &#40;mmol&#47;l&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8805; 136&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">131-135&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">126-130&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8804; 125&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Potasio &#40;mmol&#47;l&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#44;5-5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#44;2-3&#44;4&#47;5&#44;1-5&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;9-3&#44;1&#47;5&#44;4-5&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8804; 2&#44;8&#47;&#8805; 6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hemoglobina &#40;g&#47;100 ml&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13-16&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11&#44;5-12&#44;9&#47;16&#44;1-17&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10-11&#44;4&#47;17&#44;1-18&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8804; 9&#44;9&#47;&#8805;18&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Leucocitos &#40;&#215;10<span class="elsevierStyleSup">12</span>&#47;l&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4-10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10&#44;1-20&#47;3&#44;1-3&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8805; 20&#44;1&#47;&#8804; 3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Electrocardiograma&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Normal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">FA &#40;60-90&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Otros cambios&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab2257958.png"
              ]
            ]
            1 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Variables quir&#250;rgicas&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Gravedad de la cirug&#237;a&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Menor&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Moderada&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Mayor&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Mayor &#43;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">N&#250;mero de operaciones en 30 d&#237;as&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#62; 2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">P&#233;rdida de sangre por operaci&#243;n &#40;ml&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60; 100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">101-500&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">501-1000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#62; 1&#46;000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Exudado peritoneal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Seroso&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Pus local&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Peritonitis difusa&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Malignidad&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Ninguna&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Io&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Met&#225;stasis ganglionares&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Met&#225;stasis a distancia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Tipo de cirug&#237;a&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Electiva&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Urgente&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Emergente&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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          "es" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Puntuaci&#243;n del Physiological and Operative Severity Score for the enUmeration of Mortality and Morbidity &#40;sistema POSSUM&#41;</p>"
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          "leyenda" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">AUC&#58; &#225;rea bajo la curva&#59; ratio O&#47;E&#58; cociente casos observados&#47;esperados&#59; test HL&#58; prueba de Hosmer y Lemeshow&#46;</p>"
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                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Estudio &#40;autor&#44; a&#241;o&#44; pa&#237;s&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Tipo de estudio&#47;descripci&#243;n de la muestra&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Mortalidad observada&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Discriminaci&#243;n&#47;calibraci&#243;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Mohamed et al&#46;&#44; 2002<a class="elsevierStyleCrossRef" href="#bib0410"><span class="elsevierStyleSup">22</span></a>&#44;Warrington &#40;Inglaterra&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Prospectivo&#44; n&#58; 2&#46;326Cirug&#237;a ortop&#233;dica &#40;44&#37; electiva&#44; 56&#37; urgente&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">30 d&#237;as&#58; 2&#44;2&#37; &#40;cirug&#237;a urgente&#58; 3&#44;8&#37;&#59; cirug&#237;a electiva&#58; 0&#44;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">AUC &#40;gr&#225;fica&#41;&#58; buena correlaci&#243;nRatio O&#47;E &#61; 0&#44;96&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Ramanathan et al&#46;&#44; 2005<a class="elsevierStyleCrossRef" href="#bib0415"><span class="elsevierStyleSup">23</span></a>&#44;Nottingham &#40;Inglaterra&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Prospectivo&#44; n&#58; 1&#46;164Cirug&#237;a fractura de cadera &#40;86&#37; con edad &#62; 70 a&#241;os&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">30 d&#237;as&#58; 10&#44;2&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">AUC&#58; 0&#44;62Ratio O&#47;E &#61;0&#44;66&#46; Test HL&#58; p &#60;0&#44;00015&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Young et al&#46;&#44; 2006<a class="elsevierStyleCrossRef" href="#bib0580"><span class="elsevierStyleSup">56</span></a>&#44;Nueva Zelanda&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Retrospectivo &#40;base de datos&#41;&#44; n&#58; 225Cirug&#237;a fractura de cadera&#46; Edad media&#58; 83 a&#241;os&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">30 d&#237;as&#58; 12&#37;&#59; 1 a&#241;o&#58; 32&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Wright et al&#46;&#44; 2008<a class="elsevierStyleCrossRef" href="#bib0420"><span class="elsevierStyleSup">24</span></a>&#44;Warrington &#40;Inglaterra&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Prospectivo&#44; n&#58; 230Cirug&#237;a fractura de cadera&#46; Edad media&#58; 80 a&#241;os&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">30 d&#237;as&#58; 10&#44;9&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Ratio O&#47;E &#61; 1&#44;19&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Wang et al&#46;&#44; 2008<a class="elsevierStyleCrossRef" href="#bib0585"><span class="elsevierStyleSup">57</span></a>&#44;Changchun &#40;China&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Retrospectivo&#44; n&#58; 295Artroplastia por fractura de cadera en &#62; 18 a&#241;os&#46; Edad media&#58; vivos&#58; 63&#44;25 a&#241;os&#47;fallecidos&#58; 77&#44;89 a&#241;os&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">30 d&#237;as&#58; 3&#44;0&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Ratio O&#47;E &#61; 0&#44;43 &#40;estimaci&#243;n muy ajustada a la observada en la banda de alto riesgo &#40;&#62; 10&#37;&#41;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Van Zeeland et al&#46;&#44; 2011<a class="elsevierStyleCrossRef" href="#bib0435"><span class="elsevierStyleSup">27</span></a>&#44;&#193;msterdam &#40;Holanda&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-Prospectivo&#44; n&#58; 272Riesgo bajo &#40;0-28 puntos&#41;&#44; intermedio &#40;29-34&#41;&#44; alto &#40;&#8805; 35&#41;Cirug&#237;a fractura subcapital o pertrocant&#233;rea&#46;Edad media&#58; 80 a&#241;os&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Intrahospitalaria&#58; 9&#37; &#40;0&#37;&#44; 4&#44;3&#37;&#44; 23&#37;&#41;&#59; a largo plazo &#40;seguimiento medio 58 meses&#41;&#58; 57&#37; &#40;36&#37;&#47;60&#37;&#47;67&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">AUC&#58; 0&#44;83Curvas de calibraci&#243;n&#58; buena calibraci&#243;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Steinberg et al&#46;&#44; 2014<a class="elsevierStyleCrossRef" href="#bib0590"><span class="elsevierStyleSup">58</span></a>&#44;Tel-Aviv &#40;Israel&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Retrospectivo&#44; n&#58; 1&#46;770Cirug&#237;a fractura de cadera&#46; Edad media&#58; 80 a&#241;os&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-AUC 30 d&#237;as&#58; 0&#44;632Modelo que incluye niveles de prote&#237;nas&#58; AUC&#58; 742&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Bonicoli et al&#46;&#44; 2014<a class="elsevierStyleCrossRef" href="#bib0425"><span class="elsevierStyleSup">25</span></a>&#44;Pisa &#40;Italia&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Prospectivo&#44; n&#58; 134Artroplastia total por fractura intracapsular Garden III o IV&#46; Edad media hombres&#58; 84 a&#241;os&#47;mujeres&#58; 79 a&#241;os&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">30 d&#237;as&#58; 9&#44;7&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Ratio O&#47;E &#61; 0&#44;81 &#40;POSSUM&#41;&#47;2&#44;17 &#40;P-POSSUM&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Blay et al&#46;&#44; 2018<a class="elsevierStyleCrossRef" href="#bib0320"><span class="elsevierStyleSup">4</span></a>&#44;Alicante &#40;Espa&#241;a&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Retrospectivo&#44; n&#58; 229Cirug&#237;a fractura de cadera &#62; 65 a&#241;os&#46; Edad media&#58; 82&#44;3 a&#241;os&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 a&#241;o&#58; 16&#44;5&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">AUC 0&#44;65Ratio O&#47;E 1&#44;05&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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          "es" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Estudios del modelo The Physiological and Operative Severity Score for enUmeration of Mortality and morbidity &#40;POSSUM&#41;</p>"
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          "leyenda" => "<p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">ACE27&#58; Adult Comorbidity Evaluation-27&#59; AHFS&#58; The Almelo Hip Fracture Score&#59; ASA&#58; American Society Anesthesiologists&#59; ASAP&#58; The Anaesthetic Sprint Audit of Practice&#59; AUC&#58; &#225;rea bajo la curva&#59; CIRS&#58; Cumulative Illness Rating Scale&#59; E-PASS&#58; Estimation of Physiologic Ability and Surgical Stress score&#59; Hip-MFS&#58; Hip-Multidimensional Frailty Score&#59; IB&#58; &#237;ndice de Barthel&#59; ICCh&#58; &#237;ndice de comorbilidad de Charlson&#59; NHFD&#58; National Hip Fracture Database&#59; NHFS&#58; Nottingham Hip Fracture Score&#59; NHFS-a&#58; NHFS ajustado &#40;sustituye AMTS por fragilidad cognitiva&#41;&#59; O-POSSUM&#58; Orthopaedic POSSUM&#59; POSPOM&#58; Preoperative Score to Predict Postoperative Mortality&#59; POSSUM&#58; Physiologic and Operative Severity Score for the enUmeration of Mortality and Morbidity&#59; P-POSSUM&#58; Portsmouth POSSUM&#59; ratio O&#47;E&#58; cociente casos observados&#47;esperados&#59; RISK-VAS&#58; Visual Analogue Scale for Risk&#59; SORT&#58; Surgical Outcome Risk Tool&#59; Test HL&#58; prueba de Hosmer y Lemeshow&#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="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Estudio &#40;autor&#44; a&#241;o&#44; pa&#237;s&#44; modelos comparados&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Tipo de estudio&#47;descripci&#243;n de la muestra&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Mortalidad observada&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Discriminaci&#243;n&#47;calibraci&#243;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Burgos et al&#46;&#44; 2008<a class="elsevierStyleCrossRef" href="#bib0445"><span class="elsevierStyleSup">29</span></a>&#44;Madrid &#40;Espa&#241;a&#41;ASA&#47;IB&#47;Goldman&#47;ICCh&#47;POSSUM&#47;RISK-VAS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Prospectivo&#44; n&#58; 232Cirug&#237;a fractura de cadera &#8805; 65 a&#241;os&#46; Edad mediana&#58; 85 a&#241;os&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 meses&#58; 11&#44;2&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">AUC&#58; ASA&#58; 0&#44;600&#59; IB&#58; 0&#44;689&#59; Goldman&#58; 0&#44;432&#59; ICCh&#58;0&#44;590&#59; POSSUM&#58; 0&#44;635&#59; RISK-VAS&#58; 0&#44;677&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Maxwell et al&#46;&#44; 2008<a class="elsevierStyleCrossRef" href="#bib0345"><span class="elsevierStyleSup">9</span></a>&#44;Nottingham &#40;Inglaterra&#41;NHFS&#47;ASA&#47;Donati&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Prospectivo&#59; muestras de derivaci&#243;n &#40;n&#58; 2&#46;492&#41; y validaci&#243;n &#40;2&#46;475&#41;Cirug&#237;a fractura de cadera&#46; Edad media&#58; 79&#44;9&#47;80&#44;1 a&#241;os&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">30 d&#237;as&#58; 7&#44;8&#37; &#40;8&#44;0&#37;&#47;7&#44;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Muestra de validaci&#243;n&#58;AUC&#58; NHFS&#58; 0&#44;719&#59; ASA 0&#44;718 Donati 0&#44;717Test HL&#58; NHFS&#58; p &#61; 0&#44;79&#59; Donati&#58; p&#61; 0&#44;01&#59; ASA&#58; no posible una prueba significativa&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hirose et al&#46;&#44; 2009<a class="elsevierStyleCrossRef" href="#bib0595"><span class="elsevierStyleSup">59</span></a>&#44;Jap&#243;nE-PASS&#47;POSSUM&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Retrospectivo multic&#233;ntrico&#58; muestras de derivaci&#243;n &#40;E-PASS&#41; &#40;n&#58; 722&#41; y validaci&#243;n &#40;E-PASS vs&#46; POSSUM&#41; &#40;633&#41;Cirug&#237;a fractura de cadera&#46; Edad media&#58; 80&#44;0&#47;79&#44;7 a&#241;os&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Intrahospitalaria&#58; 1&#44;7&#37;&#47;2&#44;4&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Muestra de validaci&#243;n&#58;Ratio O&#47;E intrahospitalaria&#58; E-PASS&#58; 0&#44;71&#59; P-POSSUM&#58; 0&#44;15A los 30 d&#237;as&#58; E-PASS&#58; 0&#44;55&#59; O-POSSUM&#58; 0&#44;12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Karres et al&#46;&#44; 2015<a class="elsevierStyleCrossRef" href="#bib0475"><span class="elsevierStyleSup">35</span></a>&#44;&#193;msterdam &#40;Holanda&#41;ICCh&#47;E-PASS&#47;Holt&#47;Jiang&#47;NHFS&#47;O-POSSUM&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Retrospectivo&#44; n&#58; 1&#46;050Cirug&#237;a fractura de cadera&#46; Edad mediana&#58; 83 a&#241;os&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Intrahospitalaria&#58; 6&#44;0&#37;&#59;30 d&#237;as&#58; 8&#44;2&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">AUC 30 d&#237;as&#58; Jiang&#58; 0&#44;78&#59; NHFS&#58; 0&#44;77&#59; Holt&#58; 0&#44;76&#59; E-PASS&#58; 0&#44;72&#59; ICCh&#58; 0&#44;71&#59; O-POSSUM&#58; 0&#44;69Test HL 30 d&#237;as&#58; Jiang&#58; p &#61; 0&#44;041&#59; NHFS&#58; 0&#44;039&#59; Holt&#58; 0&#44;002&#59; E-PASS&#58; 0&#44;103&#59; ICCh&#58; 0&#44;291&#59; 0-POSSUM&#58; 0&#44;110&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Marufu et al&#46;&#44; 2016<a class="elsevierStyleCrossRef" href="#bib0450"><span class="elsevierStyleSup">30</span></a>&#44;Reino UnidoNHFS &#47; SORT&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Retrospectivo&#44; base de datos nacional ASAP&#58; muestras de derivaci&#243;n &#40;n&#58; 6&#46;317&#41; y validaci&#243;n &#40;2&#46;700&#41;Cirug&#237;a fractura de cadera&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">30 d&#237;as&#58; 5&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">AUC Muestra de validaci&#243;n&#58; NHFS&#58; 0&#44;71&#59; SORT&#58; 0&#44;70Test HL&#58; NHFS&#58; p &#61; 0&#44;23&#59; SORT&#58; p &#61; 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="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Nijmeijer et al&#46;&#44; 2016<a class="elsevierStyleCrossRef" href="#bib0535"><span class="elsevierStyleSup">47</span></a>&#44;Almelo&#47;Hengelo &#40;Holanda&#41;AHFS&#47;NHFS-a&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Prospectivo&#44; n&#58; 850Cirug&#237;a fractura de cadera &#8805; 70 a&#241;os&#46; Edad mediana&#58; 83 a&#241;os&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">30 d&#237;as&#58; 7&#44;5&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">AUC&#58; NHFS-a&#58; 0&#44;72&#59; AHFS&#58; 0&#44;82Test HL&#58; p &#62; 0&#44;05 para ambos modelosLikelihood ratio test&#58; ajuste significativamente mejor del AHFS &#40;p &#60; 0&#44;001&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Tahta et al&#46;&#44; 2016<a class="elsevierStyleCrossRef" href="#bib0455"><span class="elsevierStyleSup">31</span></a>&#44;Esmirna &#40;Turqu&#237;a&#41;ACE-27&#47;ASA&#47;ICCh&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Retrospectivo&#44; n&#58; 114Hemiartroplastia no cementada fractura subcapital o pertrocant&#233;rea &#8805; 65 a&#241;os y deambulaci&#243;n previa independiente&#46; Edad media&#58; 81&#44;9&#47; 81&#44;6 a&#241;os&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 a&#241;o&#58; 43&#44;0&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">AUC&#58; ASA&#58; 0&#44;630&#59; ICCh&#58; 0&#44;716&#59; ACE-27&#58; 0&#44;799&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Boddaert et al&#46;&#44; 2017<a class="elsevierStyleCrossRef" href="#bib0460"><span class="elsevierStyleSup">32</span></a>&#44;Paris &#40;Francia&#41;ASA&#47;POSPOM&#47;CIRS&#47;ICCh&#47; NFHS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-Prospectivo&#59; n&#58; 506-Cirug&#237;a fractura de cadera &#8805; 70 a&#241;os&#46; Edad media&#58; 86 a&#241;os&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">30 d&#237;as&#58; 4&#44;1&#37;&#59;6 meses&#58; 14&#46;4&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">AUC 6 meses&#58; POSPOM&#58; 0&#44;66&#59; ASA&#58; 0&#44;62&#59; CIRS&#58; 0&#44;67&#59; ICCh&#58; 0&#44;64&#59; NHFS&#58; 0&#44;64&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Tsang et al&#46;&#44; 2017<a class="elsevierStyleCrossRef" href="#bib0360"><span class="elsevierStyleSup">12</span></a>&#44;Reino UnidoModelo NHFD&#47;NHFS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Retrospectivo&#44; base de datos nacional ASAP&#58; muestras de derivaci&#243;n &#40;n&#58; 4&#46;044&#41; y validaci&#243;n &#40;3&#46;861&#41;Cirug&#237;a fractura de cadera 60-110 a&#241;os&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">30 d&#237;as&#58; 5&#46;36&#37; &#47; 6&#44;40&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">AUC&#58; NHFS&#58; 0&#44;73&#47;0&#44;70&#44; NHFD&#58; 0&#44;74&#47;0&#44;71Test HL&#58; NHFD&#58; p &#61; 0&#44;078&#47;p &#61; 0&#44;029&#59; NHFS&#58; p &#61; 0&#44;394&#47;p &#61;&#44;0&#44;599&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Choi et al&#46;&#44; 2017<a class="elsevierStyleCrossRef" href="#bib0465"><span class="elsevierStyleSup">33</span></a>Se&#250;l &#40;Rep&#250;blica de Corea&#41;Hip-MFS&#47;edad&#47;ASA&#47;NHFS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Retrospectivo&#44; n&#58; 481Cirug&#237;a fractura de cadera &#8805; 65 a&#241;os&#46; Edad media&#58; 80&#44;4 a&#241;os&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">30 d&#237;as&#58;1&#44;2&#37;&#59; 6 meses&#58; 7&#44;3&#37;&#59; 1 a&#241;o&#58; 13&#44;9&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">AUC 6 meses&#58; Hip-MFS&#58; 0&#44;78&#59; edad&#58; 0&#44;58 a&#241;os&#59; ASA&#58; 0&#44;67&#59; NHFS&#58; 0&#44;70&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Jonsson et al&#46;&#44; 2018<a class="elsevierStyleCrossRef" href="#bib0600"><span class="elsevierStyleSup">60</span></a>&#44;Lund &#40;Suecia&#41;POSSUM&#47;P-POSSUM&#47;NHFS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Prospectivo&#44; n&#58; 997Cirug&#237;a fractura de cadera&#46; Edad media&#58; 84 a&#241;os&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">30 d&#237;as&#58; 6&#44;2&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">AUC&#58; NHFS&#58;0&#44;67&#59; POSSUM&#58; 0&#44;66Ratio O&#47;E&#58; POSSUM&#58; 0&#44;90&#59; P-POSSUM&#58; 0&#44;98 y NHFS&#58; 0&#44;79Subestiman la mortalidad en las bandas de menor riesgo y la sobrestiman en las de mayor riesgo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Trevisan et al&#46;&#44; 2018<a class="elsevierStyleCrossRef" href="#bib0325"><span class="elsevierStyleSup">5</span></a>Seriate &#40;Italia&#41;ICCh&#47; NHFS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Retrospectivo&#59; n&#58; 90 &#40;a&#241;o 2000&#41;&#47;167 &#40;2015&#41;Fractura de cadera &#8805; 65 a&#241;os&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">30 d&#237;as &#40;2000&#47; 2015&#41;&#58; 13&#44;3&#37;&#47;7&#44;2&#37;&#59;1 a&#241;o&#58; 25&#44;3&#37;&#47;22&#44;2&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">AUC 30 d&#237;as &#40;2000&#47;2015&#41;&#58; ICCh&#58; 0&#44;7799&#47;0&#44;792&#59; NHFS&#58; 0&#44;6645&#47;0&#44;66231 a&#241;o &#40;2000&#47;2015&#41;&#58; ICCh&#58; 0&#44;7186&#47;0&#44;748&#59; NHFS&#58; 0&#44;6768&#47;0&#44;7097&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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          "es" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Estudios comparativos entre diferentes modelos pron&#243;sticos predictivos de mortalidad tras fractura de cadera</p>"
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Información del artículo
ISSN: 00257753
Idioma original: Español
DOI:10.1016/j.medcli.2019.09.020
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