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ORIGINAL
Análisis prospectivo de las complicaciones, eficacia y grado de satisfacción en la sedación realizada por anestesiólogos en endoscopia digestiva
Prospective analysis of the complications, efficacy, and satisfaction level on the sedation performed by anaesthetists in gastrointestinal endoscopy
R. Cabadas Aviona,
Autor para correspondencia
rcabadas@povisa.es

Autor para correspondencia.
, M. Ojea Cendóna, M.S. Leal Ruilobaa, M.A. Baluja Gonzálezb, J. Sobrino Ramalloa, J. Álvarez Escuderob
a Servicio de Anestesiología, Hospital Povisa, Vigo, España
b Servicio de Anestesiología, Hospital Clínico Universitario de Santiago, Santiago de Compostela, España
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introducci&#243;n</span><p id="par0010" class="elsevierStylePara elsevierViewall">La endoscopia digestiva ha evolucionado no solo en el &#225;mbito de las pruebas diagn&#243;sticas&#44; sino tambi&#233;n en la aparici&#243;n de nuevas alternativas terap&#233;uticas&#46; Esto lleva impl&#237;cito pruebas m&#225;s largas y con mayor molestia para los pacientes&#44; lo que incrementa la necesidad de t&#233;cnicas de sedaci&#243;n o anestesia que&#44; de otra forma&#44; no ser&#237;an tolerables para el paciente<a class="elsevierStyleCrossRefs" href="#bib0150"><span class="elsevierStyleSup">1&#44;2</span></a>&#46; Por este motivo&#44; la sedaci&#243;n deber&#237;a ofrecerse a todos los pacientes antes de una exploraci&#243;n endosc&#243;pica<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">3</span></a>&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">El envejecimiento de la poblaci&#243;n supone la presencia en la sala de endoscopias de pacientes con comorbilidades significativas que incrementan el riesgo derivado tanto de la prueba endosc&#243;pica como de la sedaci&#243;n o anestesia realizada&#46; Adem&#225;s&#44; la realizaci&#243;n de procedimientos urgentes en este grupo de pacientes supone un riesgo adicional que incrementa la morbimortalidad asociada&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Ante esta realidad&#44; en los &#250;ltimos a&#241;os el debate se centra en la seguridad de los pacientes&#44; buscando identificar procedimientos de riesgo para establecer de manera protocolizada la actuaci&#243;n cl&#237;nica m&#225;s correcta<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">4</span></a>&#46; En este momento&#44; se discute qu&#233; profesional debe realizar la sedaci&#243;n y en qu&#233; circunstancias&#44; as&#237; como los f&#225;rmacos m&#225;s adecuados para evitar el riesgo a los pacientes&#46; Hay m&#250;ltiples publicaciones sobre el papel de los no anestesi&#243;logos &#40;m&#233;dicos o enfermeras&#41; que afirman que la sedaci&#243;n llevada a cabo por estos es segura &#40;incluso con el uso de propofol&#41;<a class="elsevierStyleCrossRefs" href="#bib0170"><span class="elsevierStyleSup">5&#44;6</span></a>&#44; mientras que otros autores defienden que la sedaci&#243;n debe ser administrada por un anestesi&#243;logo al menos en determinadas situaciones<a class="elsevierStyleCrossRefs" href="#bib0180"><span class="elsevierStyleSup">7-9</span></a>&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">Es en este escenario en el que encuadramos nuestro trabajo&#44; para describir procedimientos anest&#233;sicos en el &#225;mbito de la endoscopia digestiva&#44; centr&#225;ndonos en la seguridad de los pacientes&#44; tanto programados como urgentes &#40;cuyo riesgo de complicaciones es mucho m&#225;s elevado&#41;&#46;</p><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Objetivo</span><p id="par0030" class="elsevierStylePara elsevierViewall">Estudiar la seguridad de la sedaci&#243;n por anestesi&#243;logos para endoscopia digestiva analizando las complicaciones que aparecen durante el proceso&#46; Como objetivos secundarios analizamos los factores que se asocian a la aparici&#243;n de complicaciones&#44; la eficacia de la sedaci&#243;n para completar los procesos endosc&#243;picos&#44; el grado de satisfacci&#243;n de los pacientes&#44; las diferencias encontradas entre las endoscopias programadas y urgentes y la mortalidad encontrada&#46;</p></span></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Material y m&#233;todos</span><p id="par0035" class="elsevierStylePara elsevierViewall">Se ha realizado un estudio prospectivo durante 7 a&#241;os en el &#225;mbito de la endoscopia digestiva&#46; Este estudio se realiz&#243; en conformidad con la Declaraci&#243;n de Helsinki tras la aprobaci&#243;n del Comit&#233; de &#201;tica&#44; y Calidad del Hospital Povisa de Vigo&#46; Adem&#225;s&#44; fue presentado ante el Comit&#233; Auton&#243;mico de &#201;tica e Investigaci&#243;n de Galicia &#40;tipo de estudio&#58; EPA SP&#59; C&#243;digo&#58; RAF-MID-2015-01&#59; C&#243;digo de Registro&#58; 2015&#47;411&#41;&#46; Este manuscrito se adhiere a las directrices aplicables red ECUATOR&#46; Todos los pacientes han firmado el consentimiento informado para la prueba y para la cesi&#243;n an&#243;nima de sus datos&#46; El Hospital Povisa ha sido acreditado por la Joint Commission por primera vez en el a&#241;o 2013 y reacreditado en el 2016&#46;</p><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Desarrollo del protocolo</span><p id="par0040" class="elsevierStylePara elsevierViewall">En el a&#241;o 2010&#44; se desarroll&#243; un protocolo de sedaci&#243;n en todo el hospital siguiendo los criterios de la Joint Commission International que estableci&#243; que el Servicio de Anestesia es el encargado de liderar y controlar los resultados de todas las sedaciones que se realizan en el hospital&#44; independientemente de quien realice la sedaci&#243;n&#46; Con base en dicho protocolo&#44; se establecieron los escenarios en los que obligatoriamente debe intervenir el servicio de anestesia y que detallamos a continuaci&#243;n&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Selecci&#243;n de pacientes</span><p id="par0045" class="elsevierStylePara elsevierViewall">Por protocolo&#44; en el &#225;mbito de la endoscopia digestiva en nuestro hospital los anestesi&#243;logos participan en la sedaci&#243;n de pacientes que necesitan niveles de sedaci&#243;n profunda para realizar la prueba&#44; realizaci&#243;n de t&#233;cnicas complejas como colangiopancreatograf&#237;a retr&#243;grada endosc&#243;pica&#44; ecoendoscopia&#44; polipectom&#237;as etc&#46;&#44; pacientes con comorbilidades asociadas &#40;American Society of Anaesthesiology &#91;ASA&#93; 3 y 4&#41;&#44; pacientes con v&#237;a a&#233;rea dif&#237;cil o alteraciones anat&#243;micas que dificulten el manejo de la v&#237;a a&#233;rea en situaci&#243;n de urgencia y aquellos que tuvieron alguna reacci&#243;n adversa previa en relaci&#243;n con la anestesia o con los f&#225;rmacos sedantes&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">Cada anestesi&#243;logo decidi&#243; la t&#233;cnica anest&#233;sica empleada y en los casos de sedaci&#243;n&#44; el nivel de profundidad&#44; al igual que los f&#225;rmacos empleados o la combinaci&#243;n de estos &#40;propofol&#44; opioides&#44; benzodiacepinas&#44; etc&#46;&#41;&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">La monitorizaci&#243;n incluy&#243; siempre electrocardiograf&#237;a&#44; pulsioximetr&#237;a&#44; frecuencia respiratoria y tensi&#243;n arterial&#46; El end tidal CO2 &#40;EtCO2&#41; se utiliz&#243; solamente en pacientes bajo anestesia general&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Valoraci&#243;n de la eficacia</span><p id="par0060" class="elsevierStylePara elsevierViewall">Se consider&#243; procedimiento finalizado&#44; cuando se complet&#243; el procedimiento programado<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">3</span></a>&#46; En los casos de exploraci&#243;n incompleta&#44; se document&#243; la causa&#46; Se consider&#243; sedaci&#243;n inadecuada&#44; cuando la exploraci&#243;n no se pudo realizar por intolerancia del paciente &#40;<a class="elsevierStyleCrossRef" href="#sec0100">anexo 1</a>&#41;&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Valoraci&#243;n de la seguridad</span><p id="par0065" class="elsevierStylePara elsevierViewall">An&#225;lisis de las complicaciones en la sala de endoscopia y en el postoperatorio inmediato seg&#250;n definiciones espec&#237;ficas para cada complicaci&#243;n &#40;<a class="elsevierStyleCrossRef" href="#sec0100">anexo 1</a>&#41;&#46; El registro del nivel de sedaci&#243;n no se incluy&#243; como obligatorio en el protocolo de registro&#46; Cuando se registr&#243;&#44; se emple&#243; la escala de la European Society of Anaesthesiology &#40;ESA&#41;<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">10</span></a>&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">Se valor&#243; el dolor mediante la escala descriptiva simple de Keele<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">11</span></a> cada 5 min al menos durante 30 min&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Valoraci&#243;n del grado de satisfacci&#243;n</span><p id="par0075" class="elsevierStylePara elsevierViewall">Al d&#237;a siguiente se realiz&#243; una consulta telef&#243;nica para control cl&#237;nico preguntando espec&#237;ficamente por las complicaciones y una encuesta de satisfacci&#243;n tipo Likert para valorar el grado de satisfacci&#243;n global del paciente similar a la empleada en otros estudios<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">12</span></a>&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Grupos de estudio</span><p id="par0080" class="elsevierStylePara elsevierViewall">Dado que los riesgos son mayores en las pruebas urgentes&#44; se establecen 2<span class="elsevierStyleHsp" style=""></span>grupos de estudio para comparar los riesgos de seguridad en ambos&#46; El primer grupo lo forman pacientes con pruebas programadas y el segundo grupo incluye a pacientes con pruebas urgentes&#46;</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Desarrollo inform&#225;tico</span><p id="par0085" class="elsevierStylePara elsevierViewall">Para el registro de todo el proceso de sedaci&#243;n se adapt&#243; el programa inform&#225;tico del Servicio de Anestesia &#40;a-AnesReaDol&#41; a las peculiaridades del protocolo aprobado&#46; Todo el desarrollo inform&#225;tico est&#225; integrado en los servidores y se relaciona de forma bidireccional con el sistema de historia cl&#237;nica informatizada &#40;Hospital Information System &#91;HIS&#93;&#41; del hospital&#46; El desarrollo del software se realiz&#243; con 3<span class="elsevierStyleHsp" style=""></span>premisas fundamentales&#58; posibilidad de registro de todos los datos necesarios&#44; previamente codificados&#44; incorporaci&#243;n de sistemas de ayuda a la decisi&#243;n cl&#237;nica y obligatoriedad de registro de determinados campos considerados fundamentales&#46; De esta forma&#44; hemos asegurado el registro completo del proceso de sedaci&#243;n&#46; El sistema inform&#225;tico registra autom&#225;ticamente las constantes tanto en las salas de endoscopias como en la Unidad de Recuperaci&#243;n Postanest&#233;sica &#40;URPA&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0005">fig&#46; 1</a>&#41;&#46; Adem&#225;s&#44; antes de trasladar al paciente a la URPA se debe cubrir el registro de complicaciones tal como se muestra en la <a class="elsevierStyleCrossRef" href="#fig0010">figura 2</a>&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Estad&#237;stica</span><p id="par0090" class="elsevierStylePara elsevierViewall">Las variables cuantitativas se expresan como media &#177;<span class="elsevierStyleHsp" style=""></span>DE porque siguen una distribuci&#243;n normal &#40;test de Kolmogorov-Smirnov&#41;&#46; Las variables cualitativas se expresan en frecuencias seguidas de porcentaje entre par&#233;ntesis&#46; La comparaci&#243;n entre variables cuantitativas se efectu&#243; mediante el test de la t de Student cuando se compararon muestras de 2<span class="elsevierStyleHsp" style=""></span>grupos independientes &#40;programado vs&#46; urgentes&#41;&#46; En la comparaci&#243;n de proporciones entre variables cualitativas se utiliz&#243; la prueba de la chi al cuadrado con correcci&#243;n de Yates o prueba exacta de Fisher cuando estaba indicado&#46; El an&#225;lisis multivariante para el an&#225;lisis de los factores de riesgo asociados a complicaciones durante la endoscopia se realiz&#243; mediante regresi&#243;n log&#237;stica multivariante por etapas&#46; Un valor de p &#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05 fue considerado como significativo&#46; El an&#225;lisis estad&#237;stico se realiz&#243; utilizando el software Windows SPSS v&#46;15 &#40;SPSS Inc&#46;&#44; Chicago&#44; IL&#44; EE&#46; UU&#46;&#41; o R v&#46;3&#46;0&#46;1 &#40;R Development Core Team&#44; 2013&#44; Vienna&#44; Austria&#41;&#46;</p></span></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Resultados</span><p id="par0095" class="elsevierStylePara elsevierViewall">Se realizaron 3&#46;746 procedimientos endosc&#243;picos sedados por anestesi&#243;logos desde enero del a&#241;o 2011 hasta diciembre del 2017&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">Hemos encontrado 1&#46;140 &#40;30&#44;4&#37;&#41; pacientes con complicaciones&#46; Como se aprecia en la <a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a>&#44; casi la mitad de los procedimientos realizados han sido procedimientos terap&#233;uticos&#44; con base en lo que se estableci&#243; en el protocolo &#40;en el grupo de urgentes&#44; m&#225;s del 75&#37; son procedimientos terap&#233;uticos&#41;&#46; Los pacientes programados son ambulatorios en el 60&#37; de los casos&#44; mientras que los urgentes son mayoritariamente ingresados &#40;93&#44;9&#37;&#41;&#46; Ha fallecido un paciente ASA 4 en el grupo de pruebas programadas &#40;incidencia aproximada de 1&#58;3&#46;000&#41; y 2<span class="elsevierStyleHsp" style=""></span>pacientes en ASA 5 en el grupo de pruebas urgentes&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Valoraci&#243;n de la seguridad &#40;an&#225;lisis de las complicaciones&#41;</span><p id="par0105" class="elsevierStylePara elsevierViewall">Las complicaciones m&#225;s importantes asociadas a los procedimientos anest&#233;sicos en el &#225;mbito de la endoscopia digestiva son las hemodin&#225;micas y respiratorias&#44; tal como se puede apreciar en la <a class="elsevierStyleCrossRef" href="#tbl0010">tabla 2</a>&#46; Las complicaciones m&#225;s importantes desde el punto de vista del riesgo son la hipoxemia &#40;que presenta una incidencia del 3&#37; en sedaciones programadas frente al 5&#44;7&#37;&#44; p &#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05 en pruebas urgentes&#41;&#44; la hipotensi&#243;n &#40;6&#44;4&#37; vs&#46; 18&#44;8&#37;&#44; p &#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41; y la bradicardia &#40;5&#44;4&#37; vs&#46; 3&#44;9&#37;&#44; p 0&#44;193&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0110" class="elsevierStylePara elsevierViewall">Los pacientes con ASA m&#225;s elevado tienen mayor frecuencia de complicaciones durante la sedaci&#243;n&#44; tal como se expone en la <a class="elsevierStyleCrossRef" href="#tbl0010">tabla 2</a>&#46; Los factores asociados a las complicaciones con mayor riesgo para el paciente se definen en la <a class="elsevierStyleCrossRef" href="#tbl0015">tabla 3</a> &#40;an&#225;lisis multivariante&#41;&#46; Como podemos apreciar&#44; la hipoxemia est&#225; relacionada con el ASA &#40;OR 1&#44;35&#59; IC del 95&#37; 1&#44;4-3&#44;1&#41; y el antecedente de enfermedad pulmonar obstructiva cr&#243;nica &#40;EPOC&#41; &#40;OR 2&#44;1&#59; IC del 95&#37; 1&#44;4-3&#44;1&#41;&#46; Por otro lado&#44; la hipotensi&#243;n se asocia a la anestesia general &#40;OR 3&#44;35&#59; IC del 95&#37; 2&#44;48-4&#44;53&#41; y la realizaci&#243;n de pruebas urgentes &#40;OR 2&#44;43&#59; IC del 95&#37; 1&#44;81-3&#44;26&#41;&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0130">Valoraci&#243;n de la eficacia</span><p id="par0115" class="elsevierStylePara elsevierViewall">Se han analizado los primeros 798 pacientes que se corresponden con los 2<span class="elsevierStyleHsp" style=""></span>primeros a&#241;os del estudio&#46; De ellos&#44; se han completado los procedimientos endosc&#243;picos en 749 pacientes &#40;94&#44;1&#37;&#41; y se han suspendido &#40;una vez iniciada la prueba&#41; 48 pacientes &#40;5&#44;9&#37;&#41;&#46; Las causas principales de suspensi&#243;n de la prueba una vez iniciada han sido alteraciones anat&#243;micas &#91;17&#40;2&#44;1&#37;&#41;&#93;&#44; preparaci&#243;n inadecuada &#40;16 &#91;2&#37;&#93;&#41;&#44; s&#237;ndrome adherencial &#40;7 &#91;0&#44;9&#37;&#93;&#41; y tumores intraluminales &#40;7 &#91;0&#44;9&#37;&#93;&#41;&#46; No se ha suspendido ninguna prueba por sedaci&#243;n insuficiente&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">El porcentaje de pacientes ambulatorios que han necesitado ingreso tras la prueba han sido 11 &#40;0&#44;51&#37;&#41;&#46; Las causas m&#225;s frecuentes han sido el dolor &#40;5 pacientes &#91;0&#44;23&#37;&#93;&#41; y las n&#225;useas y v&#243;mitos &#40;4 pacientes &#91;0&#44;18&#37;&#93;&#41;&#46;</p></span><span id="sec0075" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0135">Grado de satisfacci&#243;n</span><p id="par0125" class="elsevierStylePara elsevierViewall">Han respondido a la encuesta a las 24 h 674 pacientes&#46; El 99&#44;4&#37; responde que tienen un grado de satisfacci&#243;n &#171;muy alto&#187; o &#171;alto&#187;&#44; mientras que solamente 3 pacientes &#40;0&#44;6&#37;&#41; declaran que est&#225;n poco satisfechos&#46;</p></span></span><span id="sec0080" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0140">Discusi&#243;n</span><p id="par0130" class="elsevierStylePara elsevierViewall">Los resultados de nuestro estudio evidencian la seguridad de la sedaci&#243;n por anestesi&#243;logos con base en el an&#225;lisis de la incidencia de complicaciones &#40;recogidas en su mayor&#237;a autom&#225;ticamente tras an&#225;lisis de los registros automatizados desde el monitor lo que incrementa la fiabilidad del registro&#41; y su repercusi&#243;n sobre el paciente&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">En la literatura&#44; la incidencia de complicaciones importantes es muy variable puesto que las definiciones no son uniformes e incluso algunos autores no anestesi&#243;logos le restan importancia&#44; denomin&#225;ndolas marcadores cl&#237;nicos en lugar de reconocerlas como verdaderas complicaciones<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">6</span></a>&#46; En nuestro estudio&#44; la incidencia global de complicaciones es baja en el grupo programado cuando la comparamos con publicaciones similares&#46; As&#237;&#44; por ejemplo&#44; la hipoxemia&#44; que es posiblemente la complicaci&#243;n m&#225;s temida por los anestesi&#243;logos presenta una incidencia del 3&#37; en pruebas endosc&#243;picas programadas&#44; que resulta aceptable si tenemos en cuenta que muchas sedaciones realizadas por anestesi&#243;logos alcanzan niveles de sedaci&#243;n 4 o 5 en la escala ESA<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">10</span></a> &#40;sedaciones profundas&#41; y la mitad de los pacientes son ASA 3 y 4&#46; Nuestra incidencia de hipoxemia es incluso menor a la que publican otros autores como Slagelse et al&#46;<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">13</span></a>&#46; En su estudio sobre 2&#46;527 pacientes sedados con propofol por enfermeras tras un programa de entrenamiento espec&#237;fico publican una incidencia del 4&#44;7&#37; en pacientes menos complejos &#40;ASA 1 y 2&#41;&#44; teniendo que suspender la exploraci&#243;n en un 0&#44;3&#37; de los pacientes&#46; Tambi&#233;n en pacientes ASA 1 y 2 Long et al&#46;<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">14</span></a> publican una incidencia de hipoxemia del 5&#37; similar a la de otros autores &#40;Jensen et al&#46;<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">15</span></a>&#44; 4&#44;4&#37;&#41;&#46; Sin embargo&#44; Uzman et al&#46;<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">12</span></a>&#44; en pacientes sedados con propofol&#44; publican incidencias de hipoxemia mucho m&#225;s altas &#40;14&#37;&#41;&#44; Friedrich-Rust et al&#46;<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">16</span></a> publican una incidencia de hipoxemia cuando se monitoriza el EtCO2 del 18&#37; en pacientes sedados con propofol frente al 32&#37; de hipoxemia cuando no se monitoriza&#46; Tambi&#233;n Saunders et al&#46;<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">17</span></a> demuestran una reducci&#243;n de la incidencia de hipoxemia desde el 27&#44;2 hasta el 18&#37; monitorizando el EtCO2&#46; Existen tambi&#233;n publicaciones con incidencias m&#225;s bajas&#44; aunque se refieren espec&#237;ficamente a eventos cardiopulmonares mayores con consecuencias graves para el paciente y no a la incidencia de hipoxemia definida por un valor de SaO2 menor de 90&#46; En este grupo de publicaciones encontramos estudios retrospectivos&#44; como el publicado por Sharma et al&#46;<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">18</span></a>&#44; utilizando la base de datos Clinical Outcomes Research Initiative &#40;CORI&#41; sobre 324&#46;737 pacientes&#44; en el que encuentran una incidencia de eventos cardiopulmonares mayores en el 0&#44;9&#37; de los pacientes&#46; Tambi&#233;n Fatima et al&#46;<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">19</span></a>&#44; usando una base de datos retrospectiva sobre 806 pacientes&#44; encuentran una incidencia de eventos del 0&#44;7&#37; en pacientes ASA 1 y 2 sedados con propofol por enfermeras&#46; Wehrmann y Riphaus<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">20</span></a> relatan una incidencia de 0&#44;4&#37; eventos adversos mayores que han provocado la suspensi&#243;n del procedimiento&#46;</p><p id="par0140" class="elsevierStylePara elsevierViewall">Respecto a la hipotensi&#243;n en pacientes programados&#44; encontramos una incidencia del 6&#44;4&#37;&#44; similar a la que publican Tohda et al&#46;<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">21</span></a> pero muy superior al 0&#44;5&#37; de Cot&#233; et al&#46;<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">22</span></a>&#44; y mucho menor del 13&#37; de Fatima et al&#46;<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">19</span></a>&#46; En el estudio publicado en 2016 por Uzman et al&#46;<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">12</span></a>&#44; encuentran una incidencia de hipotensi&#243;n en el grupo del propofol del 12&#37;&#44; el doble que la encontrada en nuestro estudio&#46;</p><p id="par0145" class="elsevierStylePara elsevierViewall">Los factores relacionados con la hipotensi&#243;n son la edad&#44; el nivel de ASA&#44; antecedente de EPOC y el &#237;ndice de masa corporal&#44; similar a la publicaci&#243;n de Long et al&#46;&#44; que encuentran relaci&#243;n con la edad&#44; la obesidad&#44; antecedente de EPOC y la realizaci&#243;n de pruebas complejas<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">14</span></a>&#46;</p><p id="par0150" class="elsevierStylePara elsevierViewall">La inclusi&#243;n de las urgencias en el an&#225;lisis de los resultados supone un importante aumento de la incidencia de complicaciones&#44; tal como se refleja en la <a class="elsevierStyleCrossRef" href="#tbl0010">tabla 2</a> y&#44; por tanto&#44; del riesgo para el paciente&#46;</p><p id="par0155" class="elsevierStylePara elsevierViewall">Las publicaciones sobre mortalidad en endoscopia digestiva son dispares&#46; Autores como Goudra et al&#46;<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">23</span></a> sit&#250;an la mortalidad de pacientes durante el procedimiento o en el &#225;rea de recuperaci&#243;n en 4&#44;28 por 10&#46;000 tras estudiar retrospectivamente 73&#46;029 endoscopias&#44; destacando que el riesgo de mortalidad es 10 veces mayor cuando se emplea propofol&#46; Otros autores tambi&#233;n sit&#250;an la mortalidad en la endoscopia digestiva programada alrededor de un caso cada 2&#46;500-5&#46;000 procedimientos<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">23</span></a> &#40;similar al publicado en nuestro estudio en endoscopia programada&#41;&#46; Frente a estas publicaciones&#44; otros autores reflejan datos mucho menores&#44; como recientemente publican Vargo et al&#46;<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">24</span></a> en una serie retrospectiva extra&#237;da de una base de datos nacional de 1&#44;38 millones de pacientes&#46; Refieren una mortalidad en el grupo de gastroscopias por no anestesi&#243;logos de 1&#58;115&#46;000 gastroscopias &#40;similar&#44; seg&#250;n este autor&#44; al grupo sedado por anestesi&#243;logos&#41;&#46; Sin embargo&#44; este art&#237;culo ha sido muy criticado desde el &#225;mbito de la Anestesiolog&#237;a<a class="elsevierStyleCrossRefs" href="#bib0180"><span class="elsevierStyleSup">7&#44;8</span></a> por la metodolog&#237;a empleada al excluir a pacientes del analisis de mortalidad&#44; lo que&#44; de incluirlos&#44; llevar&#237;a a duplicar dicha mortalidad respecto al grupo de anestesi&#243;logos &#40;1&#58;65&#46;000&#41;&#46; Este dato es m&#225;s importante si se tiene en cuenta que los anestesi&#243;logos&#44; al igual que se refleja en nuestro estudio&#44; suelen participar en procedimientos endosc&#243;picos m&#225;s complejos y en pacientes con enfermedad basal m&#225;s grave&#44; lo que incrementa las complicaciones durante y despu&#233;s del procedimiento&#46; Esto se refleja indirectamente en nuestro estudio en el que ha habido 5 paradas cardiacas durante los procedimientos en los que la actuaci&#243;n inmediata del anestesi&#243;logo evit&#243; consecuencias fatales&#46; En endoscopia programada encontramos el fallecimiento de un &#250;nico paciente &#40;incidencia 1&#58;3&#46;000&#41;&#46; Se trataba de una mujer ASA 4&#44; que presentaba estenosis a&#243;rtica severa &#40;hab&#237;a rechazado la cirug&#237;a de reemplazo valvular previamente&#41; en estudio por anemia por rectorragias y present&#243; parada card&#237;aca s&#250;bita a las 4 h tras finalizaci&#243;n de la prueba&#46; Los otros 2<span class="elsevierStyleHsp" style=""></span>fallecidos eran pacientes urgentes ASA 5 &#40;sangrado masivo incoercible por varices esof&#225;gicas&#44; que fallece en la URPA&#44; en el primer caso&#44; y shock s&#233;ptico en el segundo caso&#44; que fallece en horas posteriores en la Unidad de Cuidados Intensivos&#41;&#46;</p><p id="par0160" class="elsevierStylePara elsevierViewall">En cuanto a la valoraci&#243;n de la eficacia&#44; los resultados nos muestran que se cumplen los est&#225;ndares de calidad establecidos<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">3</span></a> &#40;m&#225;s del 90&#37; de procedimientos completados&#41;&#46; Buxbaum et al&#46;<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">25</span></a> ya publicaron la efectividad del anestesi&#243;logo en la realizaci&#243;n de procedimientos complejos&#46; En el an&#225;lisis de la eficacia debemos tener en cuenta las causas por las que no es posible completar las pruebas endosc&#243;picas&#46; En nuestro caso&#44; las causas de pruebas incompletas son similares a las publicadas por nuestro grupo en la sedaci&#243;n por no anestesi&#243;logos excepto cuando el motivo es &#171;sedaci&#243;n insuficiente&#187;&#44; que en nuestro hospital alcanza una incidencia del 4&#44;1&#37;<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">26</span></a>&#46;</p><p id="par0165" class="elsevierStylePara elsevierViewall">La satisfacci&#243;n de los pacientes es una de las dimensiones de la calidad que se debe medir cuando se analiza un proceso asistencial<a class="elsevierStyleCrossRefs" href="#bib0165"><span class="elsevierStyleSup">4&#44;27&#44;28</span></a>&#46; Nosotros hemos empleado una escala modificada tipo Likert de 5 puntos de f&#225;cil aplicabilidad&#46; El grado de satisfacci&#243;n alcanzado permite asegurar que se han cumplido con creces las expectativas de los pacientes&#46; Los datos publicados en nuestro estudio &#40;99&#44;4&#37;&#41; son similares a los que publican Uzman et al&#46;<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">12</span></a> en un estudio de sedaci&#243;n con propofol por anestesi&#243;logos&#44; en el que el 94&#37; de los pacientes refiere estar satisfecho con el proceso de sedaci&#243;n&#46;</p><p id="par0170" class="elsevierStylePara elsevierViewall">Con respecto a los resultados alcanzados de eficacia&#44; seguridad y grado de satisfacci&#243;n&#44; creemos importante subrayar que son extrapolables a cualquier Servicio de Anestesia de nuestro pa&#237;s&#44; en contraposici&#243;n a los trabajos referentes a sedaci&#243;n por no anestesi&#243;logos&#44; que suelen estar publicados por grupos muy implicados en la sedaci&#243;n pero no se corresponde con el nivel general de las unidades de endoscopia en Espa&#241;a&#44; como reconocen Gouda et al&#46; en las conclusiones de su metaan&#225;lisis&#58; &#171;se debe tener en cuenta que la seguridad del paciente demostrada en los ensayos cl&#237;nicos puede no ser aplicable fuera de estos&#44; a menos que se asegure una formaci&#243;n adecuada&#187;<a class="elsevierStyleCrossRef" href="#bib0290"><span class="elsevierStyleSup">29</span></a>&#46;</p><p id="par0175" class="elsevierStylePara elsevierViewall">Entre las limitaciones de nuestro estudio reconocemos el hecho de realizarse en un solo centro&#44; aunque&#44; como ya dijimos&#44; son generalizables a la mayor&#237;a de los servicios de Anestesia&#44; puesto que el procedimiento descrito es el habitual en la mayor&#237;a de los hospitales espa&#241;oles&#46; Ser&#237;a interesante comparar estos datos con la sedaci&#243;n realizada por no anestesi&#243;logos&#46; En nuestro caso&#44; esto no ha sido posible puesto que la sedaci&#243;n realizada por no anestesi&#243;logos en nuestro hospital se limita a pruebas diagn&#243;sticas o terap&#233;uticas simples&#44; pacientes ASA 1 y 2&#44; y niveles de sedaci&#243;n ligera o moderada sin posibilidad de uso de propofol&#46; Otra limitaci&#243;n de nuestro estudio reside en la ausencia de registro sistem&#225;tico de los niveles de sedaci&#243;n&#44; lo que no nos permite establecer los riesgos asociados a la profundidad de la sedaci&#243;n&#46;</p></span><span id="sec0085" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0145">Conclusi&#243;n</span><p id="par0180" class="elsevierStylePara elsevierViewall">La participaci&#243;n del anestesi&#243;logo en la sedaci&#243;n para endoscopia digestiva ha demostrado en este estudio excelentes resultados en cuanto a seguridad y eficacia&#44; principalmente en los pacientes m&#225;s graves y pruebas complejas y un alto grado de satisfacci&#243;n&#46;</p></span><span id="sec0090" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0150">Conflicto de intereses</span><p id="par0185" class="elsevierStylePara elsevierViewall">Los autores no declaran conflictos de intereses en relaci&#243;n con este art&#237;culo&#46;</p></span></span>"
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              "titulo" => "Valoraci&#243;n de la seguridad &#40;an&#225;lisis de las complicaciones&#41;"
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              "titulo" => "Valoraci&#243;n de la eficacia"
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    "fechaRecibido" => "2018-05-31"
    "fechaAceptado" => "2018-06-25"
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    "resumen" => array:2 [
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objetivo</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Describir las complicaciones que aparecen durante la anestesia&#47;sedaci&#243;n en el &#225;mbito de la endoscopia digestiva&#44; comparando tambi&#233;n procedimientos programados frente a urgentes&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">M&#233;todos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Se dise&#241;&#243; un protocolo de pacientes y pruebas en los que siempre debe estar presente un anestesi&#243;logo&#46; Estos incluyen a pacientes ASA 3 y 4&#44; pruebas complejas como polipectom&#237;as&#44; colangiopancreatograf&#237;a retr&#243;grada endosc&#243;pica o ecoendoscopia&#44; necesidad de sedaci&#243;n profunda o alteraciones anat&#243;micas que dificulten el manejo de la v&#237;a a&#233;rea&#46; Se analiz&#243; la seguridad con base a las complicaciones que se recogen a partir de los datos recogidos de forma autom&#225;tica directamente desde los monitores&#44; tanto durante la sedaci&#243;n como en la unidad de recuperaci&#243;n&#46; Se analizan los factores de riesgo asociados a las complicaciones cardiorrespiratorias&#44; la eficacia en funci&#243;n de las pruebas completadas y el grado de satisfacci&#243;n global a trav&#233;s de una entrevista empleando una escala de satisfacci&#243;n&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Se estudi&#243; a 3&#46;746 pacientes durante 7 a&#241;os&#46; La incidencia de complicaciones importantes durante la prueba fue baja&#44; destacando las complicaciones hemodin&#225;micas y respiratorias&#46; As&#237; encontramos una incidencia de hipoxemia del 3&#37; en endoscopia programada frente al 5&#44;7&#37; en pruebas urgentes &#40;p &#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#41;&#46; Tambi&#233;n la hipotensi&#243;n presenta diferencias significativas entre la sedaci&#243;n programada y urgente &#40;6&#44;4&#37; vs&#46; 18&#44;8&#37;&#44; p &#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#46; En nuestro estudio&#44; no se ha suspendido ninguna prueba por mala tolerancia del paciente&#44; y el grado de satisfacci&#243;n es alto en m&#225;s del 99&#37; de los casos&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusi&#243;n</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">La participaci&#243;n del anestesi&#243;logo en la sedaci&#243;n para endoscopia digestiva ha demostrado en este estudio excelentes resultados en cuanto a seguridad y eficacia&#44; principalmente en los pacientes m&#225;s graves y pruebas complejas&#44; y un alto grado de satisfacci&#243;n&#46;</p></span>"
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        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Objective</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">To describe the anaesthesia&#47;sedation complications during gastrointestinal endoscopy&#44; as well as comparing scheduled procedures versus urgent procedures&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Methods</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">A protocol was developed to define the anaesthesia&#47;sedation in gastrointestinal endoscopy&#44; where the anaesthetist should always be present&#46; These include ASA 3 and 4 patients&#44; complex tests such as polypectomies&#44; endoscopic retrograde cholangiopancreatography &#40;ERCP&#41; or endoscopic ultrasound&#44; deep sedation&#44; or patients with probable difficult airway management&#46; An analysis was made of the safety based on the complications recorded from the data directly collected automatically from the monitors&#44; both during the sedation and in the recovery unit&#46; An analysis was also performed on the risk factors associated with cardiorespiratory complications&#44; the effectiveness based on the completed tests and the overall level of satisfaction through an interview using a satisfaction scale&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">The study included a total of 3746 patients over a 7 year-period&#46; The incidence of major complications was low&#44; especially haemodynamic and respiratory complications&#46; An incidence of hypoxaemia of 3&#37; was found in scheduled endoscopy versus 5&#46;7&#37; in urgent endoscopy &#40;<span class="elsevierStyleItalic">P</span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;05&#41;&#46; The rate of hypotension was also low&#44; with significant differences between scheduled and urgent endoscopy &#40;6&#46;4&#37; vs&#46; 18&#46;8&#37;&#44; <span class="elsevierStyleItalic">P</span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001&#41;&#46; In present study&#44; no test had to be suspended due to poor patient tolerance&#44; and the satisfaction was high in more than 99&#37; of cases&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusion</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">The participation of the anaesthetist in sedation for gastrointestinal endoscopy has shown excellent results in this study&#44; in terms of safety and efficacy&#44; mainly in the most serious patients and complex tests&#44; as well as a high level of satisfaction&#46;</p></span>"
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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="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Grupo de estudio&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Programadas&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Urgentes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Total p &#40;3 grupos&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">p&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">N&#46;&#176; pacientes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&#46;289&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">457&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&#46;746&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Sexo &#40;H&#47;M&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;563&#47;1&#46;727&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">290&#47;167&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;853&#47;1&#46;893&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Media<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>DE&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Media<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>DE&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Media<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>DE&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Edad&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">64&#44;7 &#177; 15&#44;56&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">68&#44;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>16&#44;34&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">65&#44;16<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>15&#44;69&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Peso&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">73&#44;21 &#177; 16&#44;81&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">73&#44;61 &#177; 18&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">73&#44;2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>16&#44;96&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;639&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Talla&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">163 &#177; 9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">163&#44;8 &#177; 8&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">163&#44;12<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>9&#44;05&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;092&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">IMC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">27&#44;5 &#177; 5&#44;79&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">27&#44;29 &#177; 6&#44;27&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">27&#44;47<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>5&#44;84&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;475&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">N&#46;&#176; &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">N&#46;&#176; &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">N&#46;&#176; &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Colonoscopias&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;075 &#40;32&#44;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">37 &#40;8&#44;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;112 &#40;29&#44;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Gastroscopias&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">401 &#40;12&#44;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">42 &#40;9&#44;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">443 &#40;11&#44;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Ambas&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">287 &#40;8&#44;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">14 &#40;3&#44;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">301 &#40;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Colonoscopia terap&#233;utica&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">176 &#40;5&#44;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">11 &#40;2&#44;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">187 &#40;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Gastroscopia terap&#233;utica&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">364 &#40;11&#44;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">179 &#40;39&#44;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">543 &#40;14&#44;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">CPRE&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">558 &#40;17&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">161 &#40;35&#44;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">719 &#40;19&#44;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Ecoendoscopia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">428 &#40;13&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">13 &#40;2&#44;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">441 &#40;11&#44;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Ingresados&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;158 &#40;35&#44;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">429 &#40;93&#44;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;587 &#40;42&#44;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Ambulatorios&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#46;131 &#40;64&#44;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">28 &#40;6&#44;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2159 &#40;57&#44;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Sedaci&#243;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#46;587 &#40;78&#44;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">213 &#40;46&#44;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#46;800 &#40;74&#44;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Anestesia general&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">702 &#40;21&#44;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">244 &#40;53&#44;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">946 &#40;25&#44;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">ASA 1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">142 &#40;4&#44;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10 &#40;2&#44;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">152 &#40;4&#44;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">ASA 2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;667 &#40;50&#44;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">95 &#40;20&#44;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;762 &#40;47&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">ASA 3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;268 &#40;38&#44;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">225 &#40;49&#44;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;493 &#40;39&#44;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">ASA 4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">212 &#40;6&#44;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">125 &#40;27&#44;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">337&#40;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">ASA 5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2 &#40;100&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2 &#40;0&#44;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="center" valign="top">Patolog&#237;a previa</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Fibrilaci&#243;n auricular&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">401 &#40;12&#44;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">109 &#40;21&#44;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">510 &#40;13&#44;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Arteriopat&#237;a&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">86 &#40;2&#44;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">22 &#40;4&#44;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">108 &#40;2&#44;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;<span class="elsevierStyleHsp" style=""></span>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="table-entry ; entry_with_role_rowhead " align="left" valign="top">Cardiop&#46; hipertensiva&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">99 &#40;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">24 &#40;5&#44;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">123 &#40;3&#44;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;<span class="elsevierStyleHsp" style=""></span>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="table-entry ; entry_with_role_rowhead " align="left" valign="top">Cardiop&#46; isqu&#233;mica&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">289 &#40;8&#44;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">63 &#40;13&#44;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">352 &#40;9&#44;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;<span class="elsevierStyleHsp" style=""></span>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="table-entry ; entry_with_role_rowhead " align="left" valign="top">Enfermedad valvular&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">223 &#40;6&#44;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">57 &#40;12&#44;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">280 &#40;7&#44;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Miocardiop&#46; dilatada&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">49 &#40;1&#44;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">20 &#40;4&#44;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">69 &#40;1&#44;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Insuficiencia card&#237;aca&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">163 &#40;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">42 &#40;9&#44;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">205 &#40;5&#44;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Marcapasos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">106 &#40;3&#44;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">22 &#40;4&#44;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">128 &#40;3&#44;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;07&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Dislipidemia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1294 &#40;39&#44;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">180 &#40;39&#44;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;474 &#40;39&#44;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;986&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Hipertensi&#243;n arterial&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1489 &#40;45&#44;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">245 &#40;53&#44;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;734 &#40;46&#44;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;<span class="elsevierStyleHsp" style=""></span>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="table-entry ; entry_with_role_rowhead " align="left" valign="top">Tabaquismo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">482 &#40;14&#44;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">70 &#40;15&#44;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">552 &#40;14&#44;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;708&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Diabetes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">596 &#40;18&#44;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">101 &#40;22&#44;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">697 &#40;18&#44;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;<span class="elsevierStyleHsp" style=""></span>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="table-entry ; entry_with_role_rowhead " align="left" valign="top">Depresi&#243;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">654 &#40;19&#44;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">69 &#40;15&#44;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">723 &#40;19&#44;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;<span class="elsevierStyleHsp" style=""></span>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="table-entry ; entry_with_role_rowhead " align="left" valign="top">Trastorno psiqui&#225;trico&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">69 &#40;2&#44;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">13 &#40;2&#44;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">82 &#40;2&#44;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;307&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Alcoholismo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">247 &#40;7&#44;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">49 &#40;10&#44;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">296 &#40;7&#44;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;<span class="elsevierStyleHsp" style=""></span>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="table-entry ; entry_with_role_rowhead " align="left" valign="top">EPOC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">456 &#40;13&#44;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">78 &#40;17&#44;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">534 &#40;14&#44;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;066&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">SAOS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">205 &#40;6&#44;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">24 &#40;5&#44;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">229 &#40;6&#44;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;412&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Insuficiencia renal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">282 &#40;8&#44;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">78 &#40;17&#44;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">360 &#40;9&#44;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Cirrosis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">91 &#40;2&#44;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">43 &#40;9&#44;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">134 &#40;3&#44;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Otra enf&#46; hep&#225;tica&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">248 &#40;7&#44;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">66 &#40;14&#44;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">314 &#40;8&#44;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">ACVA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">140 &#40;4&#44;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">30 &#40;6&#44;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">170 &#40;4&#44;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;<span class="elsevierStyleHsp" style=""></span>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="table-entry ; entry_with_role_rowhead " align="left" valign="top">Epilepsia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">63 &#40;1&#44;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">12 &#40;2&#44;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">75 &#40;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;31&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " colspan="5" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Complicaciones durante el procedimiento</th></tr><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Grupo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Programadas&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Urgentes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Total&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">p&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">N&#46;&#176; pacientes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&#46;289&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">457&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&#46;746&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">N&#46;&#176; pac&#46; con complicaciones&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">939 &#40;28&#44;25&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">201 &#40;43&#44;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;140 &#40;30&#44;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Parada cardiorrespiratoria&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0 &#40;0&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5 &#40;1&#44;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5 &#40;0&#44;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">p&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Sangrado&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3 &#40;0&#44;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4 &#40;0&#44;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7 &#40;0&#44;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;<span class="elsevierStyleHsp" style=""></span>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="table-entry ; entry_with_role_rowhead " align="left" valign="top">Hipoxemia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">100 &#40;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">26 &#40;5&#44;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">126 &#40;3&#44;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;<span class="elsevierStyleHsp" style=""></span>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="table-entry ; entry_with_role_rowhead " align="left" valign="top">Insuf&#46; respiratoria&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7 &#40;0&#44;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4 &#40;0&#44;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">11 &#40;0&#44;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;14&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Hipertensi&#243;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">341 &#40;10&#44;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">48 &#40;10&#44;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">389 &#40;10&#44;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;929&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Hipotensi&#243;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">209 &#40;6&#44;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">96 &#40;18&#44;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">295 &#40;7&#44;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Bradicardia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">177 &#40;5&#44;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">18 &#40;3&#44;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">195 &#40;5&#44;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;193&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Taquicardia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">213 &#91;6&#44;5&#37;&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">91 &#91;19&#44;9&#37;&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">304 &#91;8&#44;1&#37;&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="center" valign="top">Complicaciones postsedaci&#243;n</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">N&#46;&#176; pacientes URPA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3175 &#91;89&#37;&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">392 &#91;11&#37;&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3576&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Tiempo en URPA min &#40;media<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>DE&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">50&#44;15<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>27&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">81&#44;48<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>82&#44;38&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">53&#44;59<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>38&#44;37&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Fallecimiento&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1 &#40;0&#44;02&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2 &#40;0&#44;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3 &#40;0&#44;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;<span class="elsevierStyleHsp" style=""></span>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="table-entry ; entry_with_role_rowhead " align="left" valign="top">N&#225;useas&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">62 &#40;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">11 &#40;2&#44;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">73 &#40;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;260&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">V&#243;mitos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">29 &#40;0&#44;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5 &#40;1&#44;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">34 &#40;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;486&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Cefalea&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">14 &#40;0&#44;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1 &#40;0&#44;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">15 &#40;0&#44;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;592&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Hipoxemia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7 &#40;0&#44;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9 &#40;2&#44;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">16 &#40;0&#44;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Bradicardia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">36 &#40;1&#44;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2 &#40;0&#44;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">38 &#40;1&#44;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;256&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Hipotensi&#243;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">21 &#40;0&#44;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">16 &#40;4&#44;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">37 &#40;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Taquicardia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6 &#40;0&#44;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5 &#40;1&#44;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">11 &#40;0&#44;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Hipertensi&#243;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">50 &#40;1&#44;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5 &#40;1&#44;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">55 &#40;1&#44;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;650&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Sangrado&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0 &#40;0&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5 &#40;1&#44;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5 &#40;0&#44;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Dolor &#40;total&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">249 &#40;7&#44;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">49 &#40;12&#44;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">298 &#40;8&#44;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;628&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Dolor &#40;moderado&#47;severo&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">25 &#40;0&#44;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4 &#40;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">29 &#40;0&#44;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="center" valign="top">Analg&#233;sicos</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Paracetamol&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">173 &#40;2&#44;28&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">24 &#40;5&#44;26&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">63 &#40;9&#44;57&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;582&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Metamizol&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">29 &#40;0&#44;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7 &#40;1&#44;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">36 &#40;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;103&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Dexketoprofeno&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">74 &#40;2&#44;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">14 &#40;3&#44;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">88 &#40;2&#44;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;135&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Tramadol&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">20 &#40;0&#44;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3 &#40;0&#44;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">23 &#40;0&#44;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;752&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">60 &#40;1&#44;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">23 &#40;5&#44;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">83 &#40;2&#44;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">28 &#40;19&#44;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3 &#40;30&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">31 &#40;20&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">397 &#40;23&#44;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">28 &#40;28&#44;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">425 &#40;23&#44;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">ASA 3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">435 &#40;33&#44;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">103 &#40;44&#44;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">538 &#40;35&#44;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">ASA 4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">79 &#40;36&#44;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">65 &#40;52&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">144 &#40;42&#44;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">ASA 5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2 &#40;100&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2 &#40;100&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;01-1&#44;06&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;81-3&#44;26&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;020&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;39-2&#44;58&nbsp;\t\t\t\t\t\t\n
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                      "titulo" => "Quality evaluation of colonoscopy reporting and colonoscopy performance in daily clinical practice"
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                          "autores" => array:6 [
                            0 => "V&#46; De Jonge"
                            1 => "J&#46; Sint Nicolaas"
                            2 => "D&#46;L&#46; Cahen"
                            3 => "W&#46; Moolenaar"
                            4 => "R&#46;J&#46; Ouwendijk"
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                      "doi" => "10.1016/j.gie.2011.06.032"
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                        "tituloSerie" => "Gastrointest Endosc&#46;"
                        "fecha" => "2012"
                        "volumen" => "75"
                        "paginaInicial" => "98"
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                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Patient comfort and quality in colonoscopy"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "V&#46;E&#46; Ekkelenkamp"
                            1 => "K&#46; Dowler"
                            2 => "R&#46;M&#46; Valori"
                            3 => "P&#46; Dunckley"
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                    ]
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                    0 => array:2 [
                      "doi" => "10.3748/wjg.v19.i15.2355"
                      "Revista" => array:7 [
                        "tituloSerie" => "World J Gastroenterol&#46;"
                        "fecha" => "2013"
                        "volumen" => "19"
                        "paginaInicial" => "2355"
                        "paginaFinal" => "2361"
                        "link" => array:1 [
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                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23613629"
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                          "estado" => "S300"
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                0 => array:3 [
                  "comentario" => "Epub 2012 Mar 21"
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Clinical practice guidelines&#58; Quality of colonoscopy in colorectal cancer screening"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
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