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Survival curves at 28 days for patients categorised into 4 groups: 1) patients who did not receive corticosteroid treatment during their ICU stay; 2) patients treated with dexamethasone 6<span class="elsevierStyleHsp" style=""></span>mg daily for up to 10 days; 3) patients who received dexamethasone in doses higher than 6<span class="elsevierStyleHsp" style=""></span>mg daily, and 4) patients managed with low doses of methylprednisolone (40–80<span class="elsevierStyleHsp" style=""></span>mg daily) for a period of 3 to 5 days.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "A. González-Castro, A. Fernandez, E. Cuenca-Fito, Y. Peñasco, J. Ceña, J.C. Rodríguez Borregán" "autores" => array:6 [ 0 => array:2 [ "nombre" => "A." "apellidos" => "González-Castro" ] 1 => array:2 [ "nombre" => "A." "apellidos" => "Fernandez" ] 2 => array:2 [ "nombre" => "E." "apellidos" => "Cuenca-Fito" ] 3 => array:2 [ "nombre" => "Y." 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"apellidos" => "Rodríguez Borregán" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0034935623003055" "doi" => "10.1016/j.redar.2023.09.002" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0034935623003055?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341192924000349?idApp=UINPBA00004N" "url" => "/23411929/0000007100000005/v2_202407071248/S2341192924000349/v2_202407071248/en/main.assets" ] "en" => array:19 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>" "titulo" => "Factors associated with limitation of life support: Post-ICU mortality case study of a tertiary hospital" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "387" "paginaFinal" => "393" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "U.A. López González, D. Bautista Rentero, M. Crespo Gómez, P. Cárcamo Ibarra, A.M. Míguez Santiyán" "autores" => array:5 [ 0 => array:4 [ "nombre" => "U.A." "apellidos" => "López González" "email" => array:1 [ 0 => "ulogon@alumni.uv.es" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "D." "apellidos" => "Bautista Rentero" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "M." "apellidos" => "Crespo Gómez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 3 => array:3 [ "nombre" => "P." "apellidos" => "Cárcamo Ibarra" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] 4 => array:3 [ "nombre" => "A.M." "apellidos" => "Míguez Santiyán" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Servicio de Medicina Preventiva, Hospital Universitario Doctor Peset, Valencia, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Medicina Intensiva, Hospital Universitario Doctor Peset, Valencia, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Servicio de Medicina Nuclear, Hospital Clínico Universitario de Valencia, Valencia, Spain" "etiqueta" => "c" "identificador" => "aff0015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Factores asociados a la limitación del soporte vital: estudio de casos de mortalidad post-UCI de un hospital terciario" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1535 "Ancho" => 1675 "Tamanyo" => 96323 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Cox regression survival analysis comparing days of post-ICU stay and limitation of life-sustaining treatment (LLST) in the ICU.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Limitation of life-sustaining treatment (LLST) is defined as withdrawing or not initiating measures that are considered futile in a patient's specific situation, since they only prolong biological life without providing functional recovery and a minimum quality of life.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1,2,3</span></a> According to some authors, it is more appropriate to speak of “adaptation of therapy”, meaning a strategy that includes diagnostic procedures but avoids the negative connotation of limitation of therapeutic effort.<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">The definition of LLST and its ethical implications has achieved broad consensus,<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">3,4</span></a> and although it is common practice, it is still a complex decision. A futile treatment is one that does not improve survival or quality of life<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2,5,6,7</span></a>; however, a clinical prognosis is not an absolute certainty, and quality of life depends not only on the patient’s personal experience and the doctor’s opinion, but also on the socioeconomic and cultural context.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1,4,5,8</span></a> Although there is evidence that LLST is usually indicated by the medical team, the decision is taken on the basis of the patient’s functional status and prior frailty, morbidity, and the severity of their disease.<a class="elsevierStyleCrossRefs" href="#bib0045"><span class="elsevierStyleSup">9,10,11,12</span></a><span class="elsevierStyleSup">,</span><a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">13</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Epidemiological changes in recent decades have led to an increase in the percentage of elderly individuals or patients with acute on chronic diseases who are admitted to Intensive Care Units (ICU)7. These units, therefore, not only prolong life, but also produce individuals with incurable physical and/or mental disabilities who will never regain their functional capacity.<a class="elsevierStyleCrossRefs" href="#bib0025"><span class="elsevierStyleSup">5,6</span></a> Despite surviving their stay in the ICU, some of these patients will die before leaving the hospital. The term “occult mortality” was coined in the 1990s to define this phenomenon,<a class="elsevierStyleCrossRefs" href="#bib0070"><span class="elsevierStyleSup">14,15</span></a> although currently the term “post-ICU” mortality is more widely used.<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">16</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">Some studies have shown that in-hospital mortality after discharge from the ICU can be due to sub-standard healthcare,<a class="elsevierStyleCrossRefs" href="#bib0025"><span class="elsevierStyleSup">5,17,18</span></a> and that end-of-life discussions and decisions are often taken late or not at all — a situation that generates discontent among patients and their families.<a class="elsevierStyleCrossRefs" href="#bib0080"><span class="elsevierStyleSup">16,19</span></a> For this reason, LLST is currently considered one of the responsibilities of Intensive Medicine services, and is an indicator of care quality.<a class="elsevierStyleCrossRefs" href="#bib0100"><span class="elsevierStyleSup">20,21,22</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">Various tools, such as the Glasgow Coma Scale<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">23</span></a> or the Killip and Kimball system,<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">24</span></a> and more complex instruments such as the APACHE II (“Acute Physiology and Chronic Health Evaluation”),<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">25</span></a> SAPS II (“Simplified Acute Physiology Score”)<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">26</span></a> and MPM II (“Mortality Probability Model”) scales have been developed to help clinicians evaluate disease severity and the likelihood of survival,<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a> and reduce prognostic uncertainty.<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">27</span></a> These instruments are periodically updated to include new predictor variables and/or to simplify their definitions<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a>; however, they are unsuitable for individual prognoses for several reasons: they may not include factors that impact the final outcome, or they may exclude both incidental complications arising during admission and the effect of certain therapies.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a> Even so, risk of mortality scales can help doctors decide to withdraw life-sustaining therapy at an appropriate time (understood as adapting therapy to allow the patient to benefit from palliative care in a more comfortable environment where their family can accompany them in their last stages of their life).</p><p id="par0030" class="elsevierStylePara elsevierViewall">The main aim of this study is to identify the factors associated with the indication for LLST in the ICU in patients that ultimately died in hospital after ICU discharge. We also describe the factors associated with length of hospital stay until death after discharge from the ICU.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Patients and methods</span><p id="par0035" class="elsevierStylePara elsevierViewall">We performed a retrospective longitudinal review of clinical records dating from 1 January 2014 to 31 December 2019 of all adult patients admitted to the ICU of a university hospital in Valencia (Spain) for more than 24 h, and who ultimately died in hospital after discharge from the ICU.</p><p id="par0040" class="elsevierStylePara elsevierViewall">The study variables were: age, sex, probability of mortality (estimated by the MPM II on admission to the ICU), type of admission (urgent or scheduled), indication for LLST in the ICU, cancer, any degree of dependency in basic activities of daily living (estimated by the Barthel scale), use of invasive mechanical ventilation and emergency haemodialysis, blood transfusion, nosocomial infection (NI) acquired in the ICU, days of stay before ICU admission, days of stay in the ICU, and days of post-ICU stay.</p><p id="par0045" class="elsevierStylePara elsevierViewall">LLST was defined as an indication in the patient’s clinical record that advanced life support measures would not be initiated or would be withdrawn. Each decision was approved after a series of multidisciplinary discussions held by the hospital’s intensive care team following a protocol developed for this purpose. The medical team and family members agreed on LLST for the following reasons: advanced age, severe illness or the impossibility of cure, lack of response to treatment, or potentially poor quality of life.</p><p id="par0050" class="elsevierStylePara elsevierViewall">Quantitative variables were described as mean and standard deviation, and qualitative variables were described as frequencies and proportions. The data were tested for statistical significance using the X<span class="elsevierStyleSup">2</span> test in the case of proportions and the Student's <span class="elsevierStyleItalic">t</span>-test in the case of means. Significance was set at p < 0.05.</p><p id="par0055" class="elsevierStylePara elsevierViewall">A multivariate unconditional binary forward stepwise logistic regression model was fitted to determine the predictor variables of LLST in the ICU. The adjusted odds ratio and its 95% confidence interval were estimated for each variable included in the model. The goodness of fit of the logistic regression model was tested using the Hosmer-Lemeshow test. A Cox forward stepwise regression model was used to analyse the factors associated with survival time after discharge from the ICU. Hazard ratios and their 95% confidence intervals were estimated.</p><p id="par0060" class="elsevierStylePara elsevierViewall">The study was approved by the Drug Research Ethics Committee of the Dr. Peset University Hospital in Valencia.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Results</span><p id="par0065" class="elsevierStylePara elsevierViewall">Of the 1517 patients admitted to the ICU during the study period, 503 died in the ICU and 114 died on the ward after discharge. A review of the clinical records of the 114 patients who died on the ward showed that LLST was indicated in 49 cases (42.98%) during their stay in the ICU. The clinical characteristics of the patients are shown in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>, based on the indication for LLST in the ICU.</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0070" class="elsevierStylePara elsevierViewall">Variables that were statistically significantly associated with LLST in the ICU were age, post-ICU stay, and NI. Patients with an indication for LLST in the ICU were slightly older; length of post-ICU stay was longer and incidence of NI was higher in patients without an indication for LLST. There were no other significant differences between variables in patients with and without an indication for LLST; however, pre-ICU stay and cancer were close to statistical significance (p-value = 0.07).</p><p id="par0075" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a> shows the clinically relevant characteristics prior to the indication of LLST that were included in the multivariate logistic regression model to determine the probability of LLST in the ICU. Based on this multivariate analysis, age and stay prior to ICU admission were positively associated with an indication for LLST; that is, the older the patient and the longer the pre-ICU stay, the greater the probability of LLST. The model also showed that NI was less likely in patients with LLST. The goodness of fit of the logistic regression model was tested using the Hosmer-Lemeshow test (p-value = 0.896).</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0080" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a> shows the results of the multivariate Cox regression analysis. The variables that were associated with length of stay after discharge from the ICU were: days of stay before ICU admission, sex, and LLST in the ICU, so that men and, above all, patients with LLST (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>) were at greater risk, while greater length of stay before ICU admission was associated with a lower risk (greater survival). The remaining variables did not reach the level of statistical significance in the univariate and multivariate Cox regression analysis.</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><elsevierMultimedia ident="fig0005"></elsevierMultimedia></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0130">Discussion</span><p id="par0085" class="elsevierStylePara elsevierViewall">In this study, we analysed the clinical records of patients admitted to the ICU who died on the ward after ICU discharge and the factors associated with LLST during their stay in the ICU. The bivariate analysis showed that patients with an indication for LLST were around 5 years older than those without. Hospital stay after discharge from the ICU was also longer in this group, while the proportion of cases with a diagnosis of ICU-acquired NI was lower compared with those with no indication for LLST. The multivariate analysis showed that the factors significantly associated with an indication for LLST were age, NI, and days of hospital stay, in this case, prior to admission to the ICU. In the survival analysis, we observed that the variables significantly related to post-ICU hospital stay, in addition to LLST, were male sex and hospital stay before ICU admission.</p><p id="par0090" class="elsevierStylePara elsevierViewall">LLST is still a difficult subject to study due to the multitude of technical and external factors that contribute to the indication, and few studies have analysed LLST quantitatively.<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a> Similarly, although some studies have described the characteristics and factors associated with post-ICU mortality,<a class="elsevierStyleCrossRefs" href="#bib0055"><span class="elsevierStyleSup">11,16</span></a> it is difficult to find studies analysing LLST in this highly specific population.</p><p id="par0095" class="elsevierStylePara elsevierViewall">Other authors have also identified age as one of predictors of LLST.<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">28</span></a> The shorter post-ICU stay of patients with an indication for LLST reported in this study may be related to the results of the survival analysis, which showed that LLST increased the risk of early mortality on the ward 3-fold, thereby indirectly shortening the length of post-ICU stay. This association between LLST and mortality has also been observed in other studies in which LLST was a strong predictor of in-hospital mortality.<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">13</span></a></p><p id="par0100" class="elsevierStylePara elsevierViewall">In our study, we also observed that patients with an indication for LLST were 5 times less likely to develop NI, irrespective of other factors. One possible explanation for this phenomenon is that the presence of NI in the ICU is associated with greater therapeutic effort and, consequently, a longer stay. Another explanation is that the indication for LLST precludes the use of invasive devices and other measures, thereby reducing the risk of infection.<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">13</span></a> This improves patient safety and saves resources, and could therefore benefit patients, ICU staff, and the healthcare system as a whole.</p><p id="par0105" class="elsevierStylePara elsevierViewall">Regarding the methodology used in our study, LLST indicated outside the ICU was not included in our study variables because the criteria and wording for this indication varied greatly in the clinical records used in our study, thus increasing the risk of incorrectly classifying the variable. This may be due, at least in part, to differences in the work cultures of the different specialties involved in the ICU. Although clinicians base their decisions on the “best available evidence”, clinical, ethical, social, and moral factors<a class="elsevierStyleCrossRefs" href="#bib0050"><span class="elsevierStyleSup">10,12</span></a> can contribute to LLST or even propitiate dysthanasia. Decisions can also be influenced by external factors, such as the patient's advance directive, the demands of family members, or an ambiguous prognosis.</p><p id="par0110" class="elsevierStylePara elsevierViewall">In our study, we observed that LLST was indicated by ICU doctors in 43% of patients who died after discharge from the ICU, suggesting the existence of 2 different patient profiles: those who are transfer to the ward as a palliative measure (they are expected to die shortly), and those who die unexpectedly on the ward due either to the severity of their illness or to a fatal adverse event.</p><p id="par0115" class="elsevierStylePara elsevierViewall">We believe it is also important to analyse variables that, <span class="elsevierStyleItalic">a priori</span>, could correlate with a greater likelihood of LLST but that did not show significant differences in our analysis. For example, observed no correlation between use of the MPM II scale to estimate the probability of in-hospital death on ICU admission<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a> and the indication for LLST. Medical teams are likely to take into account various other factors aside from mortality prediction scale when deciding to adapt therapy. The available prognostic tools may fail to estimate a patient's severity because they are not validated for individual outcomes.<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">30</span></a> Neither clinical opinion or 24-h models of ICU mortality are accurate enough to form a basis for triage, let alone end-of-life decisions,<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">27</span></a> and it is therefore up to medical teams to manage prognostic uncertainty and take such decisions.</p><p id="par0120" class="elsevierStylePara elsevierViewall">The results of this study should be interpreted taking into account its limitations. As this is a retrospective study, some data may be missing and the timing of the phenomena analysed cannot always be established. Retrospective chart reviews also limit the analysis to the information recorded in the patient’s record. Given the lack of standardised wording of the indication for LLST in the healthcare system, we had to define it as any wording that describes this measure. However, many symptomatic measures or withdrawal of therapy in the framework of an adaptation of therapy may not have been considered LLST.</p><p id="par0125" class="elsevierStylePara elsevierViewall">Other factors are likely to be significantly associated with LSV; however, our study was not large enough to achieve the statistical power to demonstrate this relationship. Although we reviewed records over a 6-year period, we found few cases of intensive care patients who died on the hospital ward before discharge.</p><p id="par0130" class="elsevierStylePara elsevierViewall">Nevertheless, this is one of the few studies to have quantitatively analysed LLST in the context of post-ICU mortality. The regression models were constructed using forward selection, in which the variables were progressively incorporated into the model and were retained or eliminated according to the likelihood ratio. This explains why variables that showed a significant association in isolation were excluded from the final models (the same applies to variables that did not achieve statistical significance in the bivariate analysis). This allowed us to reduce the risk of bias due to the presence of interactions or confounding factors.</p><p id="par0135" class="elsevierStylePara elsevierViewall">The findings of the SUPPORT study, which showed that death in the ICU involves far more suffering and psychological stress for the patient and their family compared to elsewhere in the hospital,<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">19</span></a> have highlighted the importance of obtaining patient advance directives, the role of prognostic information at the end of life, and the need to evaluate the quality of end-of-life care provided by healthcare systems.<a class="elsevierStyleCrossRefs" href="#bib0100"><span class="elsevierStyleSup">20,21,22</span></a> Many authors have attempted to define the criteria that differentiate between useful and futile treatment.<a class="elsevierStyleCrossRefs" href="#bib0025"><span class="elsevierStyleSup">5,17,18</span></a> but the results have been inconsistent.</p><p id="par0140" class="elsevierStylePara elsevierViewall">We believe that more studies are needed to verify these results - ideally prospective, multicentre projects using a standardised LLST protocol to standardise the definition of the variables used. Quantitative methods such as survival analysis should be used to generate evidence in favour of LLST as good medical practice and a new indicator of quality of care. Additionally, a qualitative design could help capture factors related to the patient's wishes or the opinion of his or her medical team. A combination of these methods may help researchers evaluate the complexity of the clinical situation and reduce subjectivity in difficult decisions such as LLST.</p><p id="par0145" class="elsevierStylePara elsevierViewall">Indicating LLST and transferring the patient from the ICU to a ward would avoid disproportionate therapeutic measures and allow patients to end their life accompanied by their family in a less clinical environment in which palliative care is the priority.<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">29</span></a> However, indicating LLST in a patient who is likely to survive anyway would also avoid dysthanasia and its associated risks.</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0135">Funding</span><p id="par0150" class="elsevierStylePara elsevierViewall">None.</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0140">Conflict of interest</span><p id="par0155" class="elsevierStylePara elsevierViewall">The authors have no conflict of interest to declare.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:11 [ 0 => array:3 [ "identificador" => "xres2199345" "titulo" => "Abstract" "secciones" => array:9 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Background" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Objective" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Design" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Ambit" ] 4 => array:2 [ "identificador" => "abst0025" "titulo" => "Patients" ] 5 => array:2 [ "identificador" => "abst0030" "titulo" => "Interventions" ] 6 => array:2 [ "identificador" => "abst0035" "titulo" => "Variables of interest" ] 7 => array:2 [ "identificador" => "abst0040" "titulo" => "Results" ] 8 => array:2 [ "identificador" => "abst0045" "titulo" => "Conclusions" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec1845971" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres2199346" "titulo" => "Resumen" "secciones" => array:9 [ 0 => array:2 [ "identificador" => "abst0050" "titulo" => "Antecedentes" ] 1 => array:2 [ "identificador" => "abst0055" "titulo" => "Objetivo" ] 2 => array:2 [ "identificador" => "abst0060" "titulo" => "Diseño" ] 3 => array:2 [ "identificador" => "abst0065" "titulo" => "Ámbito" ] 4 => array:2 [ "identificador" => "abst0070" "titulo" => "Pacientes" ] 5 => array:2 [ "identificador" => "abst0075" "titulo" => "Intervenciones" ] 6 => array:2 [ "identificador" => "abst0080" "titulo" => "Variables de interés" ] 7 => array:2 [ "identificador" => "abst0085" "titulo" => "Resultados" ] 8 => array:2 [ "identificador" => "abst0090" "titulo" => "Conclusiones" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec1845970" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:2 [ "identificador" => "sec0010" "titulo" => "Patients and methods" ] 6 => array:2 [ "identificador" => "sec0015" "titulo" => "Results" ] 7 => array:2 [ "identificador" => "sec0020" "titulo" => "Discussion" ] 8 => array:2 [ "identificador" => "sec0025" "titulo" => "Funding" ] 9 => array:2 [ "identificador" => "sec0030" "titulo" => "Conflict of interest" ] 10 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2023-03-02" "fechaAceptado" => "2023-05-23" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec1845971" "palabras" => array:5 [ 0 => "Life-sustaining treatment limitation" 1 => "Medical futility" 2 => "Withholding" 3 => "Intensive care" 4 => "Nosocomial infections" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec1845970" "palabras" => array:5 [ 0 => "Limitación del soporte vital" 1 => "Inutilidad médica" 2 => "Retiro de la atención" 3 => "Cuidados intensivos" 4 => "Infección hospitalaria" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Background</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Life-sustaining treatment limitation (LSV) is the medical act of withdrawing or not initiating measures that are considered futile in a patient's specific situation. LSV in critically ill patients remains a difficult topic to study, due to the multitude of factors that condition it.</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Objective</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">To determine factors related to LSV in ICU in cases of post-ICU in-hospital mortality, as well as factors associated with survival after discharge from ICU.</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Design</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Retrospective longitudinal study.</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Ambit</span><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Intensive care unit of a tertiary hospital.</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Patients</span><p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">People who died in the hospitalization ward after ICU treatment between January 2014 and December 2019.</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Interventions</span><p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">None. This is an observational study.</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Variables of interest</span><p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Age, sex, probability of death, type of admission, LSV in ICU, oncological disease, dependence, invasive mechanical ventilation, emergency hemodialysis, transfusion of blood products, nosocomial infection (NI), pre-ICU, intra-ICU and post-ICU stays.</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Results</span><p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Of 114 patients who died outside the ICU, 49 had LSV registered in the ICU (42.98%). Age and stay prior to ICU admission were positively associated with LSV (OR 1,03 and 1,08, respectively). Patients without LSV had a higher post-ICU stay, while it was lower for male patients.</p></span> <span id="abst0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusions</span><p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">Our results support that LSV established within the ICU can avoid complications commonly associated with unnecessary prolongation of stay, such as NI.</p></span>" "secciones" => array:9 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Background" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Objective" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Design" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Ambit" ] 4 => array:2 [ "identificador" => "abst0025" "titulo" => "Patients" ] 5 => array:2 [ "identificador" => "abst0030" "titulo" => "Interventions" ] 6 => array:2 [ "identificador" => "abst0035" "titulo" => "Variables of interest" ] 7 => array:2 [ "identificador" => "abst0040" "titulo" => "Results" ] 8 => array:2 [ "identificador" => "abst0045" "titulo" => "Conclusions" ] ] ] "es" => array:3 [ "titulo" => "Resumen" "resumen" => "<span id="abst0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Antecedentes</span><p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">La limitación del tratamiento de soporte vital (LSV) es el acto médico de retirar o no iniciar medidas que se consideren fútiles en la situación concreta de un paciente. La LSV en pacientes críticos sigue siendo un tema difícil de estudiar, debido a la multitud de factores que la condicionan.</p></span> <span id="abst0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Objetivo</span><p id="spar0090" class="elsevierStyleSimplePara elsevierViewall">Determinar los factores relacionados con la LSV en UCI en casos de mortalidad hospitalaria post-UCI, así como los factores asociados a los días de supervivencia tras el alta de UCI.</p></span> <span id="abst0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Diseño</span><p id="spar0095" class="elsevierStyleSimplePara elsevierViewall">Estudio longitudinal retrospectivo.</p></span> <span id="abst0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Ámbito</span><p id="spar0100" class="elsevierStyleSimplePara elsevierViewall">Unidad de cuidados intensivos de un hospital terciario.</p></span> <span id="abst0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Pacientes</span><p id="spar0105" class="elsevierStyleSimplePara elsevierViewall">Personas fallecidas en sala de hospitalización tras tratamiento en UCI entre enero de 2014 y diciembre de 2019.</p></span> <span id="abst0075" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Intervenciones</span><p id="spar0110" class="elsevierStyleSimplePara elsevierViewall">No existen. Se trata de un estudio observacional.</p></span> <span id="abst0080" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Variables de interés</span><p id="spar0115" class="elsevierStyleSimplePara elsevierViewall">Edad, sexo, probabilidad de muerte, tipo de ingreso, LSV en UCI, enfermedad oncológica, dependencia, ventilación mecánica invasiva y hemodiálisis de urgencia, transfusión de hemoderivados, infección nosocomial (IN), estancias pre-UCI, intra-UCI y post-UCI.</p></span> <span id="abst0085" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Resultados</span><p id="spar0120" class="elsevierStyleSimplePara elsevierViewall">De 114 pacientes fallecidos fuera de la UCI, 49 tenían registrada LSV en UCI (42,98%). La edad y la estancia previa al ingreso en UCI se asociaron positivamente a LSV (OR 1,03 y 1,08, respectivamente) y la IN, negativamente (OR 0,19). Los pacientes sin LSV presentaron una estancia post-UCI más alta, mientras que en los pacientes varones fue menor.</p></span> <span id="abst0090" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Conclusiones</span><p id="spar0125" class="elsevierStyleSimplePara elsevierViewall">Nuestros resultados apoyan que la LSV instaurada dentro de UCI puede relacionarse con un menor número de complicaciones comúnmente asociadas a la prolongación innecesaria de la estancia, como la IN.</p></span>" "secciones" => array:9 [ 0 => array:2 [ "identificador" => "abst0050" "titulo" => "Antecedentes" ] 1 => array:2 [ "identificador" => "abst0055" "titulo" => "Objetivo" ] 2 => array:2 [ "identificador" => "abst0060" "titulo" => "Diseño" ] 3 => array:2 [ "identificador" => "abst0065" "titulo" => "Ámbito" ] 4 => array:2 [ "identificador" => "abst0070" "titulo" => "Pacientes" ] 5 => array:2 [ "identificador" => "abst0075" "titulo" => "Intervenciones" ] 6 => array:2 [ "identificador" => "abst0080" "titulo" => "Variables de interés" ] 7 => array:2 [ "identificador" => "abst0085" "titulo" => "Resultados" ] 8 => array:2 [ "identificador" => "abst0090" "titulo" => "Conclusiones" ] ] ] ] "multimedia" => array:4 [ 0 => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1535 "Ancho" => 1675 "Tamanyo" => 96323 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Cox regression survival analysis comparing days of post-ICU stay and limitation of life-sustaining treatment (LLST) in the ICU.</p>" ] ] 1 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0010" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:3 [ "leyenda" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">BADL: basic activities of daily living; BT: blood transfusion; IMV: invasive mechanical ventilation; LLSV: limitation of life-sustaining treatment; MPM II: mortality prediction model; n: number of cases, SD: standard deviation; UHD: urgent haemodialysis.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">LLSV in ICU</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col">Statistics \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col">p-Value \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Yes (n = 49) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">No (n = 65) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Age, mean (SD) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">75.18 (10.24) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">69.75 (14.51) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">T = −2.340 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.021<a class="elsevierStyleCrossRef" href="#tblfn0005">*</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">MPM II, mean (SD) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.35 (0.23) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.32 (0.25) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">T = −0.629 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.531 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Comorbidities, mean (SD) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4.27 (2.19) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4.68 (1.92) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">T = 1.062 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.290 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Pre-ICU stay, mean (SD) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4.69 (7.13) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2.66 (4.89) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">T = −1.803 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.074 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">UCI stay, mean (SD) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7.37 (7.58) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7.14 (7.82) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">T = −0,157 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.876 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Post-ICU stay, mean (SD) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4.73 (5.48) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">15.29 (17.69) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">T = 4.530 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><0.001<a class="elsevierStyleCrossRef" href="#tblfn0005">*</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Men, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">29 (59.2%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">38 (58.5%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">X <span class="elsevierStyleSup">2</span> = 0.006 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.930 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Scheduled admission, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 (8.2%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5 (7.7%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">X <span class="elsevierStyleSup">2</span> = 0.009 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.926 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Nosocomial infection, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 (8.2%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">18 (27.7%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">X <span class="elsevierStyleSup">2</span> = 6.842 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.009<a class="elsevierStyleCrossRef" href="#tblfn0005">*</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Previous ICU admission, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">28 (57.1%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">31 (47.7%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">X <span class="elsevierStyleSup">2</span> = 0.999 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.317 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Active cancer, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">17 (34.7%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">13 (20.0%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">X <span class="elsevierStyleSup">2</span> = 3.110 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.078 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Dependency for BADL, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">17 (34.7%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">17 (26.2%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">X <span class="elsevierStyleSup">2</span> = 0.974 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.324 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">IMV, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">19 (38.8%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">25 (38.5%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">X <span class="elsevierStyleSup">2</span> = 0.001 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.973 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">UHD, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8 (16.3%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">11 (16.9%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">X <span class="elsevierStyleSup">2</span> = 0.007 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.933 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">BT, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">10 (20.4%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">18 (27.7%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">X <span class="elsevierStyleSup">2</span> = 0.801 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.371 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab3589879.png" ] ] ] "notaPie" => array:1 [ 0 => array:3 [ "identificador" => "tblfn0005" "etiqueta" => "*" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Statistical significance in the hypothesis test with a value of p < 0.05.</p>" ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Characteristics of post-ICU mortality cases according to limitation of life-sustaining treatment (LLSV) in the ICU.</p>" ] ] 2 => array:8 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0015" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">aOR: adjusted odds ratio, CI: confidence interval, LTSV: limitation of life-sustaining treatment. SE: standard error.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Variable \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Coefficient \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">SE \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Wald \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">aOR (95% CI) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">p-Value \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Age \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.035 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.017 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4.259 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.036 (1.002−1.070) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.039 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Pre-ICU stay \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.079 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.037 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4.504 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.082 (1.006−1.163) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.034 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Nosocomial infection \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">−1.649 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.639 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6.665 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.192 (0.055−0.672) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.010 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab3589880.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Multivariate logistic regression model of limitation of life-sustaining treatment (LLSV) in the ICU.</p>" ] ] 3 => array:8 [ "identificador" => "tbl0015" "etiqueta" => "Table 3" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0020" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "<p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">aOR: adjusted odds ratio, CI: confidence interval, HR: hazard ratio, LLSV: limitation of life-sustaining treatment. SE: standard error.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Variable \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Coefficient \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">SE \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Wald \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">HR (95% CI) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">p-Value \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Pre-ICU stay \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">−0.044 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.019 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5.171 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.957 (0.922−0.994) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.023 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Men \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.521 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.199 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6.848 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.684 (1.140−2.489) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.009 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">LLSV in ICU \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.219 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.214 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">32.429 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3.383 (2.224−5.146) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab3589881.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Variables included in the Cox Regression model of days of post-ICU stay.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:30 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Ética y muerte digna: propuesta de consenso sobre un uso correcto de las palabras" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "P.S. 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Original article
Factors associated with limitation of life support: Post-ICU mortality case study of a tertiary hospital
Factores asociados a la limitación del soporte vital: estudio de casos de mortalidad post-UCI de un hospital terciario