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hasta constituirse en la afecci&#243;n que m&#225;s tiempo ocupa en su actividad cl&#237;nica<a class="elsevierStyleCrossRefs" href="#bb0005"><span class="elsevierStyleSup">1&#44;3-6</span></a>&#46; Se han considerado como factores que han influido en este incremento el mayor n&#250;mero de accidentes de tr&#225;fico asociado con el crecimiento del parque m&#243;vil de veh&#237;culos particulares y las importantes repercusiones econ&#243;micas que de estos accidentes se derivan y que motivan controversias judiciales en las que la valoraci&#243;n medicoforense se solicita como mediadora<a class="elsevierStyleCrossRefs" href="#bb0035"><span class="elsevierStyleSup">7&#44;8</span></a>&#46;</p><p id="p0015" class="elsevierStylePara elsevierViewall">El SLC comporta una importante carga de subjetividad en la forma de abordarlo desde el punto de vista cl&#237;nico&#46; Ello ha propiciado en la esfera medicoforense una falta de uniformidad en los criterios de estimaci&#243;n de los tiempos de sanidad&#44; en ocasiones poco coherentes con la naturaleza aparente del SLC habitualmente no complicada&#44; y en la valoraci&#243;n de las secuelas derivadas<a class="elsevierStyleCrossRefs" href="#bb0045"><span class="elsevierStyleSup">9-11</span></a>&#46;</p><p id="p0020" class="elsevierStylePara elsevierViewall">El presente trabajo se centra en los aspectos epidemiol&#243;gicos del SLC y en la problem&#225;tica de la valoraci&#243;n medicolegal de este&#46; El objetivo de este an&#225;lisis es definir las caracter&#237;sticas de su valoraci&#243;n pericial a partir de diferentes fuentes medicoforenses del Instituto de Medicina Legal de Huelva&#46; Basado en este criterio&#44; el presente trabajo &#250;nicamente pretende analizar si existe una forma com&#250;n de interpretaci&#243;n pericial de este trastorno y cu&#225;les ser&#237;an sus caracter&#237;sticas&#46;</p></span><span id="s0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0010">Material y m&#233;todos</span><p id="p0025" class="elsevierStylePara elsevierViewall">Huelva durante el a&#241;o 2008&#46; 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y en un 18&#44;2&#37; de casos no se aplicaron ninguna de las medidas descritas &#40;56 casos&#41;&#46; A todos los lesionados se les aplic&#243; tratamiento farmacol&#243;gico &#40;analg&#233;sico-antiinflamatorio y&#47;o miorrelajante&#41;&#46;</p><p id="p0130" class="elsevierStylePara elsevierViewall">Los tiempos de curaci&#243;n&#47;estabilizaci&#243;n correspondieron con una media de 60&#44;75 &#177; 26&#44;587 d&#237;as &#40;mediana&#44; 60&#59; m&#225;ximo&#44; 140&#59; m&#237;nimo&#44; 5&#41;&#46; En varones&#44; la media de tiempo de curaci&#243;n fue 53&#44;67 &#177; 24&#44;403 &#40;mediana&#44; 55&#59; m&#225;ximo&#44; 120&#59; m&#237;nimo&#44; 7&#41; y para mujeres de 65&#44;12 &#177; 26&#44;995 d&#237;as &#40;mediana&#44; 60&#59; m&#225;ximo&#44; 140&#59; m&#237;nimo&#44; 5&#41; &#40;<a class="elsevierStyleCrossRef" href="#f0010">fig&#46; 2</a>&#41;&#46;</p><elsevierMultimedia ident="f0010"></elsevierMultimedia><p id="p0135" class="elsevierStylePara elsevierViewall">La media de los d&#237;as de incapacidad fue de 45&#44;85 &#177; 31&#44;192 &#40;mediana&#44; 43&#59; m&#225;ximo&#44; 140&#59; m&#237;nimo&#44; 0&#41;&#46; En la muestra de varones la media fue de 37&#44;92 &#177; 27&#44;29 d&#237;as &#40;mediana&#44; 35&#59; m&#225;ximo&#44; 120&#59; m&#237;nimo&#44; 0&#41; y de 50&#44;73 &#177; 32&#44;486 en mujeres &#40;mediana&#44; 45&#59; m&#225;ximo&#44; 140&#59; m&#237;nimo&#44; 0&#41; &#40;<a class="elsevierStyleCrossRef" href="#f0015">fig&#46; 3</a>&#41;&#46;</p><elsevierMultimedia ident="f0015"></elsevierMultimedia><p id="p0140" class="elsevierStylePara elsevierViewall">En ninguno de los casos analizados fue preciso ingreso hospitalario como consecuencia del SLC sufrido&#46;</p><p id="p0145" class="elsevierStylePara elsevierViewall">Los lesionados que no recibieron tratamiento con collar&#237;n ni rehabilitaci&#243;n tuvieron un tiempo de estabilizaci&#243;n con una media de 39&#44;93 &#177; 21&#44;535 d&#237;as &#40;mediana&#44; 30&#59; m&#225;ximo&#44; 135&#59; m&#237;nimo&#44; 5&#41; y precisaron tiempo de incapacidad durante una media de 22&#44;86 &#177; 22 d&#237;as &#40;mediana&#44; 16&#59; m&#225;ximo&#44; 100&#59; m&#237;nimo&#44; 0&#41;&#44; mientras que se consider&#243; estabilizados a aquellos que recibieron tratamiento conjunto de collar&#237;n y rehabilitaci&#243;n tras una media de 72&#44;84 &#177; 23&#44;28 d&#237;as &#40;mediana&#44; 65&#59; m&#225;ximo&#44; 134&#59; m&#237;nimo&#44; 29&#41;&#44; con un tiempo de incapacidad promedio de 58&#44;32 &#177; 30&#44;303 d&#237;as &#40;mediana&#44; 60&#59; m&#225;ximo&#44; 134&#59; m&#237;nimo&#44; 0&#41; &#40;<a class="elsevierStyleCrossRef" href="#f0020">fig&#46; 4</a>&#41;&#46;</p><elsevierMultimedia ident="f0020"></elsevierMultimedia><p id="p0150" class="elsevierStylePara elsevierViewall">Del total de 307 casos&#44; se consider&#243; que 92 no ten&#237;an secuelas &#40;29&#44;97&#37;&#41; y que 215 ten&#237;an secuelas en el momento de emisi&#243;n del informe de sanidad medicoforense &#40;70&#44;03&#37;&#41;&#46;</p><p id="p0155" class="elsevierStylePara elsevierViewall">En relaci&#243;n con la suma de puntos de secuelas cervicales&#44; los lesionados que no recibieron tratamiento con collar&#237;n ni rehabilitaci&#243;n recibieron una media de 0&#44;59 &#177; 0&#44;733 puntos &#40;mediana&#44; 0&#59; m&#225;ximo&#44; 3&#59; m&#237;nimo&#44; 0&#41;&#44; mientras que quienes recibieron tratamiento conjunto con ambos fue de 1&#44;61 &#177; 1&#44;388 puntos &#40;mediana&#44; 1&#59; m&#225;ximo&#44; 11&#59; m&#237;nimo&#44; 0&#41;&#46;</p><p id="p0160" class="elsevierStylePara elsevierViewall">En cuanto a la puntuaci&#243;n particular de secuelas&#44; el s&#237;ndrome postraum&#225;tico cervical &#40;SPC&#41; se ha presentado como secuela en un 41&#44;1&#37; de los casos&#44; con una puntuaci&#243;n media asignada de 1&#44;55 &#177; 0&#44;887 puntos &#40;mediana&#44; 1&#59; m&#225;ximo&#44; 5&#59; m&#237;nimo&#44; 1&#41;&#44; y una variabilidad intersexual de 1&#44;25 &#177; 0&#44;534 puntos en varones &#40;mediana&#44; 1&#59; m&#225;ximo&#44; 3&#59; m&#237;nimo&#44; 2&#41; y 1&#44;68 &#177; 0&#44;962 puntos en mujeres &#40;mediana&#44; 1&#59; m&#225;ximo&#44; 5&#59; m&#237;nimo&#44; 1&#41;&#46;</p><p id="p0165" class="elsevierStylePara elsevierViewall">La agravaci&#243;n de artrosis previa al traumatismo se ha presentado como secuela en un 8&#44;4&#37; de los casos&#44; con una media de 2&#44;13 &#177; 0&#44;9 puntos &#40;mediana&#44; 2&#59; m&#225;ximo&#44; 4&#59; m&#237;nimo&#44; 1&#41;&#59; 2 &#177; 0&#44;845 puntos en varones &#40;mediana&#44; 2&#59; m&#225;ximo&#44; 4&#59; m&#237;nimo&#44; 1&#41; y 2&#44;27 &#177; 0&#44;961 en mujeres &#40;mediana&#44; 2&#59; m&#225;ximo&#44; 4&#59; m&#237;nimo&#44; 1&#41;</p><p id="p0170" class="elsevierStylePara elsevierViewall">Las algias postraum&#225;ticas cervicales sin compromiso radicular se han presentado como secuela en un 18&#44;4&#37; de los casos&#44; con una puntuaci&#243;n media de 1&#44;89 &#177; 0&#44;844 &#40;mediana&#44; 2&#59; m&#225;ximo&#44; 4&#59; m&#237;nimo&#44; 1&#41;&#44; con 1&#44;63 &#177; 0&#44;875 puntos de media en varones &#40;mediana&#44; 1&#59; m&#225;ximo&#44; 4&#59; m&#237;nimo&#44; 1&#41; y 2&#44;05 &#177; 0&#44;795 en mujeres &#40;mediana&#44; 2&#59; m&#225;ximo&#44; 3&#59; m&#237;nimo&#44; 1&#41;&#46;</p><p id="p0175" class="elsevierStylePara elsevierViewall">Las algias postraum&#225;ticas cervicales con compromiso radicular se han presentado como secuela en una sola ocasi&#243;n de los 358 casos &#40;0&#44;3&#37;&#41;&#59; era una mujer y se valor&#243; en 5 puntos&#46;</p><p id="p0180" class="elsevierStylePara elsevierViewall">La secuela catalogada como cuadro cl&#237;nico derivado de hernias o protrusiones discales sin operar se valor&#243; en un 3&#44;1&#37; de los casos&#44; con una puntuaci&#243;n media asignada de 3&#44;73 &#177; 2&#44;195 &#40;mediana&#44; 3&#59; m&#225;ximo&#44; 8&#59; m&#237;nimo&#44; 2&#41;&#59; correspond&#237;a a los varones una media de 3&#44;6 &#177; 1&#44;817 puntos &#40;mediana&#44; 3&#59; m&#225;ximo&#44; 6&#59; m&#237;nimo&#44; 2&#41; y a las mujeres&#44; 3&#44;83 &#177; 2&#44;639 &#40;mediana&#44; 3&#44;5&#59; m&#225;ximo&#44; 8&#59; m&#237;nimo&#44; 1&#41;&#46;</p><p id="p0185" class="elsevierStylePara elsevierViewall">Las secuelas psiqui&#225;tricas se registraron s&#243;lo en un 0&#44;7&#37; de la muestra &#40;2 casos&#41;&#59; en todos los casos&#44; con 2 puntos y en mujeres&#44; y se consideraron otras secuelas distintas de las psiqui&#225;tricas y de las referidas a afecci&#243;n cervical en un 0&#44;7&#37; de la muestra &#40;2 casos&#41;&#44; con 2&#8211;9 puntos&#46; No se consideraron secuelas en un 30&#37; de la muestra &#40;92 casos&#41;&#46;</p><p id="p0190" class="elsevierStylePara elsevierViewall">En la <a class="elsevierStyleCrossRef" href="#t0005">tabla 1</a> se recogen los estad&#237;sticos descriptivos relativos a edad&#44; tiempo entre el accidente de tr&#225;fico y la fecha de primer reconocimiento medicoforense&#44; n&#250;mero de d&#237;as de estabilizaci&#243;n&#44; n&#250;mero de d&#237;as de incapacidad&#44; n&#250;mero de puntos por las secuelas&#58; algias sin compromiso radicular&#44; s&#237;ndrome postraum&#225;tico cervical&#44; hernia discal intervenida o no intervenida&#44; secuelas psiqui&#225;tricas&#44; algias con compromiso radicular&#44; ausencia de secuelas y n&#250;mero de puntos por suma total de secuelas relativas al cap&#237;tulo de columna cervical del baremo&#46; Estos datos se relacionan en la <a class="elsevierStyleCrossRef" href="#t0005">tabla 1</a> con la muestra total de casos y se diferencian en funci&#243;n del m&#233;dico forense que realiz&#243; la valoraci&#243;n de los casos &#40;<a class="elsevierStyleCrossRefs" href="#f0025">figs&#46; 5 y 6</a>&#41;&#46;</p><elsevierMultimedia ident="t0005"></elsevierMultimedia><elsevierMultimedia ident="f0025"></elsevierMultimedia><elsevierMultimedia ident="f0030"></elsevierMultimedia><p id="p0195" class="elsevierStylePara elsevierViewall">En la <a class="elsevierStyleCrossRef" href="#t0010">tabla 2</a> se recogen los resultados del an&#225;lisis de correlaci&#243;n bivariante entre variables cuantitativas de la muestra utilizando como &#237;ndice el coeficiente de correlaci&#243;n de Pearson &#40;CCP&#41;&#46; Entre sus resultados destacan la alta correlaci&#243;n entre los par&#225;metros&#58; d&#237;as de curaci&#243;n&#47;estabilizaci&#243;n y d&#237;as de incapacidad &#40;CCP &#61; 0&#44;764&#59; dos colas&#59; p &#60; 0&#44;001&#41;&#59; o entre la suma de secuelas totales y la suma de secuelas s&#243;lo de origen cervical &#40;CCP &#61; 0&#44;929&#59; dos colas&#59; p &#60; 0&#44;001&#41; y&#44; por contra&#44; la muy baja correlaci&#243;n entre&#58; tiempo transcurrido desde el accidente y la fecha de la primera visita al m&#233;dico forense valorador y la edad de los pacientes &#40;CCP &#61; 0&#44;01&#59; p &#61; 0&#44;742&#41;&#59; los tiempos de curaci&#243;n &#40;CCP &#61; 0&#44;118&#59; p &#61; 0&#44;39&#41; y de incapacidad &#40;CCP &#61; 0&#44;031&#59; p &#61; 0&#44;583&#41;&#44; y la suma de secuelas totales &#40;CCP &#61; 0&#44;042&#59; p &#61; 0&#44;467&#41; y la de las secuelas de origen cervical &#40;CCP &#61; 0&#44;044&#59; p &#61; 0&#44;443&#41;&#46;</p><elsevierMultimedia ident="t0010"></elsevierMultimedia></span><span id="s0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0020">Discusi&#243;n</span><p id="p0200" class="elsevierStylePara elsevierViewall">De forma an&#225;loga a otras series<a class="elsevierStyleCrossRefs" href="#bb0055"><span class="elsevierStyleSup">11&#44;16-20</span></a>&#44; en el presente estudio tambi&#233;n destaca un predominio del sexo femenino entre los lesionados&#44; a diferencia de algunas series previas espa&#241;olas<a class="elsevierStyleCrossRef" href="#bb0005"><span class="elsevierStyleSup">1</span></a>&#46;</p><p id="p0205" class="elsevierStylePara elsevierViewall">En una revisi&#243;n en poblaci&#243;n espa&#241;ola&#44; entre 1997 y 2002&#44; se observ&#243; que los tiempos medios de curaci&#243;n e incapacidad estimados en el entorno medicoforense se hab&#237;an reducido interanualmente&#44; siendo a&#250;n inferiores a estos en la presente serie<a class="elsevierStyleCrossRef" href="#bb0005"><span class="elsevierStyleSup">1</span></a>&#46; Se aprecia&#44; pues&#44; una tendencia a la disminuci&#243;n de los tiempos medios estimados de curaci&#243;n e incapacidad&#59; es probable que dichos tiempos medios hayan podido llegar a una estabilizaci&#243;n&#44; al ajustarse a los tiempos medios estimados en series cl&#237;nicas&#46;</p><p id="p0210" class="elsevierStylePara elsevierViewall">De forma an&#225;loga a estudios previos<a class="elsevierStyleCrossRefs" href="#bb0075"><span class="elsevierStyleSup">15&#44;17-19</span></a>&#44; se encuentra que tanto el tiempo de curaci&#243;n&#47;estabilizaci&#243;n como el de incapacidad son algo mayores en las mujeres que en los varones&#44; con m&#237;nima diferencia en el primero y ligeramente elevado el segundo&#44; sin que resulte estad&#237;sticamente significativo&#46;</p><p id="p0215" class="elsevierStylePara elsevierViewall">Todas las secuelas analizadas en la muestra estudiada se han puntuado ligeramente por encima en el caso de las mujeres&#44; resultado an&#225;logo a series precedentes<a class="elsevierStyleCrossRef" href="#bb0085"><span class="elsevierStyleSup">17</span></a>&#46;</p><p id="p0220" class="elsevierStylePara elsevierViewall">En cuanto a la frecuencia de presentaci&#243;n de las secuelas&#44; debe se&#241;alarse el elevado porcentaje en que se presentan &#40;70&#37;&#41;&#44; siendo concordante con estudios previos<a class="elsevierStyleCrossRefs" href="#bb0090"><span class="elsevierStyleSup">18&#44;19</span></a>&#44; aunque inferior al encontrado por Garamendi y Landa &#40;95&#44;5&#37;&#41;<a class="elsevierStyleCrossRef" href="#bb0005"><span class="elsevierStyleSup">1</span></a>&#46; Sin embargo&#44; las campa&#241;as de sensibilizaci&#243;n fomentadas por la UNESPA entre 2001 y 2003 para unificar criterios nacionales de valoraci&#243;n medicolegal del SLC pueden haber sido un factor que explique no pocas de las diferencias entre las series cronol&#243;gicas previas y posteriores a los a&#241;os estudiados&#46;</p><p id="p0225" class="elsevierStylePara elsevierViewall">Se han contabilizado 11 casos &#40;3&#44;1&#37;&#41; de hernias o protrusiones discales consideradas como postraum&#225;ticas por el m&#233;dico valorador&#44; porcentaje muy similar al encontrado por Garamendi y Landa en su estudio &#40;3&#44;4&#37;&#41;<a class="elsevierStyleCrossRef" href="#bb0005"><span class="elsevierStyleSup">1</span></a>&#44; e inferior al encontrado por Dorado Fern&#225;ndez y Vega Vega<a class="elsevierStyleCrossRef" href="#bb0045"><span class="elsevierStyleSup">9</span></a>&#46;</p><p id="p0230" class="elsevierStylePara elsevierViewall">En relaci&#243;n con la modalidad de tratamiento aplicada en series previas<a class="elsevierStyleCrossRef" href="#bb0005"><span class="elsevierStyleSup">1</span></a>&#44; se ha observado que exist&#237;an diferencias interanuales&#46; As&#237;&#44; en el a&#241;o 1996 cerca del 80&#37; de los pacientes eran tratados con collar&#237;n cervical&#44; frente a poco m&#225;s del 50&#37; seis a&#241;os despu&#233;s&#46; De la misma manera&#44; mientras que en el a&#241;o 1996 poco m&#225;s del 50&#37; de los pacientes recib&#237;a tratamiento de rehabilitaci&#243;n&#44; tras 6 a&#241;os esta cifra se acercaba al 100&#37;&#46; En la serie analizada&#44; sin embargo&#44; se observa una distribuci&#243;n m&#225;s equilibrada&#44; con un 63&#44;1&#37; de los lesionados que recibieron tratamiento con collar&#237;n&#59; un 56&#44;7&#37;&#44; rehabilitaci&#243;n&#59; un 38&#37;&#44; tratamiento conjunto con collar&#237;n y rehabilitaci&#243;n&#44; y s&#243;lo un 18&#44;2&#37;&#44; con otras modalidades de tratamiento o ninguno&#46; Estos resultados son m&#225;s acordes con la realidad cl&#237;nica del SLC&#44; puesto que las recomendaciones m&#225;s recientes limitan el uso de la inmovilizaci&#243;n con collar&#237;n y proponen la aplicaci&#243;n del tratamiento con rehabilitaci&#243;n en casos espec&#237;ficos<a class="elsevierStyleCrossRefs" href="#bb0065"><span class="elsevierStyleSup">13&#44;20</span></a>&#46;</p><p id="p0235" class="elsevierStylePara elsevierViewall">A prop&#243;sito de la posible influencia de las modalidades terap&#233;uticas en la valoraci&#243;n pericial de tiempos de curaci&#243;n&#44; incapacidad y suma total de secuelas derivadas del SLC&#44; es evidente que el hecho de recibir un tratamiento combinado de rehabilitaci&#243;n y collar&#237;n cervical produce un aumento significativo de estos par&#225;metros periciales&#46; Y al contrario&#44; no recibir tratamiento de collar&#237;n y&#47;o rehabilitaci&#243;n disminuye de forma significativa la valoraci&#243;n de los par&#225;metros periciales de tiempo y suma de secuelas&#46; Podr&#237;a pensarse que estas diferencias son un simple reflejo de la gravedad cl&#237;nica original de cada paciente&#44; de manera que los pacientes m&#225;s leves no recibir&#237;an tratamiento y los m&#225;s graves necesitar&#237;an tratamientos combinados&#46; Sin embargo&#44; el hecho de que los tiempos medios de demora en la primera consulta medicoforense desde la fecha del accidente dupliquen o incluso tripliquen los tiempos medios de estabilizaci&#243;n se&#241;ala que estas diferencias observadas no s&#243;lo responder&#237;an a razones cl&#237;nicas&#44; sino&#44; sobre todo&#44; a la forma de interpretaci&#243;n pericial&#46;</p><p id="p0240" class="elsevierStylePara elsevierViewall">En cuanto al an&#225;lisis comparativo entre m&#233;dicos forenses valoradores&#44; cabe destacar que en relaci&#243;n con los tiempos medios de curaci&#243;n&#47;estabilizaci&#243;n no existen diferencias significativas entre ellos&#44; salvo por la invariabilidad del m&#233;dico 4&#46; Pese a las diferentes medias aritm&#233;ticas entre m&#233;dicos forenses&#44; la distribuci&#243;n intercuart&#237;lica de los tiempos medios de incapacidad se&#241;ala que estas diferencias no son tan significativas y que podr&#237;an estar influidas por valores extremos &#40;como puede ser la existencia o no de una hernia cervical como evento cl&#237;nico intercurrente&#41;&#46; Con respecto a la puntuaci&#243;n total correspondiente a secuelas cervicales&#44; la mayor&#237;a de los m&#233;dicos ajustan sus resultados a la media de la muestra sin grandes diferencias&#44; salvo el m&#233;dico forense 2&#44; que punt&#250;a habitualmente con un punto&#44; y el 6&#44; cuyos valores de secuelas superan la media &#40;2&#8211;3 puntos frente a 1&#8211;2 puntos del resto&#41;&#46;</p><p id="p0245" class="elsevierStylePara elsevierViewall">Los m&#233;dicos forenses 1&#44; 2 y 5 no contemplan como secuela las algias postraum&#225;ticas cervicales sin compromiso radicular&#44; mientras que el m&#233;dico 6 no aplica la agravaci&#243;n de artrosis previa&#46; La secuela de SPC se utiliza con frecuencia variable&#59; el cuadro cl&#237;nico derivado de hernias o protrusiones discales sin operar y las secuelas ps&#237;quicas presentan una distribuci&#243;n m&#225;s irregular en la muestra entre m&#233;dicos debido a su infrecuencia&#44; por lo que no son adecuadamente valorables&#46;</p><p id="p0250" class="elsevierStylePara elsevierViewall">La mayor&#237;a de los m&#233;dicos forenses analizados valoran la secuela de algias cervicales sin compromiso radicular en un punto pero con cierta variaci&#243;n del rango&#44; mientras que el m&#233;dico 4 las valora casi invariablemente con un punto&#46; El m&#233;dico 6 punt&#250;a esta secuela m&#225;s habitualmente con un m&#237;nimo de 2 puntos y cierto grado de variabilidad&#46; El SPC es mayoritariamente valorado con 1 punto y cierta variaci&#243;n del rango en el caso de los m&#233;dicos forenses 3&#44; 7 y 8&#44; frente a los m&#233;dicos 1&#44; 2 y 4&#44; que tienden a considerar igualmente 1 punto&#44; independientemente de otros criterios&#44; y el m&#233;dico 6&#44; que la punt&#250;a habitualmente en 3&#46; El m&#233;dico forense 9 punt&#250;a siempre por encima de 3 puntos&#46;</p><p id="p0255" class="elsevierStylePara elsevierViewall">En relaci&#243;n con la frecuencia con que cada m&#233;dico concede o no secuelas&#44; el valor promedio para toda la muestra es del 70&#37; de casos con secuelas&#58; los m&#233;dicos 1&#44; 5 y 8 lo hacen claramente por debajo de la media &#40;en torno al 50&#37; de sus casos&#41; y los m&#233;dicos 2 y 6&#44; claramente por encima &#40;superior al 90&#37;&#41;&#46;</p><p id="p0260" class="elsevierStylePara elsevierViewall">En relaci&#243;n con el an&#225;lisis de la correlaci&#243;n bivariante entre los distintos par&#225;metros cuantitativos de la muestra con diagn&#243;stico s&#243;lo de SLC&#44; los coeficientes de correlaci&#243;n de Pearson y las gr&#225;ficas de dispersi&#243;n indican correlaci&#243;n claramente positiva &#250;nicamente entre los d&#237;as de estabilizaci&#243;n y de incapacidad &#40;correlaci&#243;n de Pearson de 0&#44;764&#41;&#44; pues resulta l&#243;gico que conforme aumenten los d&#237;as de estabilizaci&#243;n tambi&#233;n lo hagan los de incapacidad&#46;</p><p id="p0265" class="elsevierStylePara elsevierViewall">El periodo de latencia entre el accidente y la primera visita al m&#233;dico forense es un par&#225;metro no estudiado en ninguna de las series previas&#44; salvo en la serie de Pujol et al<a class="elsevierStyleCrossRef" href="#bb0075"><span class="elsevierStyleSup">15</span></a>&#46; En nuestra serie destacan valores extraordinariamente elevados &#40;media de 168&#44;5 d&#237;as&#41;&#44; algo superiores pero cercanos a los descritos por Pujol et al &#40;media de 124&#44;9 d&#237;as&#41;&#46; La explicaci&#243;n de tal fen&#243;meno no debe &#250;nicamente asociarse al retraso en la tramitaci&#243;n de los expedientes por parte de los juzgados&#44; puesto que en numerosas ocasiones son los letrados quienes agotan el plazo m&#225;ximo establecido de 6 meses para la presentaci&#243;n de la denuncia&#44; suponiendo que de este modo la valoraci&#243;n medicoforense favorece m&#225;s a su cliente&#46; Sin embargo&#44; puesto que en el an&#225;lisis de correlaci&#243;n bivariante se destaca la ausencia de correlaci&#243;n entre el tiempo transcurrido entre el accidente y el primer reconocimiento medicoforense&#44; y el tiempo de incapacidad y la puntuaci&#243;n total por suma de secuelas cervicales&#44; as&#237; como la muy baja correlaci&#243;n con el tiempo de curaci&#243;n&#44; ello parece demostrar que retrasar la fecha del primer reconocimiento medicoforense no supone un aumento significativo en los d&#237;as de estabilidad&#44; curaci&#243;n y suma de secuelas cervicales y&#44; por lo tanto&#44; la supuesta ventaja de retrasar la fecha del primer reconocimiento medicoforense se revela una falacia en esta serie estad&#237;stica&#46;</p></span><span id="s0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0025">Conclusiones</span><p id="p0270" class="elsevierStylePara elsevierViewall">El presente trabajo analiza&#44; de forma an&#225;loga a estudios previos&#44; las caracter&#237;sticas de la valoraci&#243;n medicolegal que los m&#233;dicos forenses del IML de Huelva realizan en casos de SLC&#46;</p><p id="p0275" class="elsevierStylePara elsevierViewall">Como hallazgo m&#225;s destacado&#44; se ha podido evidenciar que existe una ausencia de correlaci&#243;n o una muy baja correlaci&#243;n entre el tiempo transcurrido entre el accidente y el primer reconocimiento medicoforense con los tiempos de curaci&#243;n&#44; incapacidad y la puntuaci&#243;n total por suma de secuelas cervicales&#44; lo que se&#241;ala que en el contexto del IML de Huelva retrasar la fecha del primer reconocimiento medicoforense no supone un aumento de tales par&#225;metros ni&#44; por lo tanto&#44; de la indemnizaci&#243;n econ&#243;mica asociada con el siniestro&#46;</p></span><span id="s0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0030">Conflicto de intereses</span><p id="p0280" class="elsevierStylePara elsevierViewall">Los autores declaran no tener ning&#250;n conflicto de intereses&#46;</p></span></span>"
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          "identificador" => "xres119579"
          "titulo" => array:4 [
            0 => "Resumen"
            1 => "Introducci&#243;n"
            2 => "Material y m&#233;todos"
            3 => "Resultados y conclusiones"
          ]
        ]
        1 => array:2 [
          "identificador" => "xpalclavsec106860"
          "titulo" => "Palabras clave"
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        2 => array:2 [
          "identificador" => "xres119580"
          "titulo" => array:4 [
            0 => "Abstract"
            1 => "Introduction"
            2 => "Material and methods"
            3 => "Results and conclusions"
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        3 => array:2 [
          "identificador" => "xpalclavsec106859"
          "titulo" => "Keywords"
        ]
        4 => array:2 [
          "identificador" => "s0005"
          "titulo" => "Introducci&#243;n"
        ]
        5 => array:2 [
          "identificador" => "s0010"
          "titulo" => "Material y m&#233;todos"
        ]
        6 => array:2 [
          "identificador" => "s0015"
          "titulo" => "Resultados"
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        7 => array:2 [
          "identificador" => "s0020"
          "titulo" => "Discusi&#243;n"
        ]
        8 => array:2 [
          "identificador" => "s0025"
          "titulo" => "Conclusiones"
        ]
        9 => array:2 [
          "identificador" => "s0030"
          "titulo" => "Conflicto de intereses"
        ]
        10 => array:2 [
          "identificador" => "xack37567"
          "titulo" => "Agradecimientos"
        ]
        11 => array:1 [
          "titulo" => "Bibliograf&#237;a"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2010-05-25"
    "fechaAceptado" => "2011-01-26"
    "PalabrasClave" => array:2 [
      "es" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palabras clave"
          "identificador" => "xpalclavsec106860"
          "palabras" => array:4 [
            0 => "S&#237;ndrome de latigazo cervical"
            1 => "Valoraci&#243;n del da&#241;o corporal"
            2 => "Pericia medicolegal"
            3 => "Accidentes de tr&#225;fico"
          ]
        ]
      ]
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec106859"
          "palabras" => array:4 [
            0 => "Whiplash injury"
            1 => "Physical injury assessment"
            2 => "Medicolegal expert report"
            3 => "Road traffic accidents"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "es" => array:2 [
        "titulo" => "Resumen"
        "resumen" => "<span class="elsevierStyleSectionTitle">Introducci&#243;n</span><p id="sp0045" class="elsevierStyleSimplePara elsevierViewall">El presente trabajo pretende abordar los aspectos epidemiol&#243;gicos del SLC en el IML de Huelva y los problemas que plantea en la pericia medicolegal&#46;</p> <span class="elsevierStyleSectionTitle">Material y m&#233;todos</span><p id="sp0050" class="elsevierStyleSimplePara elsevierViewall">Se analiza una poblaci&#243;n de 307 lesionados del Servicio de Cl&#237;nica M&#233;dico-Forense de Huelva a los que tras un accidente de tr&#225;fico se les hab&#237;a diagnosticado un esguince cervical&#46; Se estudian las variables&#58; sexo&#44; edad&#44; tiempo trascurrido entre el accidente y la fecha del primer reconocimiento medicoforense&#44; tratamiento realizado&#44; d&#237;as de curaci&#243;n&#47;estabilizaci&#243;n&#44; d&#237;as de incapacidad&#44; d&#237;as de hospitalizaci&#243;n&#44; m&#233;dico valorador&#44; secuelas y su puntuaci&#243;n&#46;</p> <span class="elsevierStyleSectionTitle">Resultados y conclusiones</span><p id="sp0055" class="elsevierStyleSimplePara elsevierViewall">Predominio del sexo femenino &#40;61&#44;9&#37;&#41;&#46; Media de edad&#44; 35&#44;25 a&#241;os&#46; Tiempo medio de curaci&#243;n&#47;estabilizaci&#243;n&#44; 60&#44;75 d&#237;as y tiempo medio de incapacidad&#44; 45&#44;85 d&#237;as&#46; El 71&#37; presenta secuelas&#59; las m&#225;s frecuentes&#44; el s&#237;ndrome postraum&#225;tico cervical &#40;41&#44;1&#37;&#41; y las algias cervicales postraum&#225;ticas sin compromiso radicular &#40;18&#44;4&#37;&#41;&#46; Un 63&#44;1&#37; de los lesionados recibe tratamiento con collar&#237;n&#59; el 56&#44;7&#37;&#44; rehabilitaci&#243;n&#59; el 38&#37; recibe tratamiento conjunto y un 18&#44;2&#37;&#44; otras modalidades de tratamiento o ninguno&#46; El tratamiento combinado de rehabilitaci&#243;n y collar&#237;n se relaciona con un aumento significativo de los par&#225;metros periciales&#46; Periodo de latencia entre el accidente de tr&#225;fico y la primera valoraci&#243;n medicoforense&#44; 168&#44;5 d&#237;as&#46; La duraci&#243;n de este periodo no tiene relaci&#243;n aparente con un aumento de los par&#225;metros de valoraci&#243;n ni de la indemnizaci&#243;n econ&#243;mica asociada con el siniestro&#46;</p>"
      ]
      "en" => array:2 [
        "titulo" => "Abstract"
        "resumen" => "<span class="elsevierStyleSectionTitle">Introduction</span><p id="sp0060" class="elsevierStyleSimplePara elsevierViewall">We present a statistical review of the epidemiological profile of whiplash syndrome in Legal Medicine Institute &#40;LMI&#41; of Huelva&#46;</p> <span class="elsevierStyleSectionTitle">Material and methods</span><p id="sp0065" class="elsevierStyleSimplePara elsevierViewall">We studied 307 injured persons who attended the clinical forensic medicine service of Huelva after road traffic accidents&#46; We analysed several parameters&#58; sex&#44; age&#44; time between accidents and first medical exam in the LMI&#44; treatment given&#44; days to recovery&#44; incapacity and hospitalisation&#44; physician responsible and type and number of sequels&#46;</p> <span class="elsevierStyleSectionTitle">Results and conclusions</span><p id="sp0070" class="elsevierStyleSimplePara elsevierViewall">Female predominance &#40;61&#46;9&#37;&#41;&#46; Mean age&#44; 35&#46;25 years&#46; Number of days for recovery&#44; 60&#46;75 days and mean time of incapacity&#44; 45&#46;85 days&#46; Of the 71&#37; who had sequels&#44; the most common were cervical post-traumatic cervical syndrome &#40;41&#46;1&#37;&#41; and cervical pain &#40;18&#46;4&#37;&#41;&#46; The majority &#40;63&#46;1&#37;&#41; were treated with cervical collar&#44; 56&#46;7&#37; rehabilitation&#44; 38&#37; both treatments and 18&#46;2&#37; other treatments or no treatment&#46; Combined treatment led to an increase in medico-legal parameters&#46; Mean time between accident and first medico-legal examination was 168&#46;5 days&#46; The length of this latency period did not appear to be related with medico-legal assessment parameters or with the amount of the financial compensation claimed for the road traffic accident&#46;</p>"
      ]
    ]
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          "es" => "<p id="sp0005" class="elsevierStyleSimplePara elsevierViewall">Distribuci&#243;n del tiempo &#40;d&#237;as&#41; desde el accidente hasta la fecha del primer reconocimiento medicoforense&#46;</p>"
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          "es" => "<p id="sp0010" class="elsevierStyleSimplePara elsevierViewall">Distribuci&#243;n de los d&#237;as de estabilizaci&#243;n lesional en la muestra total&#46;</p>"
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        ]
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      4 => array:7 [
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        "etiqueta" => "Figura 5"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
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        "figura" => array:1 [
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          "es" => "<p id="sp0025" class="elsevierStyleSimplePara elsevierViewall">Diagrama de &#171;cajas y bigotes&#187; de distribuci&#243;n de resultados considerando la suma de puntos por secuelas relativas al cap&#237;tulo de columna cervical en funci&#243;n del m&#233;dico forense responsable de la valoraci&#243;n medicolegal&#46;</p>"
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          "es" => "<p id="sp0030" class="elsevierStyleSimplePara elsevierViewall">Diagrama de &#171;cajas y bigotes&#187; de distribuci&#243;n de resultados considerando el n&#250;mero de d&#237;as de estabilizaci&#243;n lesional en funci&#243;n del m&#233;dico forense responsable de la valoraci&#243;n medicolegal&#46;</p>"
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        "etiqueta" => "Tabla 1"
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                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><td 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">M&#233;dico forense&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Edad&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td 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">Tiempo entre accidente y primer reconoci miento&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td 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">D&#237;as de estabili zaci&#243;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">D&#237;as de incapa cidad&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td 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">Secuela&#58; algias sin irradiaci&#243;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Secuela&#58; s&#237;ndrome postrau-m&#225;tico cervical&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td 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">Secuela&#58; hernia discal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td 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">Secuela&#58; agravaci&#243;n de artrosis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td 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">Secuelas psiqui&#225;tricas&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td 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">Secuela&#58; algias con irradiaci&#243;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Sin secuelas&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td 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">Suma de puntos por secuelas cervicales &#250;nicamente&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="7" align="left" valign="\n
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                  \t\t\t\t">1</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Media&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">31&#44;79&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">137&#44;32&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">54&#44;97&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">43&#44;15&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">1&#44;17&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#44;71&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">N&#46;&#176; de casos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">34&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">34&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">34&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">34&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">18&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">N&#46;&#176; de casos&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Mediana&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">M&#237;nimo&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">M&#237;nimo&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">N&#46;&#176; de casos&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Rango&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " rowspan="7" align="left" valign="\n
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                  \t\t\t\t">Media&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">N&#46;<span class="elsevierStyleSup">o</span> de casos&nbsp;\t\t\t\t\t\t\n
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                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab207781.png"
              ]
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        ]
        "descripcion" => array:1 [
          "es" => "<p id="sp0035" class="elsevierStyleSimplePara elsevierViewall">Datos estad&#237;sticos descriptivos en la muestra total y diferenciados seg&#250;n el m&#233;dico forense que realiz&#243; la valoraci&#243;n</p>"
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      7 => array:7 [
        "identificador" => "t0010"
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        "mostrarFloat" => true
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                  \t\t\t\t">0&#44;439 <a class="elsevierStyleCrossRef" href="#tf0010"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;409 <a class="elsevierStyleCrossRef" href="#tf0010"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;285 <a class="elsevierStyleCrossRef" href="#tf0010"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Sig&#46; &#40;2-colas&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;039&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">307&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">307&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">307&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">307&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">D&#237;as incapacidad</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Coeficiente de correlaci&#243;n de Pearson&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\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&#44;031&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#44;764 <a class="elsevierStyleCrossRef" href="#tf0010"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#44;36 <a class="elsevierStyleCrossRef" href="#tf0010"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#44;346<a class="elsevierStyleCrossRef" href="#tf0010"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#44;246 <a class="elsevierStyleCrossRef" href="#tf0010"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Sig&#46; &#40;2-colas&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#44;583&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t  " rowspan="3" align="left" valign="\n
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                  \t\t\t\t">Suma secuelas</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Coeficiente de correlaci&#243;n de Pearson&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">0&#44;042&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#44;439 <a class="elsevierStyleCrossRef" href="#tf0010"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#44;36 <a class="elsevierStyleCrossRef" href="#tf0010"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#44;929 <a class="elsevierStyleCrossRef" href="#tf0010"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#44;258 <a class="elsevierStyleCrossRef" href="#tf0010"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Sig&#46; &#40;2-colas&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#44;467&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">307&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">307&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">307&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">307&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Suma secuelas cervical solo</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Coeficiente de correlaci&#243;n de Pearson&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\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&#44;044&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\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&#44;409 <a class="elsevierStyleCrossRef" href="#tf0010"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;346<a class="elsevierStyleCrossRef" href="#tf0010"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;929 <a class="elsevierStyleCrossRef" href="#tf0010"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;244 <a class="elsevierStyleCrossRef" href="#tf0010"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Sig&#46; &#40;2-colas&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;443&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\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&nbsp;\t\t\t\t\t\t\n
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