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          "es" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Distribuci&#243;n de los pacientes seg&#250;n el nivel de riesgo y el fenotipo cl&#237;nico seg&#250;n la GesEPOC&#46;</p> <p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">El fenotipo ACO era definido por tener un diagn&#243;stico de asma bronquial o tener una cl&#237;nica sugestiva de asma y adem&#225;s una prueba broncodilatadora positiva mayor o igual que el 15&#37;&#46;</p> <p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">ACO&#58; fenotipo mixto asma-EPOC o ACO&#46;</p>"
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introducci&#243;n</span><p id="par0005" class="elsevierStylePara elsevierViewall">La EPOC es una enfermedad cr&#243;nica y compleja que requiere una aproximaci&#243;n integral y una valoraci&#243;n multidimensional que incluya la evaluaci&#243;n del riesgo&#46; En los &#250;ltimos a&#241;os&#44; como alternativa al FEV<span class="elsevierStyleInf">1</span>&#44; se han propuesto diferentes escalas multidimensionales&#44; como el BODE o BODEx<a class="elsevierStyleCrossRefs" href="#bib0175"><span class="elsevierStyleSup">1-3</span></a>&#44; que han demostrado ser superiores como factor pron&#243;stico de futuras complicaciones&#44; pero cuya utilizaci&#243;n en la pr&#225;ctica cl&#237;nica se ha constatado muy escasa<a class="elsevierStyleCrossRefs" href="#bib0190"><span class="elsevierStyleSup">4&#44;5</span></a>&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">Recientemente&#44; con base en las evidencias cient&#237;ficas y en el consenso de expertos&#44; en las actualizaciones de las gu&#237;as de pr&#225;ctica cl&#237;nica para el manejo de la EPOC se han establecido diferentes propuestas en la valoraci&#243;n de la enfermedad con el fin de ofrecer una medicina personalizada<a class="elsevierStyleCrossRefs" href="#bib0200"><span class="elsevierStyleSup">6-8</span></a>&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">La nueva edici&#243;n de la Gu&#237;a Espa&#241;ola de la EPOC &#40;GesEPOC&#41;&#44; atendiendo a la necesidad de avanzar en la categorizaci&#243;n de los pacientes como herramienta que permita simplificar la estratificaci&#243;n de riesgo y&#44; a la vez&#44; adecuar los niveles de intervenci&#243;n tanto diagn&#243;stica como terap&#233;utica&#44; propone una nueva clasificaci&#243;n en 2<span class="elsevierStyleHsp" style=""></span>niveles de riesgo&#44; bajo y alto&#44; de tal forma que en los pacientes de bajo riesgo la gesti&#243;n de la atenci&#243;n m&#233;dica se simplifica&#44; mientras que en el los de riesgo alto se recomienda una mayor precisi&#243;n diagn&#243;stica y un plan terap&#233;utico m&#225;s personalizado&#46; Sin embargo&#44; aunque esta nueva forma de categorizar a los pacientes cuenta con el respaldo de la literatura m&#233;dica&#44; hasta el momento no se ha publicado ning&#250;n an&#225;lisis sobre las implicaciones de su aplicaci&#243;n en la pr&#225;ctica cl&#237;nica diaria&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">El estudio EPOCONSUL es la primera auditor&#237;a nacional que analiza la atenci&#243;n sanitaria de la EPOC en consultas de neumolog&#237;a en Espa&#241;a<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">6</span></a>&#46; En an&#225;lisis previos&#44; EPOCONSUL confirm&#243; un alto nivel de implementaci&#243;n de la GesEPOC en su versi&#243;n de 2012<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">9</span></a>&#44; de manera que el 46&#44;3&#37; de las historias cl&#237;nicas auditadas inclu&#237;an la clasificaci&#243;n del fenotipo seg&#250;n GesEPOC&#44; aunque con una considerable variaci&#243;n entre los centros hospitalarios en la adhesi&#243;n a las recomendaciones de buena pr&#225;ctica cl&#237;nica<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">6</span></a>&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">El presente trabajo utiliza la base de datos de EPOCONSUL con el objetivo de realizar un an&#225;lisis retrospectivo de la distribuci&#243;n de los niveles de riesgo y fenotipos cl&#237;nicos de la EPOC seg&#250;n la GesEPOC 2017 y de evaluar si la atenci&#243;n m&#233;dica se adecuaba a las actuales recomendaciones de la GesEPOC 2017&#44; a tenor del nivel de riesgo&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Metodolog&#237;a</span><p id="par0030" class="elsevierStylePara elsevierViewall">La metodolog&#237;a del estudio EPOCONSUL ya ha sido extensamente descrita<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">6</span></a>&#46; De forma breve&#44; EPOCONSUL es una auditor&#237;a cl&#237;nica promovida por la Sociedad Espa&#241;ola de Neumolog&#237;a y Cirug&#237;a Tor&#225;cica &#40;SEPAR&#41; que fue dise&#241;ada para evaluar la pr&#225;ctica cl&#237;nica&#44; as&#237; como los factores cl&#237;nicos y de organizaci&#243;n relacionados con el tipo de atenci&#243;n dispensada a los pacientes con EPOC en las consultas de neumolog&#237;a en Espa&#241;a&#46; Es un estudio observacional trasversal&#44; con reclutamiento prospectivo &#40;de mayo de 2014 a mayo de 2015&#41;&#46; Participaron un total de 59 centros &#40;33&#44;7&#37; de los potencialmente elegibles&#41; de 16 de las 17 comunidades aut&#243;nomas espa&#241;olas &#40;excepto La Rioja&#41;&#46; La mayor&#237;a eran hospitales universitarios &#40;83&#44;1&#37;&#41; y con 20 o m&#225;s camas de asistencia neumol&#243;gica &#40;83&#44;7&#37;&#41;&#46; La informaci&#243;n recogida fue de naturaleza hist&#243;rica para los datos cl&#237;nicos &#40;historia cl&#237;nica y documentos relacionados&#41; y concurrente para los datos de recursos hospitalarios&#46; Se recogieron 46 variables relacionadas con los centros hospitalarios y 153 del paciente&#44; que se agruparon en 3 grupos&#58; 1&#41; de recursos disponibles y organizaci&#243;n del trabajo&#59; 2&#41; de caracter&#237;sticas del paciente y 3&#41; de modelos de pr&#225;ctica cl&#237;nica&#58; actuaciones realizadas durante el seguimiento y en la &#250;ltima visita auditada&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Para establecer los grupos de riesgo en el an&#225;lisis retrospectivo&#44; el nivel de riesgo fue definido acorde con los nuevos criterios de la GesEPOC<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">8</span></a>&#44; con base en datos funcionales &#40;porcentaje de FEV<span class="elsevierStyleInf">1</span> tras broncodilataci&#243;n&#41; y cl&#237;nicos &#40;grado de disnea e historial de agudizaciones&#41;&#44; que se describen en la <a class="elsevierStyleCrossRef" href="#fig0005">figura 1</a>&#46; El fenotipo cl&#237;nico de la EPOC tambi&#233;n se categoriz&#243; seg&#250;n la GesEPOC&#44; utilizando el siguiente algoritmo&#58; 1&#41; los pacientes con 0 o 1 agudizaci&#243;n y ninguna hospitalizaci&#243;n por agudizaci&#243;n en el a&#241;o previo se clasificaron como no agudizadores&#59; 2&#41; los pacientes que tuvieron al menos 2 agudizaciones o una hospitalizaci&#243;n en el a&#241;o previo&#44; con tos y expectoraci&#243;n cr&#243;nica&#44; se identificaron como agudizadores con bronquitis cr&#243;nica&#59; 3&#41; los pacientes que tuvieron al menos 2 agudizaciones o una hospitalizaci&#243;n en el a&#241;o previo sin tos ni expectoraci&#243;n cr&#243;nica&#44; con datos cl&#237;nicos&#47;radiol&#243;gicos o funcionales de enfisema se clasificaron como agudizadores con enfisema y 4&#41; los pacientes con un diagn&#243;stico concomitante de asma bronquial o pacientes con EPOC que tuvieran cl&#237;nica sugestiva de asma y una prueba broncodilatadora positiva mayor o igual que el 15&#37; se identificaron como fenotipo mixto asma-EPOC &#40;ACO&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0040" class="elsevierStylePara elsevierViewall">El protocolo &#40;<span class="elsevierStyleSmallCaps">C</span>&#46;I&#46; 14&#47;030-E&#41; fue aprobado por el Comit&#233; &#201;tico de Investigaci&#243;n Cl&#237;nica del Hospital Cl&#237;nico San Carlos &#40;Madrid&#44; Espa&#241;a&#41;&#44; que certific&#243; que cumpl&#237;a los preceptos &#233;ticos formulados en la Declaraci&#243;n de Helsinki sobre principios &#233;ticos para las investigaciones m&#233;dicas y salvaguarda de la confidencialidad de los pacientes participantes&#46; En cada uno de los centros participantes&#44; el Comit&#233; &#201;tico local aprob&#243; el protocolo y dio su conformidad para realizarlo&#46; La necesidad del consentimiento informado fue eximida debido a la naturaleza no intervencionista del estudio&#44; a la anonimizaci&#243;n de los datos y a la necesidad de mantener el cegamiento para evaluar el funcionamiento cl&#237;nico&#46; Esta circunstancia fue explicada en el protocolo y los comit&#233;s &#233;ticos aprobaron este procedimiento&#46; Para evitar cambios en la pr&#225;ctica cl&#237;nica habitual y mantener el cegamiento en la evaluaci&#243;n del funcionamiento cl&#237;nico&#44; tampoco se inform&#243; al personal m&#233;dico de la realizaci&#243;n de la auditor&#237;a&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">An&#225;lisis estad&#237;stico</span><p id="par0045" class="elsevierStylePara elsevierViewall">El an&#225;lisis estad&#237;stico se realiz&#243; mediante el paquete estad&#237;stico IBM SPSS Statistics &#40;IBM Corporation&#44; Armonk&#44; Nueva York&#44; EE&#46;&#160;UU&#46;&#41; versi&#243;n 23&#46;0&#46; Las variables cuantitativas se expresaron con la media y desviaci&#243;n est&#225;ndar &#40;DE&#41;&#44; o mediana y rango intercuart&#237;lico para las variables continuas que presentan asimetr&#237;a&#46; Las variables cualitativas se describieron con la frecuencia absoluta y relativa &#40;porcentaje&#41;&#46; Para la comparaci&#243;n de variables cualitativas entre los grupos de alto y bajo riesgo se utiliz&#243; el test de chi cuadrado&#46; La comparaci&#243;n de las variables cuantitativas entre los 2<span class="elsevierStyleHsp" style=""></span>grupos de riesgo se realiz&#243; mediante el test t de Student para las variables sim&#233;tricas&#44; o mediante el test no param&#233;trico U de Mann-Whitney para las variables asim&#233;tricas&#46; Se ajust&#243; un modelo de regresi&#243;n log&#237;stica con el objetivo de identificar los factores cl&#237;nicos y epidemiol&#243;gicos que se asociaban de manera independiente con el nivel de riesgo&#46; Se introdujeron en el modelo todas aquellas variables estad&#237;sticamente significativas en el modelo univariable&#46; En todos los contrastes de hip&#243;tesis se rechaz&#243; la hip&#243;tesis nula con un error de tipo I o error &#945; menor que 0&#44;05&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Resultados</span><p id="par0050" class="elsevierStylePara elsevierViewall">Participaron 59 de los 175 hospitales p&#250;blicos del Sistema Nacional de Salud con consulta de neumolog&#237;a&#44; seg&#250;n el registro del Ministerio de Sanidad del 2012&#46; La poblaci&#243;n de referencia estimada para el estudio de EPOCONSUL fue 18&#46;104&#46;350 individuos&#44; que representaban el 39&#37; de la poblaci&#243;n espa&#241;ola&#46; Los centros e investigadores participantes se describen en el <a class="elsevierStyleCrossRef" href="#sec0080">anexo A</a>&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">De un total de 17&#46;893 historias cl&#237;nicas de pacientes atendidos en consulta de neumolog&#237;a que se evaluaron durante el periodo de estudio&#44; 4&#46;508 pacientes con diagn&#243;stico de EPOC se auditaron por cumplir los criterios de aceptaci&#243;n&#46; En 2&#46;442 pacientes se analiz&#243; su nivel de riesgo&#44; al disponer de todos los criterios para definir dicho nivel seg&#250;n la GesEPOC&#46; El proceso de muestreo se describe con un diagrama de flujo STROBE<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">10</span></a> en la <a class="elsevierStyleCrossRef" href="#fig0010">figura 2</a>&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Distribuci&#243;n de los niveles de riesgo y sus caracter&#237;sticas demogr&#225;ficas y cl&#237;nicas</span><p id="par0060" class="elsevierStylePara elsevierViewall">De la cohorte estudiada&#44; 1&#46;948 &#40;79&#44;8&#37;&#41; pacientes se clasificaron como de alto riesgo y 494 &#40;20&#44;2&#37;&#41; pacientes con un bajo nivel de riesgo &#40;<a class="elsevierStyleCrossRef" href="#fig0015">fig&#46; 3</a>&#41;&#46; En la <a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a> se muestra la distribuci&#243;n de los criterios que definen a los pacientes con un nivel de alto de riesgo&#46; En el 27&#44;4&#37; de los pacientes de alto riesgo&#44; estaban presentes los 3<span class="elsevierStyleHsp" style=""></span>criterios y en un 35&#44;1&#37; se cumpl&#237;a un &#250;nico criterio&#46; El criterio de alto riesgo m&#225;s frecuente fue el grado de disnea &#8805;2&#160;MRC-m&#44; que fue el &#250;nico criterio encontrado en un 15&#44;7&#37; de los pacientes de alto riesgo&#46; En la <a class="elsevierStyleCrossRef" href="#fig0020">figura 4</a> se muestra un diagrama de Venn proporcional de los criterios que definen el nivel de alto riesgo&#46;</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><elsevierMultimedia ident="fig0020"></elsevierMultimedia><p id="par0065" class="elsevierStylePara elsevierViewall">Las caracter&#237;sticas demogr&#225;ficas y cl&#237;nicas por nivel de riesgo se muestran en la <a class="elsevierStyleCrossRef" href="#tbl0010">tabla 2</a>&#46; Se observan diferencias estad&#237;sticamente significativas en todas las variables&#44; salvo el sexo y la cl&#237;nica sugestiva de asma bronquial&#46; Los pacientes con alto riesgo se caracterizaban por tener una mayor edad y comorbilidad evaluada por el &#237;ndice de Charlson&#44; que se identificaron en el modelo multivariante &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">tabla 3</a>&#41; como factores asociados de forma independiente&#46; Adem&#225;s&#44; los pacientes con alto riesgo presentaban un nivel de gravedad mayor evaluado por los &#237;ndices BODE y BODEx&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><elsevierMultimedia ident="tbl0015"></elsevierMultimedia></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Fenotipos cl&#237;nicos seg&#250;n el nivel de riesgo</span><p id="par0070" class="elsevierStylePara elsevierViewall">En la <a class="elsevierStyleCrossRef" href="#fig0025">figura 5</a> se describe la distribuci&#243;n de los pacientes seg&#250;n nivel de riesgo y fenotipo cl&#237;nico&#44; de acuerdo con la GesEPOC&#46; El fenotipo m&#225;s frecuente en el nivel de alto riesgo fue el no agudizador &#40;46&#37;&#41;&#46; El ACO fue el fenotipo menos frecuente &#40;un 10&#44;5&#37; en bajo riesgo y un 8&#44;9&#37; en alto riesgo&#41;&#46;</p><elsevierMultimedia ident="fig0025"></elsevierMultimedia></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Tratamiento farmacol&#243;gico</span><p id="par0075" class="elsevierStylePara elsevierViewall">En la <a class="elsevierStyleCrossRef" href="#fig0030">figura 6</a> se muestra la distribuci&#243;n de los tratamientos farmacol&#243;gicos de la EPOC seg&#250;n el nivel de riesgo y el fenotipo cl&#237;nico&#46; La opci&#243;n m&#225;s utilizada en el bajo riesgo fue la monoterapia broncodilatadora &#40;en un 34&#44;8&#37;&#41; y en el alto riesgo fue la triple terapia &#40;antimuscar&#237;nico de larga duraci&#243;n&#47;&#223;-2 adren&#233;rgico de larga duraci&#243;n&#47;corticosteroides inhalados &#91;LAMA&#47;LABA&#47;CSI&#93;&#41;&#44; que estaba presente en un 53&#44;7&#37;&#46;</p><elsevierMultimedia ident="fig0030"></elsevierMultimedia></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Recursos ofrecidos en la atenci&#243;n m&#233;dica seg&#250;n el nivel de riesgo</span><p id="par0080" class="elsevierStylePara elsevierViewall">Los recursos ofrecidos en la atenci&#243;n seg&#250;n el nivel de riesgo se describen en la <a class="elsevierStyleCrossRef" href="#tbl0020">tabla 4</a>&#46; No se encontraron diferencias en el tipo de consulta &#40;general o especializada en EPOC&#41; en la que los pacientes fueron atendidos seg&#250;n su nivel de riesgo&#46; En los pacientes de bajo riesgo&#44; el origen de la consulta fue principalmente la atenci&#243;n primaria &#40;50&#44;1&#37;&#41;&#44; y entre los de alto riesgo&#44; un 20&#44;4&#37; proced&#237;an del &#225;rea de hospitalizaci&#243;n&#46; La periodicidad de las consultas fue m&#225;s frecuente en los pacientes con alto riesgo &#8212;inferior a 6 meses en un 55&#44;7&#37;&#8212; con un tiempo de seguimiento mayor&#46;</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Procedimientos diagn&#243;sticos seg&#250;n el nivel de riesgo</span><p id="par0085" class="elsevierStylePara elsevierViewall">Los principales procedimientos diagn&#243;sticos realizados durante el seguimiento se describen en la <a class="elsevierStyleCrossRef" href="#tbl0025">tabla 5</a>&#46; Respecto a las pruebas de valoraci&#243;n funcional&#44; en el nivel de alto riesgo fue m&#225;s frecuente la medici&#243;n de los vol&#250;menes pulmonares &#40;47&#44;7 versus 35&#44;8&#37;&#59; p&#160;&#60;&#160;0&#44;001&#41;&#44; el test de difusi&#243;n &#40;51&#44;4 versus 42&#44;1&#37;&#59; p&#160;&#60;&#160;0&#44;001&#41; y el test de marcha &#40;37&#44;8 versus 15&#44;8&#37;&#59; p&#160;&#60;&#160;0&#44;001&#41;&#46; Sin embargo&#44; la prueba broncodilatadora se realiz&#243; con mayor frecuencia en los pacientes con bajo riesgo &#40;70&#44;6 versus 62&#44;3&#37;&#59; p&#160;&#61;&#160;0&#44;001&#41;&#46; La realizaci&#243;n de la tomograf&#237;a axial computarizada &#40;TAC&#41; tor&#225;cica&#44; el an&#225;lisis de esputo&#44; la valoraci&#243;n de la gravedad por los &#237;ndices BODE y BODEx fueron m&#225;s frecuentes en el nivel de alto riesgo&#46;</p><elsevierMultimedia ident="tbl0025"></elsevierMultimedia></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Actuaciones realizadas seg&#250;n el nivel de riesgo</span><p id="par0090" class="elsevierStylePara elsevierViewall">En la <a class="elsevierStyleCrossRef" href="#tbl0030">tabla 6</a> se recogen las principales actuaciones cl&#237;nicas realizadas durante la &#250;ltima consulta auditada de cada paciente&#46; En el nivel alto de riesgo fue m&#225;s frecuente la caracterizaci&#243;n por fenotipos seg&#250;n la GesEPOC &#40;57&#44;6 versus 52&#37;&#59; p&#160;&#61;&#160;0&#44;014&#41;&#46; Tambi&#233;n se realizaba con mayor frecuencia la recogida de las comorbilidades &#40;82&#44;4 versus 78&#44;7&#37;&#59; p&#160;&#61;&#160;0&#44;037&#41;&#44; la revisi&#243;n de la t&#233;cnica de inhalaci&#243;n &#40;39&#44;2 versus 32&#37;&#59; p&#160;&#61;&#160;0&#44;002&#41;&#44; la utilizaci&#243;n del cuestionario CAT &#40;28&#44;2 versus 22&#44;1&#37;&#59; p&#160;&#61;&#160;0&#44;003&#41; y la vacunaci&#243;n antigripal y antineumoc&#243;cica&#46;</p><elsevierMultimedia ident="tbl0030"></elsevierMultimedia></span></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Discusi&#243;n</span><p id="par0095" class="elsevierStylePara elsevierViewall">El presente trabajo aporta por primera vez datos sobre la distribuci&#243;n y caracter&#237;sticas cl&#237;nicas de los pacientes atendidos en las consultas de neumolog&#237;a en Espa&#241;a&#44; agrupados seg&#250;n los niveles de riesgo de la EPOC de acuerdo con las actuales directrices de GesEPOC<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">8</span></a>&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">Uno de los aspectos m&#225;s relevantes que debe incluirse en la valoraci&#243;n del paciente con EPOC es la evaluaci&#243;n del riesgo&#44; que se entiende como la probabilidad de que el paciente pueda presentar exacerbaciones &#40;con o sin ingreso hospitalario&#41;&#44; progresi&#243;n de la enfermedad&#44; futuras complicaciones o mayor consumo de recursos sanitarios&#46; M&#250;ltiples estudios nos han demostrado que el FEV<span class="elsevierStyleInf">1</span> es un buen predictor de mortalidad y morbilidad<a class="elsevierStyleCrossRefs" href="#bib0225"><span class="elsevierStyleSup">11&#44;12</span></a>&#46; Sin embargo&#44; conviene recordar que otros par&#225;metros predicen la mortalidad de forma independiente de la funci&#243;n&#44; como la disnea<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">13</span></a> y las exacerbaciones<a class="elsevierStyleCrossRefs" href="#bib0195"><span class="elsevierStyleSup">5&#44;14</span></a>&#46; Estas 3<span class="elsevierStyleHsp" style=""></span>variables son las consideradas por GesEPOC en la estratificaci&#243;n del riesgo de la EPOC&#44; atendiendo a la necesidad de adecuar los niveles de intervenci&#243;n tanto diagn&#243;stica como terap&#233;utica&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">Los resultados de nuestro trabajo ponen de manifiesto que la mayor&#237;a de los pacientes con EPOC atendidos en consulta de neumolog&#237;a en Espa&#241;a se clasifican como de alto riesgo&#46; Un nivel de alto riesgo que se defini&#243;&#44; en un 37&#44;6&#37; de los pacientes&#44; por cumplir 2 criterios y en un 27&#44;4&#37; por tener los 3<span class="elsevierStyleHsp" style=""></span>criterios &#40;grado de disnea&#44; obstrucci&#243;n al flujo a&#233;reo e historial de agudizaciones&#41;&#46; Hay que destacar que el criterio tener un grado de disnea &#8805;2 MRC-m estaba presente en la mayor&#237;a de los pacientes de alto riesgo &#40;en un 74&#44;7&#37;&#41;&#44; as&#237; como tener un FEV<span class="elsevierStyleInf">1</span>&#60; 50&#37;&#44; que lo cumpl&#237;a el 63&#44;6&#37; de los pacientes con alto riesgo&#46; Sin embargo&#44; solo un 35&#44;9&#37; hab&#237;an sido hospitalizados al menos una vez y solo un 39&#44;7&#37; hab&#237;an presentado m&#225;s de una agudizaci&#243;n moderada en el a&#241;o previo&#46; Recientes estudios realizados en las consultas de neumolog&#237;a en Espa&#241;a nos confirman que el historial de agudizaciones &#8805;2 est&#225; presente en menos de 1&#47;3 de los pacientes con EPOC&#44; mientras que una disnea &#8805;2&#160;MRC-m o un FEV<span class="elsevierStyleInf">1</span>&#60;50&#37; est&#225; presente en m&#225;s de 2&#47;3 de los pacientes<a class="elsevierStyleCrossRefs" href="#bib0245"><span class="elsevierStyleSup">15-17</span></a>&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">Tambi&#233;n hay que mencionar que&#44; en nuestro an&#225;lisis&#44; tan solo 34 pacientes &#40;1&#44;75&#37; de los de alto riesgo&#41; se clasificaron como de alto riesgo por tener como &#250;nico criterio una disnea igual a 2 y estar con monoterapia broncodilatadora como tratamiento de mantenimiento&#44; por lo que podr&#237;an considerarse infratratados&#46; No obstante&#44; futuros estudios podr&#225;n aportar m&#225;s informaci&#243;n para la ponderaci&#243;n de las variables que definen el nivel de riesgo&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">En nuestro trabajo&#44; los pacientes con un nivel alto de riesgo ten&#237;an una mayor edad y carga de comorbilidad&#44; con una expectoraci&#243;n cr&#243;nica y una colonizaci&#243;n m&#225;s frecuentes&#44; factores asociados al alto riesgo de forma independiente&#46; Unos hallazgos que est&#225;n en consonancia con numerosos estudios que han demostrado que la presencia de comorbilidades&#44; de tos con expectoraci&#243;n cr&#243;nica y de carga bacteriana en la v&#237;a a&#233;rea se asocian a un mayor riesgo de agudizaciones&#44; peor pron&#243;stico y mayor mortalidad<a class="elsevierStyleCrossRefs" href="#bib0260"><span class="elsevierStyleSup">18-21</span></a>&#46; Con relaci&#243;n a la edad&#44; varios estudios han constatado que se asocia irremediablemente a un aumento de la mortalidad&#44; si bien&#44; en parte&#44; podr&#237;a ser explicado por la presencia de factores relacionados como el apoyo social&#44; la incapacidad f&#237;sica&#44; la depresi&#243;n o la calidad de vida<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">22</span></a>&#44; y que definir&#237;an un subgrupo de pacientes de alta complejidad o &#171;fr&#225;giles&#187; que&#44; adem&#225;s de tener un elevado riesgo de complicaciones&#44; precisar&#225;n una aproximaci&#243;n mucho m&#225;s individualizada<a class="elsevierStyleCrossRef" href="#bib0285"><span class="elsevierStyleSup">23</span></a>&#46; El tabaquismo activo fue menos frecuente en el nivel de alto riesgo&#44; lo que podr&#237;a ser explicado como una consecuencia de su nivel de gravedad&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">Con relaci&#243;n al nivel de gravedad medido mediante BODE&#47;BODEx&#44; en nuestro estudio los pacientes con un nivel de alto riesgo eran m&#225;s graves&#44; con diferencias estad&#237;sticamente significativas respecto al bajo riesgo&#46; Todos los pacientes con un nivel de bajo riesgo estaban en el cuartil 1 del BODEx&#46; Unos resultados que apoyan la estratificaci&#243;n del riesgo seg&#250;n GesEPOC como herramienta para la valoraci&#243;n del paciente y la adecuaci&#243;n de los niveles de intervenci&#243;n&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">La distribuci&#243;n de los fenotipos cl&#237;nicos fue similar a la obtenida en otros estudios nacionales e internacionales&#44; en los que el no agudizador es el m&#225;s frecuente entre los pacientes atendidos en las consultas de neumolog&#237;a<a class="elsevierStyleCrossRefs" href="#bib0245"><span class="elsevierStyleSup">15&#44;16&#44;24</span></a>&#46; Es este un dato que llama la atenci&#243;n&#44; si consideramos que la mayor&#237;a de los pacientes tienen una obstrucci&#243;n grave&#44; pero que podr&#237;a en parte explicarse como resultado de un tratamiento y seguimiento m&#225;s intensos&#46; Respecto a la frecuencia del fenotipo ACO&#44; definido por los criterios anteriormente comentados&#44; fue baja &#40;un 10&#44;5&#37; en bajo riesgo o un 8&#44;9&#37; en alto riesgo&#41;&#44; en consonancia con estudios previos y con m&#237;nimas diferencias seg&#250;n los criterios utilizados<a class="elsevierStyleCrossRefs" href="#bib0250"><span class="elsevierStyleSup">16&#44;24-27</span></a>&#46; No obstante&#44; en nuestro estudio no consideramos la eosinofilia perif&#233;rica como criterio diagn&#243;stico del ACO&#44; lo que podr&#237;a estar infraestimando la prevalencia&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">Con relaci&#243;n al tratamiento por nivel de riesgo y fenotipos cl&#237;nicos&#44; cabe destacar que exist&#237;a un porcentaje alto de pacientes con CSI en ambos niveles de riesgo&#46; En el alto riesgo&#44; la triple terapia fue la combinaci&#243;n m&#225;s utilizada&#44; presente en un 47&#44;4&#37; de los no agudizadores y que alcanz&#243; su m&#225;ximo en los agudizadores con bronquitis cr&#243;nica&#44; con un 60&#44;8&#37;&#46; Tambi&#233;n se dio en los pacientes con bajo riesgo&#44; pese a que la opci&#243;n m&#225;s frecuente fue la monoterapia con un broncodilatador de larga duraci&#243;n&#44; pero hay que rese&#241;ar que un 10&#44;4&#37; segu&#237;an tratamiento con LABA&#43;CSI y un 27&#44;4&#37; con LABA&#43;LAMA&#43;CSI&#46; Esta sobreutilizaci&#243;n de los CSI en el bajo riesgo no puede explicarse por la frecuencia del fenotipo ACO&#44; cuyos criterios solo cumpl&#237;an un 10&#44;5&#37;&#46; En el futuro&#44; ser&#225; de inter&#233;s analizar la frecuencia de ACO seg&#250;n los nuevos criterios de GesEPOC en el nivel de bajo riesgo<a class="elsevierStyleCrossRef" href="#bib0310"><span class="elsevierStyleSup">28</span></a> por sus implicaciones en el tratamiento&#44; dado que GesEPOC recomienda en este umbral de riesgo utilizar broncodilatadores solos&#46; Tambi&#233;n hay que mencionar que tan solo 34 pacientes &#40;1&#44;75&#37; de los de alto riesgo&#41; se clasificaron como de alto riesgo por tener como &#250;nico criterio una disnea igual a 2 y estar en tratamiento con monoterapia broncodilatadora&#44; por lo que podr&#237;an considerarse infratratados&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">Numerosos estudios nacionales e internacionales realizados en diferentes niveles asistenciales han evidenciado un elevado uso de CSI en pacientes con EPOC<a class="elsevierStyleCrossRefs" href="#bib0315"><span class="elsevierStyleSup">29&#44;30</span></a>&#46; En Espa&#241;a&#44; diferentes estudios<a class="elsevierStyleCrossRefs" href="#bib0320"><span class="elsevierStyleSup">30&#44;31</span></a> han constatado que un porcentaje superior al 60&#37; de los pacientes con EPOC leve reciben un tratamiento con CSI &#40;solos o en asociaci&#243;n con broncodilatador de larga duraci&#243;n&#41;&#44; con frecuencia a dosis altas&#46; Adem&#225;s&#44; en muchas ocasiones&#44; la prescripci&#243;n de CSI asociados a broncodilatadores se da como primer tratamiento tras el diagn&#243;stico<a class="elsevierStyleCrossRef" href="#bib0330"><span class="elsevierStyleSup">32</span></a> y no se adecua a las recomendaciones de buena pr&#225;ctica cl&#237;nica<a class="elsevierStyleCrossRef" href="#bib0335"><span class="elsevierStyleSup">33</span></a>&#46; No obstante&#44; en los &#250;ltimos a&#241;os&#44; estudios realizados en Espa&#241;a que han evaluado el tratamiento seg&#250;n fenotipos cl&#237;nicos han puesto de manifiesto que el uso de CSI ha disminuido en los pacientes no agudizadores<a class="elsevierStyleCrossRef" href="#bib0340"><span class="elsevierStyleSup">34</span></a>&#46; As&#237;&#44; el estudio FENEPOC&#44; realizado en 2013 en ambos &#225;mbitos asistenciales en Espa&#241;a&#44; nos mostraba que la triple terapia era el tratamiento de mantenimiento en un 28&#44;7&#37; de los no agudizadores&#44; en un 58&#37; en los agudizadores y en un 59&#44;5&#37; en los pacientes con ACO<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">15</span></a>&#46;</p><p id="par0140" class="elsevierStylePara elsevierViewall">En cuanto a la atenci&#243;n m&#233;dica y las actuaciones seg&#250;n el nivel de riesgo&#44; hay que destacar que&#44; si bien en el paciente de alto riesgo la periodicidad de las revisiones y el tiempo de seguimiento en consulta fueron mayores&#44; no encontramos diferencias en el tipo de consulta donde fue atendido &#40;general o monogr&#225;fica de EPOC&#41;&#46; Por el contrario&#44; s&#237; existen diferencias en las actuaciones diagn&#243;sticas y terap&#233;uticas que se realizaban entre ambos niveles de riesgo&#44; siendo m&#225;s frecuentes las pruebas espec&#237;ficas en el paciente de alto riesgo&#44; como la medici&#243;n de los vol&#250;menes pulmonares&#44; la TAC y el test de la marcha&#59; y tambi&#233;n son m&#225;s frecuentes las actuaciones como el fenotipado o la aplicaci&#243;n del cuestionario CAT&#46; Unos datos que est&#225;n en consonancia con las recomendaciones de GesEPOC&#44; que establece una mayor necesidad de intervenciones diagn&#243;sticas o terap&#233;uticas en los pacientes con un nivel alto de riesgo&#46; Sin embargo&#44; pese a estos resultados que nos muestran que en la consulta de neumolog&#237;a se lleva a cabo una pr&#225;ctica cl&#237;nica en el paciente con EPOC diferente seg&#250;n el nivel de riesgo&#44; hay que destacar que&#44; en ambos niveles de riesgo&#44; existen importantes &#225;reas de mejora en la adhesi&#243;n a las recomendaciones de buena pr&#225;ctica cl&#237;nica&#44; y cuya variabilidad solo se explica en una proporci&#243;n peque&#241;a por variables del paciente&#46; En ambos niveles de riesgo fue muy bajo el cribado del d&#233;ficit de alfa 1 antitripsina&#46;</p><p id="par0145" class="elsevierStylePara elsevierViewall">Por &#250;ltimo&#44; cabe mencionar algunas limitaciones metodol&#243;gicas que deben ser tenidas en cuenta&#44; como que la selecci&#243;n de los centros para participar en este estudio no fue aleatoria y que se realiz&#243; con base en haber participado previamente en auditor&#237;as cl&#237;nicas en EPOC y por su inter&#233;s en este estudio&#46; Tambi&#233;n debemos recordar que es un estudio transversal y que&#44; por tanto&#44; no puede evaluar si el nivel de riesgo de exacerbaciones&#44; complicaciones o la mortalidad es diferente entre niveles de riesgo&#46; Adem&#225;s&#44; debemos considerar que existe una limitaci&#243;n intr&#237;nseca a cualquier auditoria cl&#237;nica&#44; y es que&#44; pese a la metodolog&#237;a en la inclusi&#243;n y la supervisi&#243;n peri&#243;dica de la base de datos de nuestro estudio&#44; algunos valores no son recogidos por no estar disponibles&#46; No obstante&#44; pese a estas limitaciones&#44; creemos que la muestra recogida es representativa de la atenci&#243;n m&#233;dica del paciente con EPOC en la consulta de neumolog&#237;a en Espa&#241;a&#44; por su cobertura poblacional con representaci&#243;n en 16 comunidades aut&#243;nomas&#46;</p></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Conclusi&#243;n</span><p id="par0150" class="elsevierStylePara elsevierViewall">La estratificaci&#243;n en niveles de riesgo del paciente con EPOC debe ser considerada un paso clave en el abordaje y evaluaci&#243;n del paciente con EPOC&#46; Las variables que determinan el nivel de riesgo tienen la virtud de ser potencialmente modificables&#44; lo que apoya el inter&#233;s de planificar intervenciones terap&#233;uticas seg&#250;n el nivel de riesgo&#44; orientadas a revertir sus efectos y&#44; con ello&#44; a mejorar la supervivencia de los pacientes con EPOC&#46;</p><p id="par0155" class="elsevierStylePara elsevierViewall">Los resultados del presente trabajo permitir&#225;n aprender sobre las fortalezas y debilidades de nuestra atenci&#243;n sanitaria en relaci&#243;n con el nivel de riesgo definido en la GesEPOC 2017&#44; si bien debemos tener en cuenta las limitaciones intr&#237;nsecas a cualquier auditor&#237;a cl&#237;nica y a la selecci&#243;n de los centros&#46;</p><p id="par0160" class="elsevierStylePara elsevierViewall">Por todo ello&#44; son necesarios futuros estudios que eval&#250;en si el nivel de riesgo tiene un impacto sobre resultados cl&#237;nicamente relevantes&#44; como el riesgo de agudizaciones y la supervivencia&#44; lo que apoyar&#237;a futuros cambios en la estrategia diagn&#243;stica y terap&#233;utica de la EPOC&#46;</p></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Financiaci&#243;n</span><p id="par0165" class="elsevierStylePara elsevierViewall">La Sociedad Espa&#241;ola de Neumolog&#237;a y Cirug&#237;a Tor&#225;cica &#40;SEPAR&#41; promovi&#243; y patrocin&#243; el estudio&#44; con el soporte financiero de Boehringer Ingelheim&#46; Los financiadores no participaron en el dise&#241;o del estudio&#44; la recogida de datos&#44; el an&#225;lisis&#44; la publicaci&#243;n ni en la elaboraci&#243;n de este manuscrito&#46;</p></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0130">Conflicto de intereses</span><p id="par0170" class="elsevierStylePara elsevierViewall">Los autores declaran no tener ning&#250;n conflicto de intereses&#46;</p></span></span>"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Introducci&#243;n</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">EPOCONSUL es la primera auditor&#237;a nacional que analiza la atenci&#243;n sanitaria de la EPOC en consultas de neumolog&#237;a en Espa&#241;a&#46; El objetivo principal fue determinar&#44; en un an&#225;lisis retrospectivo&#44; la distribuci&#243;n de los niveles de riesgo de la EPOC seg&#250;n GesEPOC 2017 y evaluar las actuaciones cl&#237;nicas seg&#250;n las nuevas recomendaciones&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Material y m&#233;todos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Es una auditor&#237;a cl&#237;nica de dise&#241;o trasversal&#44; con reclutamiento de casos consecutivos de EPOC durante un a&#241;o&#46; Se evalu&#243; el nivel de riesgo y el fenotipo cl&#237;nico seg&#250;n GesEPOC 2017 y su relaci&#243;n con las intervenciones cl&#237;nicas realizadas&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">El nivel de alto riesgo fue m&#225;s frecuente &#40;79&#44;8 versus 20&#44;2&#37;&#59; p&#160;&#60;&#160;0&#44;001&#41; y se caracteriz&#243; por un mayor nivel de gravedad medido por los &#237;ndices BODE y BODEx&#44; adem&#225;s de por mayor comorbilidad&#46; El fenotipo cl&#237;nico m&#225;s frecuente fue el no agudizador&#46; La opci&#243;n m&#225;s utilizada en el bajo riesgo fue la monoterapia broncodilatadora &#40;en un 34&#44;8&#37;&#41; y la triple terapia en el alto riesgo &#40;en un 53&#44;7&#37;&#41;&#46; En el alto riesgo fue m&#225;s frecuente la caracterizaci&#243;n por fenotipos &#40;57&#44;6 versus 52&#37;&#59; p&#160;&#61;&#160;0&#44;014&#41; y la realizaci&#243;n de pruebas de funci&#243;n respiratoria&#58; vol&#250;menes pulmonares &#40;47&#44;7 versus 35&#44;8&#37;&#59; p&#160;&#60;&#160;0&#44;001&#41;&#44; test de difusi&#243;n &#40;51&#44;4 versus 42&#44;1&#37;&#59; p&#160;&#60;&#160;0&#44;001&#41; y test de marcha &#40;37&#44;8 versus 15&#44;8&#37;&#59; p&#160;&#60;&#160;0&#44;001&#41;&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">La mayor&#237;a de los pacientes atendidos en las consultas de neumolog&#237;a fueron de alto riesgo y con fenotipo cl&#237;nico no agudizador&#46; La pr&#225;ctica cl&#237;nica realizada fue diferente seg&#250;n el nivel de riesgo y mayoritariamente acorde con las recomendaciones de GesEPOC&#44; aunque con importantes &#225;reas de mejora&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0005"
            "titulo" => "Introducci&#243;n"
          ]
          1 => array:2 [
            "identificador" => "abst0010"
            "titulo" => "Material y m&#233;todos"
          ]
          2 => array:2 [
            "identificador" => "abst0015"
            "titulo" => "Resultados"
          ]
          3 => array:2 [
            "identificador" => "abst0020"
            "titulo" => "Conclusiones"
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      "en" => array:3 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Introduction</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">EPOCONSUL is the first national audit to analyze medical care for COPD in pulmonology departments in Spain&#46; The main objective was to perform a retrospective analysis to determine the distribution of GesEPOC 2017 COPD risk levels and to evaluate clinical activity according to the new recommendations&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Material and methods</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">This is a cross-sectional clinical audit in which consecutive COPD cases were recruited over one year&#46; The study evaluated risk and clinical phenotype according to GesEPOC 2017&#44; and their correlation with the clinical interventions employed&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">The most common risk category was high risk &#40;79&#46;8&#37; versus 20&#46;2&#37;&#59; p&#160;&#60;&#160;0&#46;001&#41;&#44; characterized by a higher level of severity on BODE and BODEx indexes&#44; and a higher comorbidity burden&#46; The most common phenotype was non-exacerbator&#46; The most commonly used treatment in low-risk patients was bronchodilator monotherapy &#40;34&#46;8&#37;&#41; and triple therapy in high-risk patients &#40;53&#46;7&#37;&#41;&#46; High risk was most frequently characterized by phenotype &#40;57&#46;6&#37; versus 52&#37;&#59; p&#160;&#61;&#160;0&#46;014&#41; and pulmonary function test results&#58; lung volume &#40;47&#46;7&#37; versus 35&#46;8&#37;&#59; p&#160;&#60;&#160;0&#46;001&#41;&#44; lung diffusion &#40;51&#46;4&#37; versus 42&#46;1&#37;&#59; p&#160;&#60;&#160;0&#46;001&#41; and walk test &#40;37&#46;8&#37; versus 15&#46;8&#37;&#59; p&#160;&#60;&#160;0&#46;001&#41;&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Most patients treated in pulmonology departments were high-risk and non-exacerbator phenotype&#46; Clinical interventions differed according to risk level and mainly followed GesEPOC recommendations&#44; although there is significant room for improvement&#46;</p></span>"
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            "identificador" => "abst0025"
            "titulo" => "Introduction"
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            "identificador" => "abst0030"
            "titulo" => "Material and methods"
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          2 => array:2 [
            "identificador" => "abst0035"
            "titulo" => "Results"
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            "identificador" => "abst0040"
            "titulo" => "Conclusions"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Los miembros del Grupo EPOCONSUL se presentan en el anexo 1&#46;</p>"
        "identificador" => "fn1"
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    "apendice" => array:1 [
      0 => array:1 [
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          0 => array:4 [
            "apendice" => "<p id="par0185" class="elsevierStylePara elsevierViewall">Centros e investigadores participantes &#40;grupo EPOCONSUL&#41;&#58;</p> <p id="par0190" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Andaluc&#237;a</span>&#58; Jos&#233; Luis Rojas Box&#44; H&#46; de Alta Resoluci&#243;n de &#201;cija&#44; Sevilla&#46; Jos&#233; Domingo Garc&#237;a Jim&#233;nez&#44; H&#46; de Alta Resoluci&#243;n de Utrera&#44; Sevilla&#46; Adolfo Domenech del R&#237;o&#44; Ana Mu&#241;oz&#44; H&#46; Carlos Hayas&#44; M&#225;laga&#46; Antonia Soto Venegas&#44; H&#46; San Juan de la Cruz&#44; &#218;beda&#44; Ja&#233;n&#46; Aurelio Arnedillo Mu&#241;oz&#44; H&#46; U&#46; Puerta del Mar&#44; C&#225;diz&#46; Agust&#237;n Valido Morales&#44; H&#46; Virgen de Macarena&#46; Sevilla&#46; Jos&#233; Velasco Garrido&#44; Carlos Rueda R&#237;os&#44; Macarena Arroyo Varela&#44; H&#46; Virgen de la Victoria&#46; M&#225;laga&#46; Francisco Ortega Ruiz&#44; Eduardo M&#225;rquez Martin&#44; Carmen Calero Acu&#241;a&#44; H&#46; Virgen del Roc&#237;o&#44; Sevilla&#46; Francisco Luis Garc&#237;a Gil&#44; H&#46; U&#46; Reina Sof&#237;a&#44; C&#243;rdoba&#46;</p> <p id="par0195" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Arag&#243;n</span>&#58; Joaqu&#237;n Carlos Costan Galicia&#44; H&#46; Cl&#237;nico U&#46; Lozano Blesa&#44; Zaragoza&#46; Ana Boldova Loscertales&#44; H&#46; Royo Villanova&#44; Zaragoza&#46;</p> <p id="par0200" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Asturias</span>&#58; Cristina Mart&#237;nez Gonz&#225;lez&#44; Rosirys Guzm&#225;n Taveras&#44; H&#46; U&#46; Central de Asturias&#44; Oviedo&#46;</p> <p id="par0205" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Murcia</span>&#58; Juan Luis de la Torre &#193;lvaro&#44; H&#46; U&#46; Santa Luc&#237;a&#44; Cartagena&#46; M&#46; Jes&#250;s Avil&#233;s Ingles&#44; H&#46; General U&#46; Reina Sof&#237;a&#44; Murcia&#46; Rub&#233;n And&#250;jar Espinosa&#44; H&#46;&#160;U&#46; Virgen de la Arrixaca&#44; Murcia&#46;</p> <p id="par0210" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Canarias</span>&#58; Juan Manuel Palmero Tejera&#44; Juan Marco Figueira Con&#231;alves&#44; H&#46;&#160;U&#46; Nuestra Se&#241;ora de la Candelaria&#44; Santa Cruz de Tenerife&#46;</p> <p id="par0215" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Cantabria</span>&#58; Ram&#243;n Ag&#252;ero Balb&#237;n&#44; Carlos Amado Diago&#44; Beatriz Abascal Bolado&#44; H&#46; Marqu&#233;s de Valdecilla&#44; Santander&#46; Juan Luis Garc&#237;a Rivero&#44; Marcelle Cohen Escovar&#44; H&#46; de Laredo&#44; Santander&#46;</p> <p id="par0220" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Castilla La Mancha</span>&#58; Francisco Javier Callejas Gonz&#225;lez&#44; Complejo Hospitalario Universitario de Albacete&#44; Albacete&#46; &#193;ngel Ortega Gonz&#225;lez&#44; H&#46; Nuestra Se&#241;ora del Prado&#44; Talavera de la Reina&#44; Toledo&#46; Rosario Vargas Gonz&#225;lez&#44; H&#46; Virgen de la Luz&#44; Cuenca&#46; Encarnaci&#243;n L&#243;pez Gabald&#243;n&#44; Ra&#250;l Hidalgo Carvajal&#44; H&#46; Virgen de la Salud&#44; Toledo&#46;</p> <p id="par0225" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Castilla y Le&#243;n</span>&#58; Elena Bollo de Miguel&#44; Silvia Fern&#225;ndez Huerga&#44; Complejo Hospitalario Universitario de Le&#243;n&#44; Le&#243;n&#46; Ana Pueyo Bastida&#44; Complejo Asistencial de Burgos&#44; Burgos&#46; Jes&#250;s R&#46; Hern&#225;ndez Hern&#225;ndez&#44; Ruth Garc&#237;a Garc&#237;a&#44; H&#46; Nuestra Se&#241;ora de Sonsoles&#44; &#193;vila&#46; Miguel Barrueco Ferrero&#44; Marco L&#243;pez Zuibizarreta&#44; E&#46; Consuelo Fern&#225;ndez&#44; H&#46; Universitario de Salamanca&#44; Salamanca&#46;</p> <p id="par0230" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Catalu&#241;a</span>&#58; David de la Rosa Carrillo&#44; H&#46; Plat&#243;&#44; Barcelona&#46; Jordi Esplugas Ab&#243;s&#44; Noelia Pablos Mateos&#44; H&#46; Sant Joan de D&#233;u&#44; Martorell&#46; Elena de Miguel Campos&#44; H&#46; Sant Joan de Desp&#237;&#44; Barcelona&#46; Pablo Rubinstein&#44; Hospital General de Catalu&#241;a&#44; Barcelona&#46; Hern&#225;n Abraham Manrique Ch&#225;vez&#44; H&#46; Sagrat Cor&#44; Barcelona&#46; Miriam Barrecheguren&#44; H&#46; U&#46; Vall d&#8217;Hebr&#243;n&#44; Barcelona&#46;</p> <p id="par0235" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Valencia</span>&#58; Carmen Aguar Benito&#44; H&#46; de Arnau de Villanova&#44; Valencia&#46; Pablo Catal&#225;n Serra&#44; H&#46; de Requena&#44; Requena&#46; Eusebi Chiner Vives&#46; H&#46; U&#46; de San Juan&#44; Alicante&#46; Juan Antonio Royo Prats&#46; H&#46; General de Castell&#243;n&#44; Castell&#243;n de la Plana&#46; Cristina Sabater Abad&#44; Esther Verdejo Mengual&#44; H&#46; General Universitario de Valencia&#44; Valencia&#46; Eva Mart&#237;nez-Morag&#243;n&#44; H&#46; Universitario Dr&#46; Peset&#44; Valencia&#46;</p> <p id="par0240" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Extremadura</span>&#58; Francisca Lourdes M&#225;rquez P&#233;rez&#44; H&#46; U&#46; Santa Cristina&#44; Badajoz&#46;</p> <p id="par0245" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Galicia</span>&#58; Alberto Fern&#225;ndez Villar&#44; Cristina Represas Represas&#44; Ana Priegue Carrera&#44; Complejo Hospitalario de Vigo&#44; Vigo&#46; Marina Blanco Aparicio&#44; Pedro Jorge Marcos Rodr&#237;guez&#44; H&#46; U&#46; Juan Canalejo&#44; La Coru&#241;a&#46;</p> <p id="par0250" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Baleares</span>&#58; Federico Gonzalo Fiorentino&#44; M&#46; Magdalena Pan Naranjo&#44; H&#46; Son Espases&#44; Palma de Mallorca&#46; Antonia Fuster Gomila&#44; H&#46; Sant Llatzer&#44; Palma de Mallorca&#46;</p> <p id="par0255" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Madrid</span>&#58; Germ&#225;n Peces Barba&#44; Felipe Villar &#193;lvarez&#44; Fundaci&#243;n Jim&#233;nez D&#237;az&#44; Madrid&#46; Carlos Jos&#233; &#193;lvarez Mart&#237;nez&#44; H&#46; 12 de Octubre&#44; Madrid&#46; Juan Luis Rodr&#237;guez Hermosa&#44; J&#46;&#160;L&#46; &#193;lvarez Sala-Walther&#44; H&#46; Cl&#237;nico San Carlos&#44; Madrid&#46; Jos&#233; Andr&#233;s Garc&#237;a Romero de Tejada&#44; H&#46; U&#46; Infanta Sof&#237;a&#44; San Sebasti&#225;n de los Reyes&#44; Madrid&#46; Javier Jare&#241;o&#44; Sergio Campos T&#233;llez&#44; H&#46; Central de la Defensa&#44; Madrid&#46; Ra&#250;l Galera Mart&#237;nez&#44; H&#46; La Paz&#46; Rosa Mar G&#243;mez Punter&#44; Emma V&#225;zquez Espinosa&#44; H&#46; La Princesa&#44; Madrid&#46; Esther Alonso Peces&#44; H&#46; Pr&#237;ncipe de Asturias&#44; Alcal&#225; de Henares&#44; Madrid&#46; Juan Manuel Diez Pi&#241;a&#44; Raquel P&#233;rez Rojo&#44; H&#46; U&#46; de M&#243;stoles&#44; Madrid&#46; Luis Puente Maestu&#44; Julia Garc&#237;a de Pedro&#44; H&#46; U&#46; Gregorio Mara&#241;&#243;n&#44; Madrid&#46; Soledad Alonso Viteri&#44; H&#46; U&#46; de Torrej&#243;n&#44; Torrej&#243;n de Ardoz&#44; Madrid&#46;</p> <p id="par0260" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Navarra</span>&#58; Mar&#237;a Hern&#225;ndez Bonaga&#44; Complejo Hospitalario de Navarra&#44; Pamplona&#46;</p> <p id="par0265" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Pa&#237;s Vasco</span>&#58; Mar&#237;a Milagros Iriberri Pascual&#44; H&#46; de Cruces&#44; Baracaldo&#46; Myriam Aburto Barrenechea&#44; H&#46; de Galdakano&#46; Sophe Garc&#237;a Fuika&#44; Hospital Santiago&#160;Apostol&#44; Vitoria&#46; Patricia Sobradillo Ecenarro&#44; Hospital Txagorritx&#44; Basurto&#46;</p>"
            "etiqueta" => "Appendix A"
            "titulo" => "Anexo 1"
            "identificador" => "sec0080"
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          "es" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">La estratificaci&#243;n del riesgo seg&#250;n GesEPOC&#46;</p>"
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          "es" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Diagrama de flujo STROBE sobre el muestreo&#46;</p>"
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          "es" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Distribuci&#243;n de los pacientes seg&#250;n el nivel de riesgo y el fenotipo cl&#237;nico seg&#250;n la GesEPOC&#46;</p> <p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">El fenotipo ACO era definido por tener un diagn&#243;stico de asma bronquial o tener una cl&#237;nica sugestiva de asma y adem&#225;s una prueba broncodilatadora positiva mayor o igual que el 15&#37;&#46;</p> <p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">ACO&#58; fenotipo mixto asma-EPOC o ACO&#46;</p>"
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          "es" => "<p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">Tratamiento farmacol&#243;gico seg&#250;n nivel de riesgo y el fenotipo cl&#237;nico de la GesEPOC&#46;</p> <p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">ACO&#58; fenotipo mixto asma-EPOC o ACO&#59; BD&#58; broncodilatadora&#59; Cu&#225;druple&#58; antimuscar&#237;nico de larga duraci&#243;n&#47;&#946;-2 adren&#233;rgico de larga duraci&#243;n&#47;corticosteroide inhalado&#47;otro f&#225;rmaco &#40;roflumilast o teofilina o antibi&#243;tico a largo plazo&#41;&#59; LABA&#58; &#946;-2 adren&#233;rgico de larga duraci&#243;n&#59; LABA&#47;CSI&#58; &#946;-2 adren&#233;rgico de larga duraci&#243;n&#47;corticosteroide inhalado&#59; LABA&#47;LAMA&#58; &#946;-2 adren&#233;rgico de larga duraci&#243;n&#47;antimuscar&#237;nico de larga duraci&#243;n&#59; LAMA&#58; antimuscar&#237;nico de larga duraci&#243;n&#59; LAMA&#47;LABA&#47;CSI&#58; antimuscar&#237;nico de larga duraci&#243;n&#47;&#946;-2 adren&#233;rgico de larga duraci&#243;n&#47;corticosteroide inhalado&#46;</p>"
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          "leyenda" => "<p id="spar0095" class="elsevierStyleSimplePara elsevierViewall">FEV<span class="elsevierStyleInf">1</span>&#58; porcentaje del FEV<span class="elsevierStyleInf">1</span> posbroncodilataci&#243;n predicho&#59; MRC-m&#58; Medical Research Council modificado&#46;</p>"
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">N&#46;&#176; de criterios encontrados&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Pacientes con un nivel alto de riesgo &#40;n&#160;&#61; 1&#46;948&#41; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Un solo criterio</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">683 &#40;35&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Solo grado de disnea&#8805;2 &#40;MRC-m&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">306 &#40;15&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Solo FEV<span class="elsevierStyleInf">1</span>&#60;50&#37; predicho&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">215 &#40;11&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Solo &#8805; 2 agudizaciones o &#8805;&#160;1 hospitalizaci&#243;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">162 &#40;8&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Dos criterios</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">732 &#40;37&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Grado de disnea &#8805;2 &#40;MRC-m&#41; y FEV<span class="elsevierStyleInf">1</span> &#60;&#160;50&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">375 &#40;19&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Grado disnea&#160;&#8805;2 &#40;MRC-m&#41; y 2 agudizaciones o &#8805;&#160;1 hospitalizaci&#243;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">242 &#40;12&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>FEV<span class="elsevierStyleInf">1</span>&#60;50&#37; y &#8805;2 agudizaciones o &#8805;1 hospitalizaci&#243;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">115 &#40;5&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Tres criterios</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">533 &#40;27&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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          "es" => "<p id="spar0090" class="elsevierStyleSimplePara elsevierViewall">Distribuci&#243;n de los pacientes de alto riesgo seg&#250;n el n&#250;mero de criterios y los criterios que definen su nivel de alto riesgo</p>"
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          "leyenda" => "<p id="spar0105" class="elsevierStyleSimplePara elsevierViewall">ACO&#58; asma-EPOC <span class="elsevierStyleItalic">overlap</span>&#59; BODE&#58; &#237;ndice de masa corporal&#44; obstrucci&#243;n al flujo a&#233;reo&#44; disnea y capacidad de ejercicio&#59; BODEx&#58; &#237;ndice de masa corporal&#44; obstrucci&#243;n al flujo a&#233;reo&#44; disnea y exacerbaciones graves&#59; Cu&#225;druple&#58; antimuscar&#237;nico de larga duraci&#243;n&#47;&#946;-2 adren&#233;rgico de larga duraci&#243;n&#47;corticosteroide inhalado&#47;otro f&#225;rmaco&#58; roflumilast o teofilina o antibi&#243;tico a largo plazo&#59; FEV<span class="elsevierStyleInf">1</span> posbr &#37;&#58; porcentaje del FEV<span class="elsevierStyleInf">1</span> posbroncodilataci&#243;n predicho&#59; IMC&#58; &#237;ndice de masa corporal&#59; IPA&#58; &#237;ndice paquetes-a&#241;o&#59; LABA&#58; &#946;-2 adren&#233;rgico de larga duraci&#243;n&#59; LABA&#47;CSI&#58; &#946;-2 adren&#233;rgico de larga duraci&#243;n&#47;corticosteroide inhalado&#59; LABA&#47;LAMA&#58; &#946;-2 adren&#233;rgico de larga duraci&#243;n&#47;antimuscar&#237;nico de larga duraci&#243;n&#59; LAMA&#58; antimuscar&#237;nico de larga duraci&#243;n&#59; LAMA&#47;LABA&#47;CSI&#58; antimuscar&#237;nico de larga duraci&#243;n &#47;&#946;-2 adren&#233;rgico de larga duraci&#243;n&#47;corticosteroide inhalado&#59; VMD&#58; ventilaci&#243;n mec&#225;nica domiciliaria&#46;</p>"
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Caracter&#237;sticas&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Total &#40;n&#160;&#61;&#160;2&#46;442&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Alto riesgo &#40;n &#61; 1&#46;948&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Bajo riesgo &#40;n&#160;&#61; 494&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">p&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Edad&#44; media &#40;DE&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#46;442&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">70&#44;37 &#40;9&#44;37&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">67&#44;99 &#40;10&#44;20&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Edad&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#46;442&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Mayor 55 a&#241;os&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;819 &#40;93&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">429 &#40;86&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Menor o igual 55 a&#241;os&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">129 &#40;6&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">65 &#40;13&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Sexo &#40;mujer&#41;&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#46;442&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">441 &#40;13&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">64 &#40;13&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;777&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">IMC&#44; m &#40;DE&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#46;436&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">27&#44;76 &#40;5&#44;40&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">28&#44;77 &#40;5&#44;08&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Tabaquismo activo&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#46;442&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">405 &#40;20&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">150 &#40;30&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">IPA&#44; mediana &#40;P25-75&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#46;442&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">50 &#40;36-75&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">40 &#40;30-60&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Charlson &#8805;3&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#46;442&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">915&#40;47&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">194 &#40;39&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Grado de disnea &#40;MRC-m&#41;&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#46;442&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Grado 0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">54 &#40;2&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">100 &#40;20&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Grado 1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">438 &#40;22&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">394 &#40;79&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Grado 2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">877 &#40;45&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Grado 3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">493 &#40;25&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Grado 4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">86 &#40;4&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Tos cr&#243;nica&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#46;442&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1001 &#40;51&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">153 &#40;31&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Colonizaci&#243;n&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#46;442&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">170 &#40;8&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9 &#40;1&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Cl&#237;nica sugestiva de asma&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#46;442&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">669 &#40;34&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">165 &#40;33&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;693&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">N&#176; agudizaciones a&#241;o previo&#44; n&#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#46;442&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">600 &#40;30&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">370 &#40;74&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">575 &#40;29&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">124 &#40;25&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>&#8805;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">773 &#40;39&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">N&#176; hospitalizaciones por agudizaci&#243;n grave a&#241;o previo&#44;n&#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#46;442&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1248 &#40;64&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">494 &#40;100&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>&#8805;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">700 &#40;35&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">FEV</span><span class="elsevierStyleInf"><span class="elsevierStyleItalic">1</span></span><span class="elsevierStyleItalic">posbr &#37;&#44;m &#40;DE&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#46;442&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">46&#44;06 &#40;16&#44;59&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">66&#46;77 &#40;11&#46;60&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">FEV1 posbd &#37;&#44; n&#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#46;442&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>&#8805;50&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">710 &#40;36&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">494 &#40;100&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>&#60;50&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1238 &#40;63&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">BODE &#237;ndice&#44; m &#40;DE&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">518&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&#46;21 &#40;1&#46;83&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;60 &#40;1&#46;31&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">BODEx &#237;ndice&#44; m &#40;DE&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#46;436&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&#44;35 &#40;1&#44;67&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;50 &#40;0&#44;52&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">BODEx&#44; n&#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#46;436&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>0-2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">701 &#40;36&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">492 &#40;100&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>3-4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">772 &#40;39&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>5-6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">379 &#40;19&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>7-9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">92 &#40;4&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Tratamiento&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#46;408&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Monoterapia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">125 &#40;6&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">167&#40;34&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>LAMA&#43;LABA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">477 &#40;24&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">126 &#40;26&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>LABA&#43;CSI&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">138 &#40;7&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">50 &#40;10&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>LAMA&#43;LABA&#43;CSI&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1035 &#40;53&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">132 &#40;27&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Cu&#225;druple</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">153 &#40;7&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5 &#40;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Oxigenoterapia domiciliaria continua&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#46;442&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">624 &#40;32&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">20 &#40;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">VMD&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#46;442&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">171 &#40;8&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">29 &#40;5&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;035&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Programa de rehabilitaci&#243;n respiratoria&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#46;442&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">257 &#40;13&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">13 &#40;2&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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          "es" => "<p id="spar0100" class="elsevierStyleSimplePara elsevierViewall">Caracter&#237;sticas cl&#237;nicas seg&#250;n el nivel de riesgo acorde a GesEPOC</p>"
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                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Factores cl&#237;nicos y epidemiol&#243;gicos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">OR &#40;95&#37;CI&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">p&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " colspan="3" align="left" valign="top"><span class="elsevierStyleItalic">Edad &#40;a&#241;os&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>&#8804;55 a&#241;os&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>&#62;55 a&#241;os&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;63 &#40;1&#44;16-2&#44;27&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;004&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">IMC &#40;kg&#47;m</span><span class="elsevierStyleSup"><span class="elsevierStyleItalic">2</span></span><span class="elsevierStyleItalic">&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;96 &#40;0&#44;94-0&#44;98&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="3" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="3" align="left" valign="top"><span class="elsevierStyleItalic">Tabaquismo activo</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>S&#237;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;60 &#40;0&#44;47-0&#44;75&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Charlson &#8805;&#160;3</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;33 &#40;1&#44;08-1&#44;65&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;008&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="3" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="3" align="left" valign="top"><span class="elsevierStyleItalic">Tos cr&#243;nica</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>S&#237;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#44;24 &#40;1&#44;80-2&#44;79&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="3" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="3" align="left" valign="top"><span class="elsevierStyleItalic">Colonizaci&#243;n</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>S&#237;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&#44;17 &#40;1&#44;59-6&#44;33&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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          "es" => "<p id="spar0110" class="elsevierStyleSimplePara elsevierViewall">Factores asociados al nivel de alto riesgo&#46; An&#225;lisis multivariante</p>"
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Total &#40;n&#160;&#61;&#160;2&#46;442&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Alto riesgo &#40;n&#160;&#61;&#160;1&#46;948&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Bajo riesgo &#40;n&#160;&#61;&#160;494&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">p&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Tipo de consulta de neumolog&#237;a</span> n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#46;442&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;155&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>General&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;337 &#40;68&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">356 &#40;72&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Monogr&#225;fica EPOC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">611 &#40;31&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">138 &#40;27&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Procedencia&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#46;030&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>&#193;rea de hospitalizaci&#243;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">365 &#40;22&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">48 &#40;11&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Urgencias&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">131 &#40;8&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">29 &#40;7&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Atenci&#243;n Primaria&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">670 &#40;41&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">205 &#40;50&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Otras especialidades&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">455 &#40;28&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">127 &#40;31&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Tiempo de revisi&#243;n</span>&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#46;371&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Menos 6 meses&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;052 &#40;55&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">158 &#40;32&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>6-12 meses&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">577 &#40;30&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">187 &#40;38&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>M&#225;s 12 meses&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">258 &#40;13&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">139 &#40;28&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Se solicitaban pruebas complementarias&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#46;442&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;176 &#40;60&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">323 &#40;65&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;044&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Tiempo seguimiento &#40;a&#241;os&#41;&#44; mediana &#40;P25-75&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#46;442&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4 &#40;3-7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3 &#40;2-6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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          "es" => "<p id="spar0115" class="elsevierStyleSimplePara elsevierViewall">Atenci&#243;n m&#233;dica seg&#250;n el nivel de riesgo</p>"
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      10 => array:8 [
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          "leyenda" => "<p id="spar0125" class="elsevierStyleSimplePara elsevierViewall">Alfa 1 AT&#58; &#945; 1 antitripsina&#59; BODE&#58; &#237;ndice de masa corporal&#44; obstrucci&#243;n al flujo a&#233;reo&#44; disnea y capacidad de ejercicio&#59; BODEx&#58; &#237;ndice de masa corporal&#44; obstrucci&#243;n al flujo a&#233;reo&#44; disnea y exacerbaciones graves&#59; Prueba BD&#58; prueba broncodilatadora&#59;</p><p id="spar0130" class="elsevierStyleSimplePara elsevierViewall">TAC&#58; tomograf&#237;a axial computarizada&#46;</p>"
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            0 => array:2 [
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                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Alto riesgo &#40;n&#160;&#61;&#160;1&#46;948&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Bajo riesgo &#40;n &#61; 494&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">p&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Prueba BD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;213 &#40;62&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">349 &#40;70&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Gasometr&#237;a arterial&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;357 &#40;69&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">199 &#40;40&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Niveles Alfa 1 AT&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">468 &#40;24&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">124 &#40;25&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;328&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Cultivo de esputo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;046 &#40;53&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">137 &#40;27&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Vol&#250;menes pulmonares&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">929 &#40;47&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">177 &#40;35&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Difusi&#243;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;001 &#40;51&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">208 &#40;42&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Test de marcha 6<span class="elsevierStyleHsp" style=""></span>min&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">736 &#40;37&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">78 &#40;15&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Ergometr&#237;a respiratoria&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">85 &#40;4&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7 &#40;1&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">&#205;ndice BODE&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">466 &#40;23&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">52 &#40;10&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">&#205;ndice BODEx&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">217 &#40;11&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">40 &#40;8&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;027&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">TAC tor&#225;cico&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;216 &#40;62&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">226 &#40;45&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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          "es" => "<p id="spar0120" class="elsevierStyleSimplePara elsevierViewall">Procedimientos diagn&#243;sticos realizados seg&#250;n el nivel de riesgo</p>"
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      11 => array:8 [
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          "leyenda" => "<p id="spar0140" class="elsevierStyleSimplePara elsevierViewall">CAT&#58; COPD assessment test&#59; GOLD&#58; Global Initiative for Chronic Obstructive Lung Disease&#46;</p>"
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            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Alto riesgo n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Bajo riesgo n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">p&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">169 &#40;34&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;002&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">257 &#40;52&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;014&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Realizar cuestionario CAT&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">550 &#40;28&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">109 &#40;22&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;003&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Recoger tratamientos de la EPOC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;888 &#40;96&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">484 &#40;98&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;133&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;001 &#40;51&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">264 &#40;53&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;222&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">661 &#40;33&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">142 &#40;28&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;016&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">500 &#40;25&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">107 &#40;21&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;036&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Revisi&#243;n t&#233;cnica inhalatoria&nbsp;\t\t\t\t\t\t\n
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          "es" => "<p id="spar0135" class="elsevierStyleSimplePara elsevierViewall">Actuaciones realizadas seg&#250;n el nivel de riesgo</p>"
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