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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 tromboembolia de pulm&#243;n &#40;TEP&#41; constituye una enfermedad con un espectro amplio de manifestaciones cl&#237;nicas&#44; con diferente pron&#243;stico y tratamiento<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">1</span></a>&#46; En funci&#243;n de la situaci&#243;n hemodin&#225;mica y de la funci&#243;n del ventr&#237;culo derecho en el momento del diagn&#243;stico de la enfermedad se distinguen la TEP de <span class="elsevierStyleItalic">alto riesgo</span> &#40;antiguamente denominada TEP masiva&#41;&#44; que se caracteriza por la presencia de hipotensi&#243;n arterial o shock&#59; la TEP de <span class="elsevierStyleItalic">riesgo intermedio</span> &#40;antigua TEP submasiva&#41;&#44; presente en los pacientes normotensos con disfunci&#243;n del ventr&#237;culo derecho y da&#241;o mioc&#225;rdico&#59; y la TEP de <span class="elsevierStyleItalic">riesgo bajo</span>&#44; en la que el paciente se encuentra estable hemodin&#225;micamente y la funci&#243;n del ventr&#237;culo derecho es normal<a class="elsevierStyleCrossRefs" href="#bib0140"><span class="elsevierStyleSup">2-4</span></a>&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">No obstante&#44; el pron&#243;stico a corto plazo de los pacientes con TEP aguda sintom&#225;tica depende no solo de la gravedad de la presentaci&#243;n de la TEP&#44; sino tambi&#233;n de las caracter&#237;sticas basales de los pacientes y del factor desencadenante del evento tromb&#243;tico&#46; En este sentido&#44; los pacientes con TEP secundaria a c&#225;ncer tienen un pron&#243;stico significativamente peor que los pacientes con TEP secundaria a inmovilizaci&#243;n m&#233;dica<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">5</span></a>&#46; Los pacientes con TEP secundaria a cirug&#237;a mayor presentan el mejor pron&#243;stico a corto plazo<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">6</span></a>&#46; Varios estudios han demostrado que los viajes a&#233;reos prolongados &#40;s&#237;ndrome de clase turista &#91;SCT&#93;&#41; constituyen un factor de riesgo para la TEP aguda sintom&#225;tica<a class="elsevierStyleCrossRefs" href="#bib0165"><span class="elsevierStyleSup">7-9</span></a>&#46; Sin embargo&#44; no se conocen suficientemente la forma cl&#237;nica de presentaci&#243;n y el pron&#243;stico a corto plazo de los pacientes con SCT&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">El objetivo de este estudio fue analizar las caracter&#237;sticas basales de una cohorte de pacientes con TEP aguda sintom&#225;tica&#44; estratificadas seg&#250;n el factor de riesgo desencadenante &#40;SCT vs&#46; otros&#41;&#46; Asimismo&#44; comparamos el pron&#243;stico a corto plazo de los pacientes con TEP secundaria a SCT con el de los pacientes con TEP idiop&#225;tica&#44; secundaria a c&#225;ncer&#44; secundaria a inmovilizaci&#243;n y secundaria a cirug&#237;a&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">M&#233;todo</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Dise&#241;o</span><p id="par0020" class="elsevierStylePara elsevierViewall">Se ha realizado un estudio observacional retrospectivo en el que se analizaron las caracter&#237;sticas basales y el pron&#243;stico a corto plazo de una cohorte de pacientes estables e inestables con TEP aguda sintom&#225;tica&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Pacientes y criterios de selecci&#243;n</span><p id="par0025" class="elsevierStylePara elsevierViewall">Se incluyeron en el estudio todos los pacientes diagnosticados consecutivamente de TEP aguda sintom&#225;tica en el servicio de urgencias del Hospital Ram&#243;n y Cajal &#40;Madrid&#44; Espa&#241;a&#41; entre enero de 2003 y junio de 2016&#46; El diagn&#243;stico de TEP se confirm&#243; mediante el hallazgo en la angiotomograf&#237;a computarizada &#40;TC&#41; de un defecto intraluminal parcial rodeado de contraste o una oclusi&#243;n completa de una arteria pulmonar en dos cortes consecutivos de TC<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">10</span></a>&#46; El diagn&#243;stico de TEP mediante gammagraf&#237;a de ventilaci&#243;n&#47;perfusi&#243;n se realiz&#243; en los casos de alta probabilidad definidos seg&#250;n criterios PIOPED<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">11</span></a> &#40;al menos un defecto de perfusi&#243;n segmentario o dos subsegmentarios con ventilaci&#243;n normal&#41;&#44; o en los casos con sospecha cl&#237;nica de TEP&#44; gammagraf&#237;a no concluyente y ecograf&#237;a de miembros inferiores diagn&#243;stica que mostrase un defecto de compresibilidad de la luz venosa como signo de trombosis venosa profunda &#40;TVP&#41;<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">12</span></a>&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Intervenciones</span><p id="par0030" class="elsevierStylePara elsevierViewall">Los pacientes fueron tratados con heparina de bajo peso molecular &#40;HBPM&#41; a dosis ajustadas al peso del paciente cada 12<span class="elsevierStyleHsp" style=""></span>h durante un m&#237;nimo de 5<span class="elsevierStyleHsp" style=""></span>d&#237;as&#46; Se inici&#243; la administraci&#243;n de antagonistas de la vitamina<span class="elsevierStyleHsp" style=""></span>K junto con la HBPM entre el primer y el tercer d&#237;a de tratamiento y la HBPM fue interrumpida cuando la raz&#243;n normalizada internacional &#40;<span class="elsevierStyleItalic">international normalized ratio</span> &#91;INR&#93;&#41; era estable y superior a 2&#44;0&#46; La monitorizaci&#243;n de los niveles de INR se realiz&#243; de acuerdo con las pr&#225;cticas locales del centro&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">El tratamiento de recanalizaci&#243;n &#40;trombol&#237;ticos&#44; fragmentaci&#243;n o embolectom&#237;a&#41; se emple&#243; en los pacientes inestables hemodin&#225;micamente a criterio del m&#233;dico responsable&#46; De forma general&#44; la fragmentaci&#243;n mec&#225;nica y la embolectom&#237;a se reservaron para los pacientes inestables con contraindicaci&#243;n para la tromb&#243;lisis&#46; Se insert&#243; un filtro de vena cava a los pacientes con contraindicaci&#243;n para la anticoagulaci&#243;n &#40;sangrado activo o alto riesgo de sangrado&#41;&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Definiciones seg&#250;n el factor desencadenante</span><p id="par0040" class="elsevierStylePara elsevierViewall">Los pacientes del estudio fueron clasificados en uno o varios de los siguientes grupos&#58;<ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005"><span class="elsevierStyleLabel">1&#46;</span><p id="par0045" class="elsevierStylePara elsevierViewall">SCT en los pacientes que realizaron un viaje de m&#225;s de 4<span class="elsevierStyleHsp" style=""></span>h de duraci&#243;n en el mes previo al diagn&#243;stico de TEP&#44; con independencia del medio de transporte&#46;</p></li><li class="elsevierStyleListItem" id="lsti0010"><span class="elsevierStyleLabel">2&#46;</span><p id="par0050" class="elsevierStylePara elsevierViewall">C&#225;ncer&#44; activo o en tratamiento&#44; en el a&#241;o previo al diagn&#243;stico de TEP&#46;</p></li><li class="elsevierStyleListItem" id="lsti0015"><span class="elsevierStyleLabel">3&#46;</span><p id="par0055" class="elsevierStylePara elsevierViewall">Cirug&#237;a&#44; en el mes previo al diagn&#243;stico de TEP&#46;</p></li><li class="elsevierStyleListItem" id="lsti0020"><span class="elsevierStyleLabel">4&#46;</span><p id="par0060" class="elsevierStylePara elsevierViewall">Inmovilizaci&#243;n&#44; en los pacientes no quir&#250;rgicos encamados 4 o m&#225;s d&#237;as en el mes previo al diagn&#243;stico de TEP&#46;</p></li><li class="elsevierStyleListItem" id="lsti0025"><span class="elsevierStyleLabel">5&#46;</span><p id="par0065" class="elsevierStylePara elsevierViewall">Embarazo&#44; puerperio&#44; uso de anticonceptivos orales&#44; en el mes previo al diagn&#243;stico de TEP&#46;</p></li><li class="elsevierStyleListItem" id="lsti0030"><span class="elsevierStyleLabel">6&#46;</span><p id="par0070" class="elsevierStylePara elsevierViewall">Idiop&#225;tica&#44; en ausencia de cualquiera de los desencadenantes anteriores&#46;</p></li></ul></p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Episodios analizados</span><p id="par0075" class="elsevierStylePara elsevierViewall">Definimos como par&#225;metro de valoraci&#243;n principal la mortalidad por todas las causas en el mes posterior al diagn&#243;stico&#46; Los par&#225;metros secundarios fueron la mortalidad por la propia TEP&#44; las recurrencias tromboemb&#243;licas no mortales objetivamente confirmadas y los sangrados mayores no mortales en el mes posterior al diagn&#243;stico&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">Los criterios diagn&#243;sticos de recurrencia tromb&#243;tica no mortal fueron la presencia de un nuevo defecto intraluminal en el angio-TC o un nuevo defecto de ventilaci&#243;n&#47;perfusi&#243;n en la gammagraf&#237;a pulmonar&#59; un nuevo segmento venoso no compresible&#44; o el aumento del di&#225;metro del trombo de al menos 4<span class="elsevierStyleHsp" style=""></span>mm en la ecograf&#237;a de miembros inferiores<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">13</span></a>&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">Se definieron los sangrados mayores no mortales como aquellos que requirieron transfusi&#243;n de al menos dos concentrados de hemat&#237;es&#44; que requirieron cirug&#237;a&#44; o las hemorragias de localizaci&#243;n cerebral&#44; retroperitoneal y articular<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">14</span></a>&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">An&#225;lisis estad&#237;stico</span><p id="par0090" class="elsevierStylePara elsevierViewall">Las variables continuas se expresaron como media &#177;<span class="elsevierStyleHsp" style=""></span>desviaci&#243;n est&#225;ndar o la mediana &#40;intervalo intercuart&#237;lico&#41; seg&#250;n procediera&#44; y se compararon con el test de la t de Student &#40;o la prueba de la U de Mann-Whitney para los datos asim&#233;tricos&#41;&#46; Las variables categ&#243;ricas se representaron como porcentajes y se compararon con el test de chi-cuadrado&#44; o con el test exacto de Fisher en caso necesario&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">Se estimaron las curvas de incidencia acumulada mediante el m&#233;todo de Kaplan-Meier y se compararon mediante la prueba de <span class="elsevierStyleItalic">log rank</span><a class="elsevierStyleCrossRefs" href="#bib0205"><span class="elsevierStyleSup">15&#44;16</span></a>&#46; Para evaluar la posible asociaci&#243;n independiente entre el SCT y la mortalidad se construy&#243; un modelo de regresi&#243;n log&#237;stica multivariable<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">17</span></a>&#46; Se especific&#243; un modelo m&#225;ximo de 14 variables seleccionadas en funci&#243;n de la experiencia publicada y de la opini&#243;n de expertos&#46; Las variables fueron&#58; a&#41;<span class="elsevierStyleHsp" style=""></span>edad&#59; b&#41;<span class="elsevierStyleHsp" style=""></span>sexo&#59; c&#41;<span class="elsevierStyleHsp" style=""></span>enfermedad pulmonar obstructiva cr&#243;nica &#40;EPOC&#41;&#59; d&#41;<span class="elsevierStyleHsp" style=""></span>insuficiencia cardiaca congestiva &#40;ICC&#41;&#59; e&#41;<span class="elsevierStyleHsp" style=""></span>frecuencia cardiaca&#59; f&#41;<span class="elsevierStyleHsp" style=""></span>presi&#243;n arterial sist&#243;lica&#59; g&#41;<span class="elsevierStyleHsp" style=""></span>disnea&#59; h&#41;<span class="elsevierStyleHsp" style=""></span>dolor tor&#225;cico&#59; i&#41;<span class="elsevierStyleHsp" style=""></span>s&#237;ncope&#59; j&#41;<span class="elsevierStyleHsp" style=""></span>SCT&#59; k&#41;<span class="elsevierStyleHsp" style=""></span>c&#225;ncer&#59; l&#41;<span class="elsevierStyleHsp" style=""></span>cirug&#237;a reciente&#59; m&#41;<span class="elsevierStyleHsp" style=""></span>inmovilizaci&#243;n&#44; y n&#41;<span class="elsevierStyleHsp" style=""></span>escala <span class="elsevierStyleItalic">Pulmonary Embolism Severity Index</span> &#40;PESI&#41; simplificada<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">18</span></a>&#46; El an&#225;lisis fue construido partiendo del modelo m&#225;ximo y por exclusi&#243;n <span class="elsevierStyleItalic">&#40;backward&#41;</span> de variables&#46; Se mantuvieron en el modelo las variables confusoras &#40;es decir&#44; el coeficiente de la variable evaluada se modificaba m&#225;s del 10&#37; cuando se eliminaba la variable confusora del modelo&#41; del efecto del SCT sobre el par&#225;metro de valoraci&#243;n principal&#46; Se calcularon las <span class="elsevierStyleItalic">odds ratio</span> &#40;OR&#41; con su intervalos del confianza del 95&#37; &#40;IC<span class="elsevierStyleHsp" style=""></span>95&#37;&#41;&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">Para el an&#225;lisis estad&#237;stico empleamos el programa SPSS &#40;versi&#243;n 19&#46;0&#44; SPSS Inc&#46;&#44; Chicago&#44; Illinois&#44; EE&#46;UU&#46;&#41;&#46; Se consider&#243; como resultado estad&#237;sticamente significativo un valor bilateral de p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#46;</p></span></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Resultados</span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Pacientes</span><p id="par0105" class="elsevierStylePara elsevierViewall">Durante el per&#237;odo de estudio se evaluaron 12&#46;629 pacientes con sospecha de TEP aguda sintom&#225;tica&#44; y el diagn&#243;stico se confirm&#243; en 2&#46;445 &#40;19&#44;4&#37;&#41;&#46; De ellos&#44; 113 fueron perdidos durante el seguimiento&#44; por lo que la muestra final fue de 2&#46;333 pacientes &#40;1&#46;089 hombres y 1&#46;244 mujeres&#41;&#44; el 95&#37; de la poblaci&#243;n evaluada &#40;<a class="elsevierStyleCrossRef" href="#fig0005">fig&#46; 1</a>&#41;&#46; No se encontraron diferencias estad&#237;sticamente significativas entre las variables basales de los pacientes incluidos y excluidos&#46; Aproximadamente el 70&#37; de los pacientes &#40;1&#46;659&#47;2&#46;333&#41; fueron diagnosticados mediante angio-TC de t&#243;rax&#44; 744 &#40;32&#37;&#41; mediante gammagraf&#237;a ventilaci&#243;n&#47;perfusi&#243;n de alta probabilidad&#44; y 76 &#40;3&#37;&#41; tuvieron pruebas tor&#225;cicas negativas y TVP confirmada mediante ecograf&#237;a de miembros inferiores&#46; Algunos pacientes tuvieron varias pruebas diagn&#243;sticas positivas simult&#225;neamente&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0110" class="elsevierStylePara elsevierViewall">Las caracter&#237;sticas de los pacientes incluidos en el estudio se muestran en <a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a>&#46; El n&#250;mero de pacientes tratados con filtros de vena cava inferior fue bajo &#40;2&#44;2&#37;&#59; 52 de 2&#46;333 pacientes&#41;&#46; Un 4&#37; &#40;103 de 2&#46;333 pacientes&#41; fueron tratados con trombol&#237;ticos&#46; Los pacientes con SCT eran menos frecuentemente varones &#40;34&#37; frente a 47&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;01&#41;&#44; m&#225;s j&#243;venes &#40;55&#44;8<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>14&#44;2 frente a 69&#44;6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>16&#44;5&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41; y ten&#237;an menos EPOC &#40;0&#37; frente a 8&#44;1&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#44; insuficiencia cardiaca &#40;0&#44;8&#37; frente a 6&#44;0&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;01&#41;&#44; c&#225;ncer &#40;4&#44;8&#37; frente a 21&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41; y antecedentes de hemorragia reciente &#40;0&#37; frente a 3&#44;4&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;03&#41;&#46; Una proporci&#243;n mayor de pacientes con SCT fueron clasificados de bajo riesgo seg&#250;n la escala PESI simplificada &#40;45&#37; frente a 29&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#46; La presentaci&#243;n de la TEP fue m&#225;s grave en los pacientes con SCT&#46; Comenzaron m&#225;s frecuentemente con s&#237;ncope &#40;48&#37; frente a 14&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#44; taquicardia &#40;37&#37; frente a 21&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#44; disfunci&#243;n del ventr&#237;culo derecho &#40;VD&#41; &#40;31&#37; frente a 19&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;01&#41; y da&#241;o mioc&#225;rdico &#40;57&#37; frente a 28&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41; que los pacientes con TEP idiop&#225;tica o secundaria a otras etiolog&#237;as&#46; Los pacientes con SCT presentaron menos frecuentemente TVP residual &#40;45&#37; frente a 57&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;02&#41;&#46; En relaci&#243;n con el tratamiento&#44; los pacientes con SCT recibieron con m&#225;s frecuencia tratamiento trombol&#237;tico &#40;9&#44;8&#37; frente a 4&#44;1&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;01&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0115" class="elsevierStylePara elsevierViewall">De los 2&#46;333 pacientes&#44; 213 &#40;9&#44;1&#37;&#59; IC<span class="elsevierStyleHsp" style=""></span>95&#37;&#58; 8&#44;0-10&#44;4&#41; fallecieron durante los primeros 30<span class="elsevierStyleHsp" style=""></span>d&#237;as de seguimiento &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">tabla 2</a>&#41;&#46; Setenta y seis pacientes &#40;36&#37;&#41; fallecieron por la propia TEP&#44; 59 &#40;28&#37;&#41; por c&#225;ncer&#44; 25 &#40;12&#37;&#41; por infecci&#243;n&#44; 10 &#40;4&#44;7&#37;&#41; por insuficiencia cardiaca&#44; 8 &#40;3&#44;8&#37;&#41; por hemorragia y 35 &#40;16&#37;&#41; por otras causas&#46; El evento secundario se produjo en 75 pacientes&#59; 21 pacientes presentaron una recurrencia tromb&#243;tica objetivamente confirmada&#44; 50 pacientes sufrieron una hemorragia mayor no mortal y 4 pacientes sangraron y presentaron recurrencia simult&#225;neamente&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0120" class="elsevierStylePara elsevierViewall">Los pacientes con SCT tuvieron un riesgo significativamente menor de fallecer por cualquier causa que los pacientes con TEP idiop&#225;tica o secundaria a otros desencadenantes &#40;prueba de <span class="elsevierStyleItalic">log rank</span>&#44; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;01&#59; <a class="elsevierStyleCrossRef" href="#fig0015">fig&#46; 2</a>&#41;&#46; Por otra parte&#44; la mortalidad por la propia TEP durante el primer mes de seguimiento no fue distinta en los pacientes con TEP secundaria a SCT que en el resto de pacientes &#40;prueba de <span class="elsevierStyleItalic">log rank</span>&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;11&#41;&#46; Ninguno de los pacientes con SCT experiment&#243; una recurrencia tromboemb&#243;lica&#44; y solo uno &#40;0&#44;8&#37;&#41; present&#243; un sangrado mayor no fatal en los primeros 30<span class="elsevierStyleHsp" style=""></span>d&#237;as de seguimiento&#46;</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0125" class="elsevierStylePara elsevierViewall">En el an&#225;lisis univariable&#44; la edad &#62;<span class="elsevierStyleHsp" style=""></span>80<span class="elsevierStyleHsp" style=""></span>a&#241;os &#40;OR&#58; 1&#44;82&#59; IC<span class="elsevierStyleHsp" style=""></span>95&#37;&#58; 1&#44;36-2&#44;44&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#44; algunas comorbilidades &#40;EPOC &#91;OR&#58; 2&#44;15&#59; IC<span class="elsevierStyleHsp" style=""></span>95&#37;&#58; 1&#44;41-3&#44;28&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#93;&#44; insuficiencia cardiaca &#91;OR&#58; 2&#44;59&#59; IC<span class="elsevierStyleHsp" style=""></span>95&#37;&#58; 1&#44;64-4&#44;07&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#93;&#44; c&#225;ncer &#91;OR&#58; 3&#44;60&#59; IC<span class="elsevierStyleHsp" style=""></span>95&#37;&#58; 2&#44;68-4&#44;82&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#93;&#44; inmovilizaci&#243;n de causa m&#233;dica &#91;OR&#58; 1&#44;82&#59; IC<span class="elsevierStyleHsp" style=""></span>95&#37;&#58; 1&#44;33-2&#44;49&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#93;&#41;&#44; y la forma de presentaci&#243;n cl&#237;nica &#40;taquicardia &#91;OR&#58; 1&#44;55&#59; IC<span class="elsevierStyleHsp" style=""></span>95&#37;&#58; 1&#44;13-2&#44;12&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;01&#93;&#44; hipotensi&#243;n &#91;OR&#58; 2&#44;90&#59; IC<span class="elsevierStyleHsp" style=""></span>95&#37;&#58; 1&#44;99-4&#44;23&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#93;&#44; y una escala PESI simplificada de alto riesgo &#91;OR&#58; 7&#44;25&#59; IC<span class="elsevierStyleHsp" style=""></span>95&#37;&#58; 4&#44;11-12&#44;80&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#93;&#41; incrementaron significativamente el riesgo de muerte por todas las causas en los 30<span class="elsevierStyleHsp" style=""></span>d&#237;as posteriores al diagn&#243;stico de la TEP &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">tabla 3</a>&#41;&#46; Por el contrario&#44; los antecedentes de cirug&#237;a reciente &#40;OR&#58; 0&#44;39&#59; IC<span class="elsevierStyleHsp" style=""></span>95&#37;&#58; 0&#44;19-0&#44;81&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;01&#41; y el SCT &#40;OR&#58; 0&#44;16&#59; IC<span class="elsevierStyleHsp" style=""></span>95&#37;&#58; 0&#44;04-0&#44;63&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;01&#41; se asociaron a una reducci&#243;n estad&#237;sticamente significativa del riesgo de muerte&#46; En el an&#225;lisis multivariable&#44; el SCT se asoci&#243; de forma independiente a la mortalidad por todas las causas durante los primeros 30<span class="elsevierStyleHsp" style=""></span>d&#237;as de seguimiento &#40;OR&#58; 0&#44;22&#59; IC<span class="elsevierStyleHsp" style=""></span>95&#37;&#58; 0&#44;05-0&#44;94&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;04&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0020">tabla 4</a>&#41;&#46; El SCT no se asoci&#243; de forma independiente a la mortalidad por la propia TEP durante los primeros 30<span class="elsevierStyleHsp" style=""></span>d&#237;as de seguimiento &#40;OR&#58; 0&#44;37&#59; IC<span class="elsevierStyleHsp" style=""></span>95&#37;&#58; 0&#44;05-2&#44;77&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;33&#41;&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><elsevierMultimedia ident="tbl0020"></elsevierMultimedia></span></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Discusi&#243;n</span><p id="par0130" class="elsevierStylePara elsevierViewall">El presente estudio ha analizado la presentaci&#243;n cl&#237;nica y el pron&#243;stico a corto plazo del SCT en una cohorte amplia de pacientes con TEP aguda sintom&#225;tica&#46; Nuestros resultados indican que la TEP de los pacientes con SCT produce con m&#225;s frecuencia disfunci&#243;n del ventr&#237;culo derecho y da&#241;o mioc&#225;rdico que la TEP idiop&#225;tica o secundaria a otros desencadenantes&#46; Sin embargo&#44; el pron&#243;stico a corto plazo de estos pacientes es excelente&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">Nuestros resultados indican que&#44; aunque los pacientes con TEP secundaria a SCT son m&#225;s j&#243;venes y tienen menos comorbilidad &#40;p&#46;<span class="elsevierStyleHsp" style=""></span>ej&#46;&#44; EPOC&#44; insuficiencia cardiaca&#41; que los pacientes con TEP idiop&#225;tica o secundaria a otros desencadenantes&#44; su forma de presentaci&#243;n es m&#225;s grave&#46; De hecho&#44; comenzaron m&#225;s frecuentemente con s&#237;ncope&#44; taquicardia e hipotensi&#243;n&#44; todos ellos factores de mal pron&#243;stico en la fase aguda de la TEP<a class="elsevierStyleCrossRefs" href="#bib0225"><span class="elsevierStyleSup">19-22</span></a>&#46; Hay que destacar que la disfunci&#243;n del ventr&#237;culo derecho y la necrosis mioc&#225;rdica fueron significativamente m&#225;s frecuentes en estos pacientes&#46; Estos resultados son similares a los de un estudio previo que evalu&#243; la forma de presentaci&#243;n de los pacientes con SCT<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">23</span></a>&#46; No se conocen los motivos por los que estos pacientes tienen esta presentaci&#243;n&#46; Se podr&#237;an sugerir algunos mecanismos&#46; Por un lado&#44; la hipoxia de la cabina del avi&#243;n incrementa la presi&#243;n arterial pulmonar y podr&#237;a empeorar la funci&#243;n del ventr&#237;culo derecho<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">24</span></a>&#46; Por otro lado&#44; la TVP residual fue menos frecuente en los pacientes con SCT que en los pacientes con TEP idiop&#225;tica o secundaria a otros desencadenantes&#59; y podr&#237;a ocurrir que en estos pacientes la totalidad del trombo formado en los miembros inferiores embolizara y la TEP presentara mayor carga tromb&#243;tica&#46;</p><p id="par0140" class="elsevierStylePara elsevierViewall">A pesar de presentarse con una TEP m&#225;s grave&#44; el pron&#243;stico a corto plazo de estos pacientes es excelente&#44; y significativamente mejor que el de los pacientes con TEP secundaria a c&#225;ncer o a inmovilizaci&#243;n&#46; Estos hallazgos se explican porque&#44; aunque la mortalidad precoz &#40;en los primeros d&#237;as&#41; de los pacientes con TEP es la consecuencia del fracaso del ventr&#237;culo derecho&#44; la mortalidad tard&#237;a es el resultado de la comorbilidad de los pacientes<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">25</span></a>&#46;</p><p id="par0145" class="elsevierStylePara elsevierViewall">&#191;Cu&#225;les son las consecuencias cl&#237;nicas de este estudio&#63; Las gu&#237;as de pr&#225;ctica cl&#237;nica desaconsejan el uso de tratamiento fibrinol&#237;tico en pacientes con TEP de riesgo intermedio-alto&#46; El ensayo cl&#237;nico PEITHO analiz&#243; la eficacia y seguridad del tratamiento con tenecteplasa en pacientes normotensos con TEP que presentaban disfunci&#243;n del ventr&#237;culo derecho y da&#241;o mioc&#225;rdico&#46; Aunque el tratamiento fibrinol&#237;tico redujo significativamente el colapso hemodin&#225;mico de estos pacientes&#44; la mortalidad no se modific&#243; y los sangrados graves fueron significativamente m&#225;s frecuentes en aquellos que recibieron fibrin&#243;lisis<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">26</span></a>&#46; Nuestros resultados refuerzan esta recomendaci&#243;n en el subgrupo de pacientes con TEP secundaria a SCT&#46; Aunque su forma de presentaci&#243;n sea m&#225;s grave &#40;p&#46;<span class="elsevierStyleHsp" style=""></span>ej&#46;&#44; TEP de riesgo intermedio-alto&#41;&#44; su pron&#243;stico es excelente cuando reciben tratamiento anticoagulaci&#243;n convencional&#46;</p><p id="par0150" class="elsevierStylePara elsevierViewall">Este estudio tiene algunas limitaciones&#46; En primer lugar&#44; al tratarse de un an&#225;lisis de una cohorte hist&#243;rica compuesta por pacientes de un &#250;nico centro est&#225; sujeto a los sesgos inherentes a este tipo de estudios y los resultados no son generalizables&#46; Sin embargo&#44; representa una poblaci&#243;n no seleccionada de pacientes con TEP de nuestro medio de pr&#225;ctica cl&#237;nica habitual&#44; por lo que supone una muestra ideal para evaluar la forma de presentaci&#243;n y el pron&#243;stico de los pacientes con SCT&#46; En segundo lugar&#44; no pudimos medir la carga tromb&#243;tica de nuestros pacientes&#44; por lo que no es posible establecer una asociaci&#243;n entre el grado de obstrucci&#243;n arterial pulmonar y la presencia o ausencia de disfunci&#243;n del ventr&#237;culo derecho&#46;</p><p id="par0155" class="elsevierStylePara elsevierViewall">En conclusi&#243;n&#44; nuestros resultados muestran que los pacientes con TEP secundaria a SCT tienen menos comorbilidad que los pacientes con TEP idiop&#225;tica o secundaria a otras causas&#46; Aunque se presentan con m&#225;s frecuencia como TEP de riesgo intermedio-alto&#44; su pron&#243;stico a corto plazo es excelente con tratamiento anticoagulante convencional&#46; Se requieren estudios bien dise&#241;ados para conocer el motivo por el que estos pacientes presentan m&#225;s frecuentemente disfunci&#243;n del ventr&#237;culo derecho y da&#241;o mioc&#225;rdico en la fase aguda de la TEP&#46;</p></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Conflicto de intereses</span><p id="par0160" class="elsevierStylePara elsevierViewall">Los autores declaran no tener ning&#250;n conflicto de intereses&#46;</p></span></span>"
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        "titulo" => "Resumen"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objetivo</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">No se conocen suficientemente las caracter&#237;sticas cl&#237;nicas y el pron&#243;stico de los pacientes con tromboembolia de pulm&#243;n &#40;TEP&#41; aguda sintom&#225;tica asociada a los viajes prolongados &#40;s&#237;ndrome de clase turista &#91;SCT&#93;&#41;&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">M&#233;todos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Se analizaron retrospectivamente las caracter&#237;sticas basales de los pacientes con TEP aguda y se estratificaron seg&#250;n el factor de riesgo desencadenante&#46; Se determinaron la mortalidad por todas las causas&#44; la mortalidad por la propia TEP&#44; las recurrencias tromb&#243;ticas no fatales y los sangrados mayores no fatales durante los primeros 30<span class="elsevierStyleHsp" style=""></span>d&#237;as de seguimiento&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">De los 2&#46;333 pacientes incluidos&#44; un total de 124 &#40;5&#44;3&#37;&#59; intervalo de confianza del 95&#37;&#58; 4&#44;4-6&#44;3&#41; fueron diagnosticados de TEP secundaria a SCT&#46; Estos pacientes fueron m&#225;s j&#243;venes&#44; presentaron menos frecuentemente comorbilidad y m&#225;s frecuentemente s&#237;ncope &#40;48&#37; vs&#46; 14&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#44; taquicardia &#40;37&#37; vs&#46; 21&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#44; disfunci&#243;n de ventr&#237;culo derecho &#40;VD&#41; &#40;31&#37; vs&#46; 19&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;01&#41; y da&#241;o mioc&#225;rdico &#40;57&#37; vs&#46; 28&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41; que los dem&#225;s pacientes con TEP&#46; La mortalidad por todas las causas a 30<span class="elsevierStyleHsp" style=""></span>d&#237;as fue significativamente menor para los pacientes con TEP secundaria a SCT &#40;1&#44;6&#37; vs&#46; 9&#44;6&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;01&#41;&#46; La mortalidad a 30<span class="elsevierStyleHsp" style=""></span>d&#237;as por TEP no fue diferente entre los dos grupos de pacientes &#40;0&#44;8&#37; vs&#46; 3&#44;1&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;18&#41;&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Los pacientes con TEP y SCT son m&#225;s j&#243;venes y tienen menos comorbilidad que los dem&#225;s pacientes con TEP&#46; Aunque se presentan m&#225;s frecuentemente con disfunci&#243;n de VD y da&#241;o mioc&#225;rdico&#44; el pron&#243;stico a corto plazo es excelente&#46;</p></span>"
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        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Objective</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Clinical presentation and short-term prognosis of patients with travel-associated acute pulmonary embolism &#40;PE&#41; &#40;i&#46;e&#46;&#44; economy class syndrome &#91;ECS&#93;&#41; is not well understood&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Methods</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">In this retrospective cohort study of patients with acute PE identified from a single center registry&#44; we assessed the clinical presentation and the association between ECS and the outcomes of all-cause mortality&#44; PE-related mortality&#44; nonfatal venous thromboembolism and nonfatal major bleeding rates through 30<span class="elsevierStyleHsp" style=""></span>days after initiation of PE treatment&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Of the 2&#44;333 patients with acute symptomatic PE&#44; 124 &#40;5&#46;3&#37;&#59; 95&#37; confidence interval&#44; 4&#46;4-6&#46;3&#37;&#41; had ECS&#46; Patients with ECS were younger and had fewer comorbid diseases &#40;recent bleeding&#44; chronic obstructive pulmonary disease&#44; congestive heart failure&#41;&#44; but they presented with more signs of clinical severity &#40;syncope &#91;48&#37; vs&#46; 14&#37;&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001&#93;&#44; tachycardia &#91;37&#37; vs&#46; 21&#37;&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001&#93;&#44; right ventricular dysfunction &#91;31&#37; vs&#46; 19&#37;&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;01&#93; and myocardial injury &#91;57&#37; vs&#46; 28&#37;&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001&#93;&#41; compared to those without ECS&#46; Regression analyses showed a significantly lower risk of all-cause mortality for patients with ECS compared to patients without ECS &#40;1&#46;6&#37; vs&#46; 9&#46;6&#37;&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;01&#41;&#46; We did not detect a difference in PE-related mortality at 30<span class="elsevierStyleHsp" style=""></span>days between those with and those without ECS &#40;0&#46;8&#37; vs&#46; 3&#46;1&#37;&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;18&#41;&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">PE patients with ECS are younger and have fewer comorbid diseases compared to those without ECS&#46; Though they present with more signs of clinical severity&#44; their short-term prognosis is excellent&#46;</p></span>"
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                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Todos<br>n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#46;333<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Inmovilizaci&#243;n<br>n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>477&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">Cirug&#237;a<br>n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>200&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="7" align="left" valign="top"><span class="elsevierStyleItalic">Caracter&#237;sticas cl&#237;nicas&#44; n &#40;&#37;&#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>Edad&#44; a&#241;os&#44; mediana &#40;percentiles 25-75&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">75 &#40;63-82&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">72 &#40;61-78&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">79 &#40;68-86&#41;&nbsp;\t\t\t\t\t\t\n
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                  \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>Edad<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>80 a&#241;os&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">285 &#40;29&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1 &#40;0&#44;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">79 &#40;17&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">210 &#40;44&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \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>Sexo var&#243;n&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">510 &#40;52&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">42 &#40;34&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">252 &#40;55&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">178 &#40;37&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">88 &#40;44&#37;&#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="7" 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="7" align="left" valign="top"><span class="elsevierStyleItalic">Comorbilidad&#44; n &#40;&#37;&#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>Antecedentes hemorragia grave<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">c</span></a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">19 &#40;1&#44;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0 &#40;0&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">11 &#40;2&#44;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">42 &#40;8&#44;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">10 &#40;5&#44;0&#37;&#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>EPOC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">180 &#40;7&#44;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">80 &#40;8&#44;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0 &#40;0&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">32 &#40;6&#44;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">53 &#40;11&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8 &#40;4&#44;0&#37;&#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>Insuficiencia cardiaca&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">134 &#40;5&#44;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">62 &#40;6&#44;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1 &#40;0&#44;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">13 &#40;2&#44;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">48 &#40;10&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5 &#40;2&#44;5&#37;&#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="7" 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="7" align="left" valign="top"><span class="elsevierStyleItalic">S&#237;ntomas y signos al diagn&#243;stico&#44; n &#40;&#37;&#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>S&#237;ncope&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">372 &#40;16&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">156 &#40;16&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">60 &#40;48&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">56 &#40;12&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">74 &#40;16&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">20 &#40;10&#37;&#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>Dolor tor&#225;cico&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;019 &#40;44&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">450 &#40;46&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">52 &#40;42&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">174 &#40;38&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">158 &#40;33&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">93 &#40;47&#37;&#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>Disnea&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;681 &#40;72&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">706 &#40;72&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">78 &#40;63&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">329 &#40;71&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">363 &#40;76&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">147 &#40;74&#37;&#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>S&#237;ntomas TVP&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">545 &#40;23&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">239 &#40;24&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">24 &#40;19&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">108 &#40;23&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">92 &#40;19&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">34 &#40;17&#37;&#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>Frecuencia cardiaca &#8805;<span class="elsevierStyleHsp" style=""></span>110&#47;min&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">498 &#40;21&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">206 &#40;21&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">46 &#40;37&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">93 &#40;20&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">115 &#40;24&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">42 &#40;21&#37;&#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>Saturaci&#243;n de la hemoglobina &#40;SaO<span class="elsevierStyleInf">2</span>&#41;<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>90&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">643 &#40;28&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">290 &#40;30&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">28 &#40;23&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">207 &#40;45&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">167 &#40;35&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">53 &#40;27&#37;&#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>PAS<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>90<span class="elsevierStyleHsp" style=""></span>mmHg&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">94 &#40;4&#44;0&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">31 &#40;3&#44;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4 &#40;3&#44;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">24 &#40;5&#44;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">30 &#40;6&#44;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8 &#40;4&#44;0&#37;&#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="7" 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="7" align="left" valign="top"><span class="elsevierStyleItalic">PESI simplificado &#40;18&#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>Bajo riesgo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">693 &#40;30&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">356 &#40;36&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">56 &#40;45&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0 &#40;0&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">97 &#40;20&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">69 &#40;34&#37;&#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>Alto riesgo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;640 &#40;70&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">626 &#40;64&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">68 &#40;55&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">462 &#40;100&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">380 &#40;80&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">131 &#40;66&#37;&#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="7" 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="7" align="left" valign="top"><span class="elsevierStyleItalic">Determinaciones anal&#237;ticas</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>Hemoglobina&#44; g&#47;dl&#44; mediana &#40;percentiles 25-75&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">13&#44;3 &#40;12&#44;0-14&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">13&#44;9 &#40;12&#44;7-15&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">13&#44;6 &#40;12&#44;6-14&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12&#44;4 &#40;10&#44;8-13&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12&#44;9 &#40;11&#44;9-13&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12&#44;3 &#40;10&#44;7-13&#44;5&#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>Creatinina<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>2<span class="elsevierStyleHsp" style=""></span>mg&#47;dl &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#44;306&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">89 &#40;3&#44;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">49 &#40;5&#44;0&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2 &#40;1&#44;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12 &#40;2&#44;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">28 &#40;5&#44;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4 &#40;2&#44;0&#37;&#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="7" 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="7" align="left" valign="top"><span class="elsevierStyleItalic">Ecograf&#237;a y biomarcadores&#44; n &#40;&#37;&#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>TVP concomitante &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#46;784&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;010 &#40;57&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">422 &#40;43&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">43 &#40;35&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">218 &#40;47&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">207 &#40;43&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">72 &#40;36&#37;&#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>Disfunci&#243;n ventr&#237;culo derecho &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#46;275&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">458 &#40;36&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">228 &#40;23&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">38 &#40;31&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">58 &#40;13&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">89 &#40;19&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">32 &#40;16&#37;&#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>BNP<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>100<span class="elsevierStyleHsp" style=""></span>pg&#47;ml &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>917&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">446 &#40;49&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">221 &#40;23&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">18 &#40;15&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">70 &#40;15&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">110 &#40;23&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">31 &#40;16&#37;&#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="7" 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="7" align="left" valign="top"><span class="elsevierStyleItalic">Tratamientos&#44; n &#40;&#37;&#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>Tromb&#243;lisis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">103 &#40;4&#44;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">51 &#40;5&#44;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12 &#40;9&#44;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9 &#40;1&#44;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">19 &#40;4&#44;0&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">10 &#40;5&#37;&#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>Filtro de vena cava inferior&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">52 &#40;2&#44;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">21 &#40;2&#44;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1 &#40;0&#44;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">10 &#40;2&#44;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">16 &#40;3&#44;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7 &#40;3&#44;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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            0 => array:3 [
              "identificador" => "tblfn0005"
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              "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Algunos pacientes presentaron varios factores de riesgo simult&#225;neamente&#46;</p>"
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            1 => array:3 [
              "identificador" => "tblfn0010"
              "etiqueta" => "b"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Dado que no se analizaron los pacientes con TEP secundaria a tratamiento hormonal sustitutivo&#44; uso de anticonceptivos orales&#44; embarazo&#44; puerperio o trombofilia hereditaria&#44; la suma de pacientes de las columnas no es 2&#46;333&#46;</p>"
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            2 => array:3 [
              "identificador" => "tblfn0015"
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              "nota" => "<p class="elsevierStyleNotepara" id="npar0015">En el mes previo&#46;</p>"
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          "es" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Caracter&#237;sticas basales y tratamiento de los pacientes del estudio<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a></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">Todos<br>n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#46;333&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">Idiop&#225;tica<br>n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>982&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">SCT<br>n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>124&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">C&#225;ncer<br>n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>462&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">Inmovilizaci&#243;n<br>n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>477&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">Cirug&#237;a<br>n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>200&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">Muerte por todas las causas&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">213 &#40;9&#44;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">54 &#40;5&#44;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2 &#40;1&#44;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">92 &#40;19&#44;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">65 &#40;13&#44;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8 &#40;4&#44;0&#37;&#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">Muerte por TEP&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">76 &#40;3&#44;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">19 &#40;1&#44;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1 &#40;0&#44;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">24 &#40;5&#44;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">30 &#40;6&#44;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3 &#40;1&#44;5&#37;&#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">Recurrencias no fatales&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">25 &#40;1&#44;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9 &#40;0&#44;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0 &#40;0&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7 &#40;1&#44;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5 &#40;1&#44;0&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6 &#40;3&#44;0&#37;&#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">Sangrados no fatales&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">54 &#40;2&#44;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">23 &#40;2&#44;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1 &#40;0&#44;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">11 &#40;2&#44;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">11 &#40;2&#44;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5 &#40;2&#44;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
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        "descripcion" => array:1 [
          "es" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Distribuci&#243;n de mortalidad y eventos adversos no mortales durante los primeros 30 d&#237;as de seguimiento<a class="elsevierStyleCrossRef" href="#tblfn0020"><span class="elsevierStyleSup">a</span></a></p>"
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          "leyenda" => "<p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">EPOC&#58; enfermedad pulmonar obstructiva cr&#243;nica&#59; FC&#58; frecuencia cardiaca&#59; ICC&#58; insuficiencia cardiaca congestiva&#59; OR&#58; <span class="elsevierStyleItalic">odds ratio</span>&#59; PAS&#58; presi&#243;n arterial sist&#243;lica&#59; PESI&#58; <span class="elsevierStyleItalic">Pulmonary Embolism Severity Index</span>&#59; SCT&#58; s&#237;ndrome de clase turista&#46;</p>"
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                0 => """
                  <table border="0" frame="\n
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                  \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">Variable predictora&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 no ajustado &#40;IC<span class="elsevierStyleHsp" style=""></span>95&#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
                  \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">Edad<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>80 a&#241;os&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#44;82 &#40;1&#44;36-2&#44;44&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60; 0&#44;001&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">EPOC&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60; 0&#44;001&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" 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">FC<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>110&#47;min&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60; 0&#44;01&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">PAS<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>100<span class="elsevierStyleHsp" style=""></span>mmHg&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#44;90 &#40;1&#44;99-4&#44;23&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" 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">Disnea&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#44;81 &#40;1&#44;27-2&#44;60&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60; 0&#44;01&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Dolor tor&#225;cico&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" 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">S&#237;ncope&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;02&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">SCT&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60; 0&#44;01&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">C&#225;ncer<a class="elsevierStyleCrossRef" href="#tblfn0025"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" 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">Cirug&#237;a reciente<a class="elsevierStyleCrossRef" href="#tblfn0030"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;39 &#40;0&#44;19-0&#44;81&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;01&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Inmovilizaci&#243;n<a class="elsevierStyleCrossRef" href="#tblfn0035"><span class="elsevierStyleSup">c</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#44;82 &#40;1&#44;33-2&#44;49&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" 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">PESI simplificado de alto riesgo &#40;18&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7&#44;25 &#40;4&#44;11-12&#44;80&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60; 0&#44;001&nbsp;\t\t\t\t\t\t\n
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                  """
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            1 => array:3 [
              "identificador" => "tblfn0030"
              "etiqueta" => "b"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0030">En el mes previo&#46;</p>"
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              "identificador" => "tblfn0035"
              "etiqueta" => "c"
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            ]
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        "descripcion" => array:1 [
          "es" => "<p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">An&#225;lisis univariable para mortalidad por todas las causas en pacientes con TEP</p>"
        ]
      ]
      5 => array:8 [
        "identificador" => "tbl0020"
        "etiqueta" => "Tabla 4"
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          0 => array:3 [
            "identificador" => "at4"
            "detalle" => "Tabla "
            "rol" => "short"
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        "tabla" => array:3 [
          "leyenda" => "<p id="spar0095" class="elsevierStyleSimplePara elsevierViewall">FC&#58; frecuencia cardiaca&#59; OR&#58; <span class="elsevierStyleItalic">odds ratio</span>&#59; PAS&#58; presi&#243;n arterial sist&#243;lica&#59; PESI&#58; <span class="elsevierStyleItalic">Pulmonary Embolism Severity Index</span>&#59; SCT&#58; s&#237;ndrome de clase turista&#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">Variable predictora&nbsp;\t\t\t\t\t\t\n
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                  \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">FC<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>110&#47;min&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;12&nbsp;\t\t\t\t\t\t\n
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                  \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">SCT&nbsp;\t\t\t\t\t\t\n
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                  \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">PESI simplificado de alto riesgo &#40;18&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60; 0&#44;01&nbsp;\t\t\t\t\t\t\n
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                  """
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            1 => array:3 [
              "identificador" => "tblfn0045"
              "etiqueta" => "b"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0045">En el mes previo&#46;</p>"
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          "es" => "<p id="spar0090" class="elsevierStyleSimplePara elsevierViewall">An&#225;lisis multivariable para mortalidad por todas las causas en pacientes con TEP</p>"
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    "bibliografia" => array:2 [
      "titulo" => "Bibliograf&#237;a"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:26 [
            0 => array:3 [
              "identificador" => "bib0135"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Acute pulmonary embolism&#58; Clinical outcomes in the International Coopeative Pulmonary Embolism Registry"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "S&#46;Z&#46; Goldhaber"
                            1 => "L&#46; Visani"
                            2 => "M&#46; de Rosa"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Lancet"
                        "fecha" => "1999"
                        "volumen" => "353"
                        "paginaInicial" => "1386"
                        "paginaFinal" => "1389"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10227218"
                            "web" => "Medline"
                          ]
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Original
Características clínicas y pronóstico de la tromboembolia pulmonar secundaria al síndrome de clase turista
Clinical Characteristics and Prognosis of Pulmonary Embolism Caused by Economy Class Syndrome
María Abellása, Ana Menéndezb, Raquel Morilloc, Luis Jara-Palomaresd, Deisy Barriosc, Rosa Nietoc, Esther Barberoc, Jesús Correse, Pedro Ruiz-Artachof, David Jiménezc,
Corresponding author
djimenez.hrc@gmail.com

Autor para correspondencia.
a Servicio de Cardiología, Hospital Ramón y Cajal, IRYCIS, Madrid, España
b Medicina Familiar y Comunitaria, Hospital Ramón y Cajal, IRYCIS, Madrid, España
c Servicio de Neumología, Hospital Ramón y Cajal, Universidad de Alcalá, IRYCIS, Madrid, España
d Unidad Médico-Quirúrgica de Enfermedades Respiratorias, Servicio de Neumología, Hospital Universitario Virgen del Rocío, CIBERES, Sevilla, España
e Servicio de Urgencias, Hospital Ramón y Cajal, IRYCIS, Madrid, España
f Servicio de Urgencias, Hospital Clínico San Carlos, IdISSC, Madrid, España
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introducci&#243;n</span><p id="par0005" class="elsevierStylePara elsevierViewall">La tromboembolia de pulm&#243;n &#40;TEP&#41; constituye una enfermedad con un espectro amplio de manifestaciones cl&#237;nicas&#44; con diferente pron&#243;stico y tratamiento<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">1</span></a>&#46; En funci&#243;n de la situaci&#243;n hemodin&#225;mica y de la funci&#243;n del ventr&#237;culo derecho en el momento del diagn&#243;stico de la enfermedad se distinguen la TEP de <span class="elsevierStyleItalic">alto riesgo</span> &#40;antiguamente denominada TEP masiva&#41;&#44; que se caracteriza por la presencia de hipotensi&#243;n arterial o shock&#59; la TEP de <span class="elsevierStyleItalic">riesgo intermedio</span> &#40;antigua TEP submasiva&#41;&#44; presente en los pacientes normotensos con disfunci&#243;n del ventr&#237;culo derecho y da&#241;o mioc&#225;rdico&#59; y la TEP de <span class="elsevierStyleItalic">riesgo bajo</span>&#44; en la que el paciente se encuentra estable hemodin&#225;micamente y la funci&#243;n del ventr&#237;culo derecho es normal<a class="elsevierStyleCrossRefs" href="#bib0140"><span class="elsevierStyleSup">2-4</span></a>&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">No obstante&#44; el pron&#243;stico a corto plazo de los pacientes con TEP aguda sintom&#225;tica depende no solo de la gravedad de la presentaci&#243;n de la TEP&#44; sino tambi&#233;n de las caracter&#237;sticas basales de los pacientes y del factor desencadenante del evento tromb&#243;tico&#46; En este sentido&#44; los pacientes con TEP secundaria a c&#225;ncer tienen un pron&#243;stico significativamente peor que los pacientes con TEP secundaria a inmovilizaci&#243;n m&#233;dica<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">5</span></a>&#46; Los pacientes con TEP secundaria a cirug&#237;a mayor presentan el mejor pron&#243;stico a corto plazo<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">6</span></a>&#46; Varios estudios han demostrado que los viajes a&#233;reos prolongados &#40;s&#237;ndrome de clase turista &#91;SCT&#93;&#41; constituyen un factor de riesgo para la TEP aguda sintom&#225;tica<a class="elsevierStyleCrossRefs" href="#bib0165"><span class="elsevierStyleSup">7-9</span></a>&#46; Sin embargo&#44; no se conocen suficientemente la forma cl&#237;nica de presentaci&#243;n y el pron&#243;stico a corto plazo de los pacientes con SCT&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">El objetivo de este estudio fue analizar las caracter&#237;sticas basales de una cohorte de pacientes con TEP aguda sintom&#225;tica&#44; estratificadas seg&#250;n el factor de riesgo desencadenante &#40;SCT vs&#46; otros&#41;&#46; Asimismo&#44; comparamos el pron&#243;stico a corto plazo de los pacientes con TEP secundaria a SCT con el de los pacientes con TEP idiop&#225;tica&#44; secundaria a c&#225;ncer&#44; secundaria a inmovilizaci&#243;n y secundaria a cirug&#237;a&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">M&#233;todo</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Dise&#241;o</span><p id="par0020" class="elsevierStylePara elsevierViewall">Se ha realizado un estudio observacional retrospectivo en el que se analizaron las caracter&#237;sticas basales y el pron&#243;stico a corto plazo de una cohorte de pacientes estables e inestables con TEP aguda sintom&#225;tica&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Pacientes y criterios de selecci&#243;n</span><p id="par0025" class="elsevierStylePara elsevierViewall">Se incluyeron en el estudio todos los pacientes diagnosticados consecutivamente de TEP aguda sintom&#225;tica en el servicio de urgencias del Hospital Ram&#243;n y Cajal &#40;Madrid&#44; Espa&#241;a&#41; entre enero de 2003 y junio de 2016&#46; El diagn&#243;stico de TEP se confirm&#243; mediante el hallazgo en la angiotomograf&#237;a computarizada &#40;TC&#41; de un defecto intraluminal parcial rodeado de contraste o una oclusi&#243;n completa de una arteria pulmonar en dos cortes consecutivos de TC<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">10</span></a>&#46; El diagn&#243;stico de TEP mediante gammagraf&#237;a de ventilaci&#243;n&#47;perfusi&#243;n se realiz&#243; en los casos de alta probabilidad definidos seg&#250;n criterios PIOPED<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">11</span></a> &#40;al menos un defecto de perfusi&#243;n segmentario o dos subsegmentarios con ventilaci&#243;n normal&#41;&#44; o en los casos con sospecha cl&#237;nica de TEP&#44; gammagraf&#237;a no concluyente y ecograf&#237;a de miembros inferiores diagn&#243;stica que mostrase un defecto de compresibilidad de la luz venosa como signo de trombosis venosa profunda &#40;TVP&#41;<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">12</span></a>&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Intervenciones</span><p id="par0030" class="elsevierStylePara elsevierViewall">Los pacientes fueron tratados con heparina de bajo peso molecular &#40;HBPM&#41; a dosis ajustadas al peso del paciente cada 12<span class="elsevierStyleHsp" style=""></span>h durante un m&#237;nimo de 5<span class="elsevierStyleHsp" style=""></span>d&#237;as&#46; Se inici&#243; la administraci&#243;n de antagonistas de la vitamina<span class="elsevierStyleHsp" style=""></span>K junto con la HBPM entre el primer y el tercer d&#237;a de tratamiento y la HBPM fue interrumpida cuando la raz&#243;n normalizada internacional &#40;<span class="elsevierStyleItalic">international normalized ratio</span> &#91;INR&#93;&#41; era estable y superior a 2&#44;0&#46; La monitorizaci&#243;n de los niveles de INR se realiz&#243; de acuerdo con las pr&#225;cticas locales del centro&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">El tratamiento de recanalizaci&#243;n &#40;trombol&#237;ticos&#44; fragmentaci&#243;n o embolectom&#237;a&#41; se emple&#243; en los pacientes inestables hemodin&#225;micamente a criterio del m&#233;dico responsable&#46; De forma general&#44; la fragmentaci&#243;n mec&#225;nica y la embolectom&#237;a se reservaron para los pacientes inestables con contraindicaci&#243;n para la tromb&#243;lisis&#46; Se insert&#243; un filtro de vena cava a los pacientes con contraindicaci&#243;n para la anticoagulaci&#243;n &#40;sangrado activo o alto riesgo de sangrado&#41;&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Definiciones seg&#250;n el factor desencadenante</span><p id="par0040" class="elsevierStylePara elsevierViewall">Los pacientes del estudio fueron clasificados en uno o varios de los siguientes grupos&#58;<ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005"><span class="elsevierStyleLabel">1&#46;</span><p id="par0045" class="elsevierStylePara elsevierViewall">SCT en los pacientes que realizaron un viaje de m&#225;s de 4<span class="elsevierStyleHsp" style=""></span>h de duraci&#243;n en el mes previo al diagn&#243;stico de TEP&#44; con independencia del medio de transporte&#46;</p></li><li class="elsevierStyleListItem" id="lsti0010"><span class="elsevierStyleLabel">2&#46;</span><p id="par0050" class="elsevierStylePara elsevierViewall">C&#225;ncer&#44; activo o en tratamiento&#44; en el a&#241;o previo al diagn&#243;stico de TEP&#46;</p></li><li class="elsevierStyleListItem" id="lsti0015"><span class="elsevierStyleLabel">3&#46;</span><p id="par0055" class="elsevierStylePara elsevierViewall">Cirug&#237;a&#44; en el mes previo al diagn&#243;stico de TEP&#46;</p></li><li class="elsevierStyleListItem" id="lsti0020"><span class="elsevierStyleLabel">4&#46;</span><p id="par0060" class="elsevierStylePara elsevierViewall">Inmovilizaci&#243;n&#44; en los pacientes no quir&#250;rgicos encamados 4 o m&#225;s d&#237;as en el mes previo al diagn&#243;stico de TEP&#46;</p></li><li class="elsevierStyleListItem" id="lsti0025"><span class="elsevierStyleLabel">5&#46;</span><p id="par0065" class="elsevierStylePara elsevierViewall">Embarazo&#44; puerperio&#44; uso de anticonceptivos orales&#44; en el mes previo al diagn&#243;stico de TEP&#46;</p></li><li class="elsevierStyleListItem" id="lsti0030"><span class="elsevierStyleLabel">6&#46;</span><p id="par0070" class="elsevierStylePara elsevierViewall">Idiop&#225;tica&#44; en ausencia de cualquiera de los desencadenantes anteriores&#46;</p></li></ul></p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Episodios analizados</span><p id="par0075" class="elsevierStylePara elsevierViewall">Definimos como par&#225;metro de valoraci&#243;n principal la mortalidad por todas las causas en el mes posterior al diagn&#243;stico&#46; Los par&#225;metros secundarios fueron la mortalidad por la propia TEP&#44; las recurrencias tromboemb&#243;licas no mortales objetivamente confirmadas y los sangrados mayores no mortales en el mes posterior al diagn&#243;stico&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">Los criterios diagn&#243;sticos de recurrencia tromb&#243;tica no mortal fueron la presencia de un nuevo defecto intraluminal en el angio-TC o un nuevo defecto de ventilaci&#243;n&#47;perfusi&#243;n en la gammagraf&#237;a pulmonar&#59; 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seg&#250;n procediera&#44; y se compararon con el test de la t de Student &#40;o la prueba de la U de Mann-Whitney para los datos asim&#233;tricos&#41;&#46; Las variables categ&#243;ricas se representaron como porcentajes y se compararon con el test de chi-cuadrado&#44; o con el test exacto de Fisher en caso necesario&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">Se estimaron las curvas de incidencia acumulada mediante el m&#233;todo de Kaplan-Meier y se compararon mediante la prueba de <span class="elsevierStyleItalic">log rank</span><a class="elsevierStyleCrossRefs" href="#bib0205"><span class="elsevierStyleSup">15&#44;16</span></a>&#46; Para evaluar la posible asociaci&#243;n independiente entre el SCT y la mortalidad se construy&#243; un modelo de regresi&#243;n log&#237;stica multivariable<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">17</span></a>&#46; Se especific&#243; un modelo m&#225;ximo de 14 variables seleccionadas en funci&#243;n de la experiencia publicada y de la opini&#243;n de expertos&#46; Las variables fueron&#58; a&#41;<span class="elsevierStyleHsp" style=""></span>edad&#59; b&#41;<span class="elsevierStyleHsp" style=""></span>sexo&#59; c&#41;<span class="elsevierStyleHsp" style=""></span>enfermedad pulmonar obstructiva cr&#243;nica &#40;EPOC&#41;&#59; d&#41;<span class="elsevierStyleHsp" style=""></span>insuficiencia cardiaca congestiva &#40;ICC&#41;&#59; e&#41;<span class="elsevierStyleHsp" style=""></span>frecuencia cardiaca&#59; f&#41;<span class="elsevierStyleHsp" style=""></span>presi&#243;n arterial sist&#243;lica&#59; g&#41;<span class="elsevierStyleHsp" style=""></span>disnea&#59; h&#41;<span class="elsevierStyleHsp" style=""></span>dolor tor&#225;cico&#59; i&#41;<span class="elsevierStyleHsp" style=""></span>s&#237;ncope&#59; j&#41;<span class="elsevierStyleHsp" style=""></span>SCT&#59; k&#41;<span class="elsevierStyleHsp" style=""></span>c&#225;ncer&#59; l&#41;<span class="elsevierStyleHsp" style=""></span>cirug&#237;a reciente&#59; m&#41;<span class="elsevierStyleHsp" style=""></span>inmovilizaci&#243;n&#44; y n&#41;<span class="elsevierStyleHsp" style=""></span>escala <span class="elsevierStyleItalic">Pulmonary Embolism Severity Index</span> &#40;PESI&#41; simplificada<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">18</span></a>&#46; El an&#225;lisis fue construido partiendo del modelo m&#225;ximo y por exclusi&#243;n <span class="elsevierStyleItalic">&#40;backward&#41;</span> de variables&#46; Se mantuvieron en el modelo las variables confusoras &#40;es decir&#44; el coeficiente de la variable evaluada se modificaba m&#225;s del 10&#37; cuando se eliminaba la variable confusora del modelo&#41; del efecto del SCT sobre el par&#225;metro de valoraci&#243;n principal&#46; Se calcularon las <span class="elsevierStyleItalic">odds ratio</span> &#40;OR&#41; con su intervalos del confianza del 95&#37; &#40;IC<span class="elsevierStyleHsp" style=""></span>95&#37;&#41;&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">Para el an&#225;lisis estad&#237;stico empleamos el programa SPSS &#40;versi&#243;n 19&#46;0&#44; SPSS Inc&#46;&#44; Chicago&#44; Illinois&#44; EE&#46;UU&#46;&#41;&#46; Se consider&#243; como resultado estad&#237;sticamente significativo un valor bilateral de p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#46;</p></span></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Resultados</span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Pacientes</span><p id="par0105" class="elsevierStylePara elsevierViewall">Durante el per&#237;odo de estudio se evaluaron 12&#46;629 pacientes con sospecha de TEP aguda sintom&#225;tica&#44; y el diagn&#243;stico se confirm&#243; en 2&#46;445 &#40;19&#44;4&#37;&#41;&#46; De ellos&#44; 113 fueron perdidos durante el seguimiento&#44; por lo que la muestra final fue de 2&#46;333 pacientes &#40;1&#46;089 hombres y 1&#46;244 mujeres&#41;&#44; el 95&#37; de la poblaci&#243;n evaluada &#40;<a class="elsevierStyleCrossRef" href="#fig0005">fig&#46; 1</a>&#41;&#46; No se encontraron diferencias estad&#237;sticamente significativas entre las variables basales de los pacientes incluidos y excluidos&#46; Aproximadamente el 70&#37; de los pacientes &#40;1&#46;659&#47;2&#46;333&#41; fueron diagnosticados mediante angio-TC de t&#243;rax&#44; 744 &#40;32&#37;&#41; mediante gammagraf&#237;a ventilaci&#243;n&#47;perfusi&#243;n de alta probabilidad&#44; y 76 &#40;3&#37;&#41; tuvieron pruebas tor&#225;cicas negativas y TVP confirmada mediante ecograf&#237;a de miembros inferiores&#46; Algunos pacientes tuvieron varias pruebas diagn&#243;sticas positivas simult&#225;neamente&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0110" class="elsevierStylePara elsevierViewall">Las caracter&#237;sticas de los pacientes incluidos en el estudio se muestran en <a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a>&#46; El n&#250;mero de pacientes tratados con filtros de vena cava inferior fue bajo &#40;2&#44;2&#37;&#59; 52 de 2&#46;333 pacientes&#41;&#46; Un 4&#37; &#40;103 de 2&#46;333 pacientes&#41; fueron tratados con trombol&#237;ticos&#46; Los pacientes con SCT eran menos frecuentemente varones &#40;34&#37; frente a 47&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;01&#41;&#44; m&#225;s j&#243;venes &#40;55&#44;8<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>14&#44;2 frente a 69&#44;6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>16&#44;5&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41; y ten&#237;an menos EPOC &#40;0&#37; frente a 8&#44;1&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#44; insuficiencia cardiaca &#40;0&#44;8&#37; frente a 6&#44;0&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;01&#41;&#44; c&#225;ncer &#40;4&#44;8&#37; frente a 21&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41; y antecedentes de hemorragia reciente &#40;0&#37; frente a 3&#44;4&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;03&#41;&#46; Una proporci&#243;n mayor de pacientes con SCT fueron clasificados de bajo riesgo seg&#250;n la escala PESI simplificada &#40;45&#37; frente a 29&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#46; La presentaci&#243;n de la TEP fue m&#225;s grave en los pacientes con SCT&#46; Comenzaron m&#225;s frecuentemente con s&#237;ncope &#40;48&#37; frente a 14&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#44; taquicardia &#40;37&#37; frente a 21&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#44; disfunci&#243;n del ventr&#237;culo derecho &#40;VD&#41; &#40;31&#37; frente a 19&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;01&#41; y da&#241;o mioc&#225;rdico &#40;57&#37; frente a 28&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41; que los pacientes con TEP idiop&#225;tica o secundaria a otras etiolog&#237;as&#46; Los pacientes con SCT presentaron menos frecuentemente TVP residual &#40;45&#37; frente a 57&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;02&#41;&#46; En relaci&#243;n con el tratamiento&#44; los pacientes con SCT recibieron con m&#225;s frecuencia tratamiento trombol&#237;tico &#40;9&#44;8&#37; frente a 4&#44;1&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;01&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0115" class="elsevierStylePara elsevierViewall">De los 2&#46;333 pacientes&#44; 213 &#40;9&#44;1&#37;&#59; IC<span class="elsevierStyleHsp" style=""></span>95&#37;&#58; 8&#44;0-10&#44;4&#41; fallecieron durante los primeros 30<span class="elsevierStyleHsp" style=""></span>d&#237;as de seguimiento &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">tabla 2</a>&#41;&#46; Setenta y seis pacientes &#40;36&#37;&#41; fallecieron por la propia TEP&#44; 59 &#40;28&#37;&#41; por c&#225;ncer&#44; 25 &#40;12&#37;&#41; por infecci&#243;n&#44; 10 &#40;4&#44;7&#37;&#41; por insuficiencia cardiaca&#44; 8 &#40;3&#44;8&#37;&#41; por hemorragia y 35 &#40;16&#37;&#41; por otras causas&#46; El evento secundario se produjo en 75 pacientes&#59; 21 pacientes presentaron una recurrencia tromb&#243;tica objetivamente confirmada&#44; 50 pacientes sufrieron una hemorragia mayor no mortal y 4 pacientes sangraron y presentaron recurrencia simult&#225;neamente&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0120" class="elsevierStylePara elsevierViewall">Los pacientes con SCT tuvieron un riesgo significativamente menor de fallecer por cualquier causa que los pacientes con TEP idiop&#225;tica o secundaria a otros desencadenantes &#40;prueba de <span class="elsevierStyleItalic">log rank</span>&#44; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;01&#59; <a class="elsevierStyleCrossRef" href="#fig0015">fig&#46; 2</a>&#41;&#46; Por otra parte&#44; la mortalidad por la propia TEP durante el primer mes de seguimiento no fue distinta en los pacientes con TEP secundaria a SCT que en el resto de pacientes &#40;prueba de <span class="elsevierStyleItalic">log rank</span>&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;11&#41;&#46; Ninguno de los pacientes con SCT experiment&#243; una recurrencia tromboemb&#243;lica&#44; y solo uno &#40;0&#44;8&#37;&#41; present&#243; un sangrado mayor no fatal en los primeros 30<span class="elsevierStyleHsp" style=""></span>d&#237;as de seguimiento&#46;</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0125" class="elsevierStylePara elsevierViewall">En el an&#225;lisis univariable&#44; la edad &#62;<span class="elsevierStyleHsp" style=""></span>80<span class="elsevierStyleHsp" style=""></span>a&#241;os &#40;OR&#58; 1&#44;82&#59; IC<span class="elsevierStyleHsp" style=""></span>95&#37;&#58; 1&#44;36-2&#44;44&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#44; algunas comorbilidades &#40;EPOC &#91;OR&#58; 2&#44;15&#59; IC<span class="elsevierStyleHsp" style=""></span>95&#37;&#58; 1&#44;41-3&#44;28&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#93;&#44; insuficiencia cardiaca &#91;OR&#58; 2&#44;59&#59; IC<span class="elsevierStyleHsp" style=""></span>95&#37;&#58; 1&#44;64-4&#44;07&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#93;&#44; c&#225;ncer &#91;OR&#58; 3&#44;60&#59; IC<span class="elsevierStyleHsp" style=""></span>95&#37;&#58; 2&#44;68-4&#44;82&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#93;&#44; inmovilizaci&#243;n de causa m&#233;dica &#91;OR&#58; 1&#44;82&#59; IC<span class="elsevierStyleHsp" style=""></span>95&#37;&#58; 1&#44;33-2&#44;49&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#93;&#41;&#44; y la forma de presentaci&#243;n cl&#237;nica &#40;taquicardia &#91;OR&#58; 1&#44;55&#59; IC<span class="elsevierStyleHsp" style=""></span>95&#37;&#58; 1&#44;13-2&#44;12&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;01&#93;&#44; hipotensi&#243;n &#91;OR&#58; 2&#44;90&#59; IC<span class="elsevierStyleHsp" style=""></span>95&#37;&#58; 1&#44;99-4&#44;23&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#93;&#44; y una escala PESI simplificada de alto riesgo &#91;OR&#58; 7&#44;25&#59; IC<span class="elsevierStyleHsp" style=""></span>95&#37;&#58; 4&#44;11-12&#44;80&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#93;&#41; incrementaron significativamente el riesgo de muerte por todas las causas en los 30<span class="elsevierStyleHsp" style=""></span>d&#237;as posteriores al diagn&#243;stico de la TEP &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">tabla 3</a>&#41;&#46; Por el contrario&#44; los antecedentes de cirug&#237;a reciente &#40;OR&#58; 0&#44;39&#59; IC<span class="elsevierStyleHsp" style=""></span>95&#37;&#58; 0&#44;19-0&#44;81&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;01&#41; y el SCT &#40;OR&#58; 0&#44;16&#59; IC<span class="elsevierStyleHsp" style=""></span>95&#37;&#58; 0&#44;04-0&#44;63&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;01&#41; se asociaron a una reducci&#243;n estad&#237;sticamente significativa del riesgo de muerte&#46; En el an&#225;lisis multivariable&#44; el SCT se asoci&#243; de forma independiente a la mortalidad por todas las causas durante los primeros 30<span class="elsevierStyleHsp" style=""></span>d&#237;as de seguimiento &#40;OR&#58; 0&#44;22&#59; IC<span class="elsevierStyleHsp" style=""></span>95&#37;&#58; 0&#44;05-0&#44;94&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;04&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0020">tabla 4</a>&#41;&#46; El SCT no se asoci&#243; de forma independiente a la mortalidad por la propia TEP durante los primeros 30<span class="elsevierStyleHsp" style=""></span>d&#237;as de seguimiento &#40;OR&#58; 0&#44;37&#59; IC<span class="elsevierStyleHsp" style=""></span>95&#37;&#58; 0&#44;05-2&#44;77&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;33&#41;&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><elsevierMultimedia ident="tbl0020"></elsevierMultimedia></span></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Discusi&#243;n</span><p id="par0130" class="elsevierStylePara elsevierViewall">El presente estudio ha analizado la presentaci&#243;n cl&#237;nica y el pron&#243;stico a corto plazo del SCT en una cohorte amplia de pacientes con TEP aguda sintom&#225;tica&#46; Nuestros resultados indican que la TEP de los pacientes con SCT produce con m&#225;s frecuencia disfunci&#243;n del ventr&#237;culo derecho y da&#241;o mioc&#225;rdico que la TEP idiop&#225;tica o secundaria a otros desencadenantes&#46; Sin embargo&#44; el pron&#243;stico a corto plazo de estos pacientes es excelente&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">Nuestros resultados indican que&#44; aunque los pacientes con TEP secundaria a SCT son m&#225;s j&#243;venes y tienen menos comorbilidad &#40;p&#46;<span class="elsevierStyleHsp" style=""></span>ej&#46;&#44; EPOC&#44; insuficiencia cardiaca&#41; que los pacientes con TEP idiop&#225;tica o secundaria a otros desencadenantes&#44; su forma de presentaci&#243;n es m&#225;s grave&#46; De hecho&#44; comenzaron m&#225;s frecuentemente con s&#237;ncope&#44; taquicardia e hipotensi&#243;n&#44; todos ellos factores de mal pron&#243;stico en la fase aguda de la TEP<a class="elsevierStyleCrossRefs" href="#bib0225"><span class="elsevierStyleSup">19-22</span></a>&#46; Hay que destacar que la disfunci&#243;n del ventr&#237;culo derecho y la necrosis mioc&#225;rdica fueron significativamente m&#225;s frecuentes en estos pacientes&#46; Estos resultados son similares a los de un estudio previo que evalu&#243; la forma de presentaci&#243;n de los pacientes con SCT<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">23</span></a>&#46; No se conocen los motivos por los que estos pacientes tienen esta presentaci&#243;n&#46; Se podr&#237;an sugerir algunos mecanismos&#46; Por un lado&#44; la hipoxia de la cabina del avi&#243;n incrementa la presi&#243;n arterial pulmonar y podr&#237;a empeorar la funci&#243;n del ventr&#237;culo derecho<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">24</span></a>&#46; Por otro lado&#44; la TVP residual fue menos frecuente en los pacientes con SCT que en los pacientes con TEP idiop&#225;tica o secundaria a otros desencadenantes&#59; y podr&#237;a ocurrir que en estos pacientes la totalidad del trombo formado en los miembros inferiores embolizara y la TEP presentara mayor carga tromb&#243;tica&#46;</p><p id="par0140" class="elsevierStylePara elsevierViewall">A pesar de presentarse con una TEP m&#225;s grave&#44; el pron&#243;stico a corto plazo de estos pacientes es excelente&#44; y significativamente mejor que el de los pacientes con TEP secundaria a c&#225;ncer o a inmovilizaci&#243;n&#46; Estos hallazgos se explican porque&#44; aunque la mortalidad precoz &#40;en los primeros d&#237;as&#41; de los pacientes con TEP es la consecuencia del fracaso del ventr&#237;culo derecho&#44; la mortalidad tard&#237;a es el resultado de la comorbilidad de los pacientes<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">25</span></a>&#46;</p><p id="par0145" class="elsevierStylePara elsevierViewall">&#191;Cu&#225;les son las consecuencias cl&#237;nicas de este estudio&#63; Las gu&#237;as de pr&#225;ctica cl&#237;nica desaconsejan el uso de tratamiento fibrinol&#237;tico en pacientes con TEP de riesgo intermedio-alto&#46; El ensayo cl&#237;nico PEITHO analiz&#243; la eficacia y seguridad del tratamiento con tenecteplasa en pacientes normotensos con TEP que presentaban disfunci&#243;n del ventr&#237;culo derecho y da&#241;o mioc&#225;rdico&#46; Aunque el tratamiento fibrinol&#237;tico redujo significativamente el colapso hemodin&#225;mico de estos pacientes&#44; la mortalidad no se modific&#243; y los sangrados graves fueron significativamente m&#225;s frecuentes en aquellos que recibieron fibrin&#243;lisis<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">26</span></a>&#46; Nuestros resultados refuerzan esta recomendaci&#243;n en el subgrupo de pacientes con TEP secundaria a SCT&#46; Aunque su forma de presentaci&#243;n sea m&#225;s grave &#40;p&#46;<span class="elsevierStyleHsp" style=""></span>ej&#46;&#44; TEP de riesgo intermedio-alto&#41;&#44; su pron&#243;stico es excelente cuando reciben tratamiento anticoagulaci&#243;n convencional&#46;</p><p id="par0150" class="elsevierStylePara elsevierViewall">Este estudio tiene algunas limitaciones&#46; En primer lugar&#44; al tratarse de un an&#225;lisis de una cohorte hist&#243;rica compuesta por pacientes de un &#250;nico centro est&#225; sujeto a los sesgos inherentes a este tipo de estudios y los resultados no son generalizables&#46; Sin embargo&#44; representa una poblaci&#243;n no seleccionada de pacientes con TEP de nuestro medio de pr&#225;ctica cl&#237;nica habitual&#44; por lo que supone una muestra ideal para evaluar la forma de presentaci&#243;n y el pron&#243;stico de los pacientes con SCT&#46; En segundo lugar&#44; no pudimos medir la carga tromb&#243;tica de nuestros pacientes&#44; por lo que no es posible establecer una asociaci&#243;n entre el grado de obstrucci&#243;n arterial pulmonar y la presencia o ausencia de disfunci&#243;n del ventr&#237;culo derecho&#46;</p><p id="par0155" class="elsevierStylePara elsevierViewall">En conclusi&#243;n&#44; nuestros resultados muestran que los pacientes con TEP secundaria a SCT tienen menos comorbilidad que los pacientes con TEP idiop&#225;tica o secundaria a otras causas&#46; Aunque se presentan con m&#225;s frecuencia como TEP de riesgo intermedio-alto&#44; su pron&#243;stico a corto plazo es excelente con tratamiento anticoagulante convencional&#46; Se requieren estudios bien dise&#241;ados para conocer el motivo por el que estos pacientes presentan m&#225;s frecuentemente disfunci&#243;n del ventr&#237;culo derecho y da&#241;o mioc&#225;rdico en la fase aguda de la TEP&#46;</p></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Conflicto de intereses</span><p id="par0160" class="elsevierStylePara elsevierViewall">Los autores declaran no tener ning&#250;n conflicto de intereses&#46;</p></span></span>"
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              "identificador" => "sec0025"
              "titulo" => "Intervenciones"
            ]
            3 => array:2 [
              "identificador" => "sec0030"
              "titulo" => "Definiciones seg&#250;n el factor desencadenante"
            ]
            4 => array:2 [
              "identificador" => "sec0035"
              "titulo" => "Episodios analizados"
            ]
            5 => array:2 [
              "identificador" => "sec0040"
              "titulo" => "An&#225;lisis estad&#237;stico"
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          "titulo" => "Resultados"
          "secciones" => array:1 [
            0 => array:2 [
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              "titulo" => "Pacientes"
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          ]
        ]
        7 => array:2 [
          "identificador" => "sec0055"
          "titulo" => "Discusi&#243;n"
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        8 => array:2 [
          "identificador" => "sec0060"
          "titulo" => "Conflicto de intereses"
        ]
        9 => array:1 [
          "titulo" => "Bibliograf&#237;a"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2016-12-05"
    "fechaAceptado" => "2017-02-18"
    "PalabrasClave" => array:2 [
      "es" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palabras clave"
          "identificador" => "xpalclavsec874221"
          "palabras" => array:3 [
            0 => "Tromboembolia de pulm&#243;n"
            1 => "S&#237;ndrome de clase turista"
            2 => "Pron&#243;stico"
          ]
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      ]
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec874222"
          "palabras" => array:3 [
            0 => "Pulmonary embolism"
            1 => "Economy-class syndrome"
            2 => "Prognosis"
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    "resumen" => array:2 [
      "es" => array:3 [
        "titulo" => "Resumen"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objetivo</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">No se conocen suficientemente las caracter&#237;sticas cl&#237;nicas y el pron&#243;stico de los pacientes con tromboembolia de pulm&#243;n &#40;TEP&#41; aguda sintom&#225;tica asociada a los viajes prolongados &#40;s&#237;ndrome de clase turista &#91;SCT&#93;&#41;&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">M&#233;todos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Se analizaron retrospectivamente las caracter&#237;sticas basales de los pacientes con TEP aguda y se estratificaron seg&#250;n el factor de riesgo desencadenante&#46; Se determinaron la mortalidad por todas las causas&#44; la mortalidad por la propia TEP&#44; las recurrencias tromb&#243;ticas no fatales y los sangrados mayores no fatales durante los primeros 30<span class="elsevierStyleHsp" style=""></span>d&#237;as de seguimiento&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">De los 2&#46;333 pacientes incluidos&#44; un total de 124 &#40;5&#44;3&#37;&#59; intervalo de confianza del 95&#37;&#58; 4&#44;4-6&#44;3&#41; fueron diagnosticados de TEP secundaria a SCT&#46; Estos pacientes fueron m&#225;s j&#243;venes&#44; presentaron menos frecuentemente comorbilidad y m&#225;s frecuentemente s&#237;ncope &#40;48&#37; vs&#46; 14&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#44; taquicardia &#40;37&#37; vs&#46; 21&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#44; disfunci&#243;n de ventr&#237;culo derecho &#40;VD&#41; &#40;31&#37; vs&#46; 19&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;01&#41; y da&#241;o mioc&#225;rdico &#40;57&#37; vs&#46; 28&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41; que los dem&#225;s pacientes con TEP&#46; La mortalidad por todas las causas a 30<span class="elsevierStyleHsp" style=""></span>d&#237;as fue significativamente menor para los pacientes con TEP secundaria a SCT &#40;1&#44;6&#37; vs&#46; 9&#44;6&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;01&#41;&#46; La mortalidad a 30<span class="elsevierStyleHsp" style=""></span>d&#237;as por TEP no fue diferente entre los dos grupos de pacientes &#40;0&#44;8&#37; vs&#46; 3&#44;1&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;18&#41;&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Los pacientes con TEP y SCT son m&#225;s j&#243;venes y tienen menos comorbilidad que los dem&#225;s pacientes con TEP&#46; Aunque se presentan m&#225;s frecuentemente con disfunci&#243;n de VD y da&#241;o mioc&#225;rdico&#44; el pron&#243;stico a corto plazo es excelente&#46;</p></span>"
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          0 => array:2 [
            "identificador" => "abst0005"
            "titulo" => "Objetivo"
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          1 => array:2 [
            "identificador" => "abst0010"
            "titulo" => "M&#233;todos"
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          2 => array:2 [
            "identificador" => "abst0015"
            "titulo" => "Resultados"
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          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">Objective</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Clinical presentation and short-term prognosis of patients with travel-associated acute pulmonary embolism &#40;PE&#41; &#40;i&#46;e&#46;&#44; economy class syndrome &#91;ECS&#93;&#41; is not well understood&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Methods</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">In this retrospective cohort study of patients with acute PE identified from a single center registry&#44; we assessed the clinical presentation and the association between ECS and the outcomes of all-cause mortality&#44; PE-related mortality&#44; nonfatal venous thromboembolism and nonfatal major bleeding rates through 30<span class="elsevierStyleHsp" style=""></span>days after initiation of PE treatment&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Of the 2&#44;333 patients with acute symptomatic PE&#44; 124 &#40;5&#46;3&#37;&#59; 95&#37; confidence interval&#44; 4&#46;4-6&#46;3&#37;&#41; had ECS&#46; Patients with ECS were younger and had fewer comorbid diseases &#40;recent bleeding&#44; chronic obstructive pulmonary disease&#44; congestive heart failure&#41;&#44; but they presented with more signs of clinical severity &#40;syncope &#91;48&#37; vs&#46; 14&#37;&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001&#93;&#44; tachycardia &#91;37&#37; vs&#46; 21&#37;&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001&#93;&#44; right ventricular dysfunction &#91;31&#37; vs&#46; 19&#37;&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;01&#93; and myocardial injury &#91;57&#37; vs&#46; 28&#37;&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001&#93;&#41; compared to those without ECS&#46; Regression analyses showed a significantly lower risk of all-cause mortality for patients with ECS compared to patients without ECS &#40;1&#46;6&#37; vs&#46; 9&#46;6&#37;&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;01&#41;&#46; We did not detect a difference in PE-related mortality at 30<span class="elsevierStyleHsp" style=""></span>days between those with and those without ECS &#40;0&#46;8&#37; vs&#46; 3&#46;1&#37;&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;18&#41;&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">PE patients with ECS are younger and have fewer comorbid diseases compared to those without ECS&#46; Though they present with more signs of clinical severity&#44; their short-term prognosis is excellent&#46;</p></span>"
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            "titulo" => "Methods"
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            "identificador" => "abst0035"
            "titulo" => "Results"
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            "titulo" => "Conclusions"
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          "es" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Diagrama de flujo de pacientes del estudio&#46;TEP&#58; tromboembolia de pulm&#243;n&#46;</p>"
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          "es" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Curva de supervivencia para la variable primaria considerada&#46;Prueba de rangos logar&#237;tmicos&#44; p &#60; 0&#44;01&#46;</p>"
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          "leyenda" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">BNP&#58; p&#233;ptido natriur&#233;tico cerebral&#59; cTnI&#58; troponina cardiaca<span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleSmallCaps">i</span>&#59; EPOC&#58; enfermedad pulmonar obstructiva cr&#243;nica&#59; PAS&#58; presi&#243;n arterial sist&#243;lica&#59; PESI&#58; <span class="elsevierStyleItalic">Pulmonary Embolism Severity Index</span>&#59; SCT&#58; s&#237;ndrome de clase turista&#59; TVP&#58; trombosis venosa profunda&#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="" 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">Todos<br>n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#46;333<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a>&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">Idiop&#225;tica<br>n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>982&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">SCT<br>n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>124&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">C&#225;ncer<br>n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>462&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">Inmovilizaci&#243;n<br>n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>477&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">Cirug&#237;a<br>n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>200&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="7" align="left" valign="top"><span class="elsevierStyleItalic">Caracter&#237;sticas cl&#237;nicas&#44; n &#40;&#37;&#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>Edad&#44; a&#241;os&#44; mediana &#40;percentiles 25-75&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">74 &#40;59-81&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">75 &#40;63-82&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">54 &#40;44-67&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">72 &#40;61-78&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">79 &#40;68-86&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">68 &#40;52-77&#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>Edad<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>80 a&#241;os&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">624 &#40;27&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">285 &#40;29&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1 &#40;0&#44;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">79 &#40;17&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">210 &#40;44&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">35 &#40;18&#37;&#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>Sexo var&#243;n&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">510 &#40;52&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">42 &#40;34&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">252 &#40;55&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">178 &#40;37&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">88 &#40;44&#37;&#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="7" 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="7" align="left" valign="top"><span class="elsevierStyleItalic">Comorbilidad&#44; n &#40;&#37;&#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>Antecedentes hemorragia grave<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">c</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">74 &#40;3&#44;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">19 &#40;1&#44;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0 &#40;0&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">11 &#40;2&#44;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">42 &#40;8&#44;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">10 &#40;5&#44;0&#37;&#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>EPOC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">180 &#40;7&#44;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">80 &#40;8&#44;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0 &#40;0&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">32 &#40;6&#44;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">53 &#40;11&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8 &#40;4&#44;0&#37;&#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>Insuficiencia cardiaca&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">134 &#40;5&#44;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">62 &#40;6&#44;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1 &#40;0&#44;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">13 &#40;2&#44;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">48 &#40;10&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5 &#40;2&#44;5&#37;&#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="7" 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="7" align="left" valign="top"><span class="elsevierStyleItalic">S&#237;ntomas y signos al diagn&#243;stico&#44; n &#40;&#37;&#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>S&#237;ncope&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">372 &#40;16&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">156 &#40;16&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">60 &#40;48&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">56 &#40;12&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">74 &#40;16&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">20 &#40;10&#37;&#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>Dolor tor&#225;cico&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;019 &#40;44&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">450 &#40;46&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">52 &#40;42&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">174 &#40;38&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">158 &#40;33&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">93 &#40;47&#37;&#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>Disnea&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;681 &#40;72&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">706 &#40;72&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">78 &#40;63&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">329 &#40;71&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">363 &#40;76&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">147 &#40;74&#37;&#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>S&#237;ntomas TVP&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">545 &#40;23&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">239 &#40;24&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">24 &#40;19&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">108 &#40;23&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">92 &#40;19&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">34 &#40;17&#37;&#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>Frecuencia cardiaca &#8805;<span class="elsevierStyleHsp" style=""></span>110&#47;min&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">498 &#40;21&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">206 &#40;21&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">46 &#40;37&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">93 &#40;20&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">115 &#40;24&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">42 &#40;21&#37;&#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>Saturaci&#243;n de la hemoglobina &#40;SaO<span class="elsevierStyleInf">2</span>&#41;<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>90&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">643 &#40;28&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">290 &#40;30&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">28 &#40;23&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">207 &#40;45&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">167 &#40;35&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">53 &#40;27&#37;&#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>PAS<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>90<span class="elsevierStyleHsp" style=""></span>mmHg&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">94 &#40;4&#44;0&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">31 &#40;3&#44;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4 &#40;3&#44;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">24 &#40;5&#44;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">30 &#40;6&#44;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8 &#40;4&#44;0&#37;&#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="7" 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="7" align="left" valign="top"><span class="elsevierStyleItalic">PESI simplificado &#40;18&#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>Bajo riesgo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">693 &#40;30&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">356 &#40;36&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">56 &#40;45&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0 &#40;0&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">97 &#40;20&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">69 &#40;34&#37;&#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>Alto riesgo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;640 &#40;70&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">626 &#40;64&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">68 &#40;55&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">462 &#40;100&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">380 &#40;80&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">131 &#40;66&#37;&#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="7" 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="7" align="left" valign="top"><span class="elsevierStyleItalic">Determinaciones anal&#237;ticas</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>Hemoglobina&#44; g&#47;dl&#44; mediana &#40;percentiles 25-75&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">13&#44;3 &#40;12&#44;0-14&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">13&#44;9 &#40;12&#44;7-15&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">13&#44;6 &#40;12&#44;6-14&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12&#44;4 &#40;10&#44;8-13&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12&#44;9 &#40;11&#44;9-13&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12&#44;3 &#40;10&#44;7-13&#44;5&#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>Creatinina<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>2<span class="elsevierStyleHsp" style=""></span>mg&#47;dl &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#44;306&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">89 &#40;3&#44;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">49 &#40;5&#44;0&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2 &#40;1&#44;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12 &#40;2&#44;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">28 &#40;5&#44;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4 &#40;2&#44;0&#37;&#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="7" 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="7" align="left" valign="top"><span class="elsevierStyleItalic">Ecograf&#237;a y biomarcadores&#44; n &#40;&#37;&#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>TVP concomitante &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#46;784&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;010 &#40;57&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">422 &#40;43&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">43 &#40;35&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">218 &#40;47&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">207 &#40;43&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">72 &#40;36&#37;&#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>Disfunci&#243;n ventr&#237;culo derecho &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#46;275&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">458 &#40;36&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">228 &#40;23&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">38 &#40;31&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">58 &#40;13&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">89 &#40;19&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">32 &#40;16&#37;&#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>BNP<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>100<span class="elsevierStyleHsp" style=""></span>pg&#47;ml &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>917&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">446 &#40;49&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">221 &#40;23&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">18 &#40;15&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">70 &#40;15&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">110 &#40;23&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">31 &#40;16&#37;&#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="7" 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="7" align="left" valign="top"><span class="elsevierStyleItalic">Tratamientos&#44; n &#40;&#37;&#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>Tromb&#243;lisis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">103 &#40;4&#44;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">51 &#40;5&#44;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12 &#40;9&#44;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9 &#40;1&#44;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">19 &#40;4&#44;0&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">10 &#40;5&#37;&#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>Filtro de vena cava inferior&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">52 &#40;2&#44;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">21 &#40;2&#44;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1 &#40;0&#44;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">10 &#40;2&#44;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">16 &#40;3&#44;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7 &#40;3&#44;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab1501135.png"
              ]
            ]
          ]
          "notaPie" => array:3 [
            0 => array:3 [
              "identificador" => "tblfn0005"
              "etiqueta" => "a"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Algunos pacientes presentaron varios factores de riesgo simult&#225;neamente&#46;</p>"
            ]
            1 => array:3 [
              "identificador" => "tblfn0010"
              "etiqueta" => "b"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Dado que no se analizaron los pacientes con TEP secundaria a tratamiento hormonal sustitutivo&#44; uso de anticonceptivos orales&#44; embarazo&#44; puerperio o trombofilia hereditaria&#44; la suma de pacientes de las columnas no es 2&#46;333&#46;</p>"
            ]
            2 => array:3 [
              "identificador" => "tblfn0015"
              "etiqueta" => "c"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0015">En el mes previo&#46;</p>"
            ]
          ]
        ]
        "descripcion" => array:1 [
          "es" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Caracter&#237;sticas basales y tratamiento de los pacientes del estudio<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a></p>"
        ]
      ]
      3 => array:8 [
        "identificador" => "tbl0010"
        "etiqueta" => "Tabla 2"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at2"
            "detalle" => "Tabla "
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        "tabla" => array:2 [
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="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">Todos<br>n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#46;333&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">Idiop&#225;tica<br>n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>982&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">SCT<br>n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>124&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">C&#225;ncer<br>n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>462&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">Inmovilizaci&#243;n<br>n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>477&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">Cirug&#237;a<br>n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>200&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">Muerte por todas las causas&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">213 &#40;9&#44;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">54 &#40;5&#44;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2 &#40;1&#44;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">92 &#40;19&#44;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">65 &#40;13&#44;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8 &#40;4&#44;0&#37;&#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">Muerte por TEP&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">76 &#40;3&#44;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">19 &#40;1&#44;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1 &#40;0&#44;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">24 &#40;5&#44;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">30 &#40;6&#44;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3 &#40;1&#44;5&#37;&#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">Recurrencias no fatales&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">25 &#40;1&#44;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9 &#40;0&#44;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0 &#40;0&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7 &#40;1&#44;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5 &#40;1&#44;0&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6 &#40;3&#44;0&#37;&#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">Sangrados no fatales&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">54 &#40;2&#44;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">23 &#40;2&#44;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1 &#40;0&#44;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">11 &#40;2&#44;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">11 &#40;2&#44;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5 &#40;2&#44;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
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                0 => "xTab1501134.png"
              ]
            ]
          ]
          "notaPie" => array:1 [
            0 => array:3 [
              "identificador" => "tblfn0020"
              "etiqueta" => "a"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0020">Algunos pacientes presentaron varios factores de riesgo simult&#225;neamente&#46;</p>"
            ]
          ]
        ]
        "descripcion" => array:1 [
          "es" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Distribuci&#243;n de mortalidad y eventos adversos no mortales durante los primeros 30 d&#237;as de seguimiento<a class="elsevierStyleCrossRef" href="#tblfn0020"><span class="elsevierStyleSup">a</span></a></p>"
        ]
      ]
      4 => array:8 [
        "identificador" => "tbl0015"
        "etiqueta" => "Tabla 3"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at3"
            "detalle" => "Tabla "
            "rol" => "short"
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        ]
        "tabla" => array:3 [
          "leyenda" => "<p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">EPOC&#58; enfermedad pulmonar obstructiva cr&#243;nica&#59; FC&#58; frecuencia cardiaca&#59; ICC&#58; insuficiencia cardiaca congestiva&#59; OR&#58; <span class="elsevierStyleItalic">odds ratio</span>&#59; PAS&#58; presi&#243;n arterial sist&#243;lica&#59; PESI&#58; <span class="elsevierStyleItalic">Pulmonary Embolism Severity Index</span>&#59; SCT&#58; s&#237;ndrome de clase turista&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Variable predictora&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 no ajustado &#40;IC<span class="elsevierStyleHsp" style=""></span>95&#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
                  \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">Edad<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>80 a&#241;os&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#44;82 &#40;1&#44;36-2&#44;44&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" 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">Sexo var&#243;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#44;17 &#40;0&#44;88-1&#44;55&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;28&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">EPOC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#44;15 &#40;1&#44;41-3&#44;28&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" 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">ICC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#44;59 &#40;1&#44;64-4&#44;07&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" 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">FC<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>110&#47;min&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#44;55 &#40;1&#44;13-2&#44;12&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60; 0&#44;01&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">PAS<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>100<span class="elsevierStyleHsp" style=""></span>mmHg&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#44;90 &#40;1&#44;99-4&#44;23&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" 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">Disnea&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#44;81 &#40;1&#44;27-2&#44;60&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60; 0&#44;01&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Dolor tor&#225;cico&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;52 &#40;0&#44;39-0&#44;71&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" 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">S&#237;ncope&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;58 &#40;0&#44;37-0&#44;92&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;02&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">SCT&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;16 &#40;0&#44;04-0&#44;63&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60; 0&#44;01&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">C&#225;ncer<a class="elsevierStyleCrossRef" href="#tblfn0025"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&#44;60 &#40;2&#44;68-4&#44;82&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" 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">Cirug&#237;a reciente<a class="elsevierStyleCrossRef" href="#tblfn0030"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;39 &#40;0&#44;19-0&#44;81&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;01&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Inmovilizaci&#243;n<a class="elsevierStyleCrossRef" href="#tblfn0035"><span class="elsevierStyleSup">c</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#44;82 &#40;1&#44;33-2&#44;49&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" 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">PESI simplificado de alto riesgo &#40;18&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7&#44;25 &#40;4&#44;11-12&#44;80&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60; 0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab1501132.png"
              ]
            ]
          ]
          "notaPie" => array:3 [
            0 => array:3 [
              "identificador" => "tblfn0025"
              "etiqueta" => "a"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0025">Activo o en tratamiento en el &#250;ltimo a&#241;o&#46;</p>"
            ]
            1 => array:3 [
              "identificador" => "tblfn0030"
              "etiqueta" => "b"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0030">En el mes previo&#46;</p>"
            ]
            2 => array:3 [
              "identificador" => "tblfn0035"
              "etiqueta" => "c"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0035">Pacientes no quir&#250;rgicos encamados &#8805;<span class="elsevierStyleHsp" style=""></span>4<span class="elsevierStyleHsp" style=""></span>d&#237;as en el mes previo al diagn&#243;stico de TEP&#46;</p>"
            ]
          ]
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