Editorial
BODE Index: A Good Quality of Life Marker in Chronic Obstructive Pulmonary Disease Patients
El índice BODE: un buen marcador de calidad de vida en pacientes con enfermedad pulmonar obstructiva crónica
Pablo Sanchez-Salcedo, Juan P. de Torres
Corresponding author
Departamento de Neumología, Clínica Universidad de Navarra, Pamplona, Navarra, Spain
Read
6009
Timeswas read the article
2093
Total PDF
3916
Total HTML
Share statistics
array:23 [ "pii" => "S1579212915001676" "issn" => "15792129" "doi" => "10.1016/j.arbr.2015.03.013" "estado" => "S300" "fechaPublicacion" => "2015-07-01" "aid" => "1146" "copyright" => "SEPAR" "copyrightAnyo" => "2015" "documento" => "article" "crossmark" => 1 "subdocumento" => "sco" "cita" => "Arch Bronconeumol. 2015;51:311-2" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 2488 "formatos" => array:3 [ "EPUB" => 157 "HTML" => 1608 "PDF" => 723 ] ] "Traduccion" => array:1 [ "es" => array:19 [ "pii" => "S0300289615000952" "issn" => "03002896" "doi" => "10.1016/j.arbres.2015.03.003" "estado" => "S300" "fechaPublicacion" => "2015-07-01" "aid" => "1146" "copyright" => "SEPAR" "documento" => "article" "crossmark" => 1 "subdocumento" => "sco" "cita" => "Arch Bronconeumol. 2015;51:311-2" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 27721 "formatos" => array:3 [ "EPUB" => 149 "HTML" => 22750 "PDF" => 4822 ] ] "es" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Editorial</span>" "titulo" => "El índice BODE: un buen marcador de calidad de vida en pacientes con enfermedad pulmonar obstructiva crónica" "tienePdf" => "es" "tieneTextoCompleto" => "es" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "311" "paginaFinal" => "312" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "BODE Index: A Good Quality of Life Marker in Chronic Obstructive Pulmonary Disease Patients" ] ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Pablo Sanchez-Salcedo, Juan P. de Torres" "autores" => array:2 [ 0 => array:2 [ "nombre" => "Pablo" "apellidos" => "Sanchez-Salcedo" ] 1 => array:2 [ "nombre" => "Juan P." "apellidos" => "de Torres" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S1579212915001676" "doi" => "10.1016/j.arbr.2015.03.013" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212915001676?idApp=UINPBA00003Z" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289615000952?idApp=UINPBA00003Z" "url" => "/03002896/0000005100000007/v2_201506280052/S0300289615000952/v2_201506280052/es/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S1579212915001445" "issn" => "15792129" "doi" => "10.1016/j.arbr.2015.05.007" "estado" => "S300" "fechaPublicacion" => "2015-07-01" "aid" => "1106" "copyright" => "SEPAR" "documento" => "article" "crossmark" => 1 "subdocumento" => "sco" "cita" => "Arch Bronconeumol. 2015;51:313-4" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 2724 "formatos" => array:3 [ "EPUB" => 142 "HTML" => 1945 "PDF" => 637 ] ] "en" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Editorial</span>" "titulo" => "E-Cigarette: A Modern Trojan Horse?" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "313" "paginaFinal" => "314" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Cigarrillo electrónico: ¿un moderno caballo de Troya?" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Daniel Buljubasich" "autores" => array:1 [ 0 => array:2 [ "nombre" => "Daniel" "apellidos" => "Buljubasich" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S030028961400489X" "doi" => "10.1016/j.arbres.2014.12.004" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S030028961400489X?idApp=UINPBA00003Z" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212915001445?idApp=UINPBA00003Z" "url" => "/15792129/0000005100000007/v1_201506250123/S1579212915001445/v1_201506250123/en/main.assets" ] "en" => array:12 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Editorial</span>" "titulo" => "BODE Index: A Good Quality of Life Marker in Chronic Obstructive Pulmonary Disease Patients" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "311" "paginaFinal" => "312" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Pablo Sanchez-Salcedo, Juan P. de Torres" "autores" => array:2 [ 0 => array:2 [ "nombre" => "Pablo" "apellidos" => "Sanchez-Salcedo" ] 1 => array:4 [ "nombre" => "Juan P." "apellidos" => "de Torres" "email" => array:1 [ 0 => "jpdetorres@unav.es" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Departamento de Neumología, Clínica Universidad de Navarra, Pamplona, Navarra, Spain" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "El índice BODE: un buen marcador de calidad de vida en pacientes con enfermedad pulmonar obstructiva crónica" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Since the introduction of the BODE index a little over a decade ago,<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">1</span></a> our perception of patients with chronic obstructive pulmonary disease (COPD) has changed radically. The one-dimensional view of the condition based solely on the forced respiratory volume in the first second has been replaced by a more comprehensive evaluation of the patient, taking into account other domains of the disease (perceptive, nutritional and exercise capacity). This concept was well received by the scientific community, and both Spanish COPD guidelines (GesEPOC)<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">2</span></a> and <span class="elsevierStyleItalic">Global Initiative for chronic Obstructive Lung Disease</span> (<span class="elsevierStyleItalic">GOLD</span>)<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">3</span></a> recommendations now include a multidimensional assessment of the disease.</p><p id="par0010" class="elsevierStylePara elsevierViewall">The main contribution of the BODE index lies in its ability to predict mortality in COPD patients.<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">1</span></a> Over the past few years, numerous studies have reported other benefits, such as its ability to predict hospitalization, adapt to treatments such as pulmonary rehabilitation and volume reduction surgery,<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">4</span></a> and complement the COPD-morbidity TEst (COTE) index for predicting mortality in COPD patients.<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">5</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">In this edition of <span class="elsevierStyleItalic">Archivos de Bronconeumología</span>, Nonato et al. present new evidence on the relationship of the BODE index with health-related quality of life measured using the disease-specific <span class="elsevierStyleItalic">Saint George's Respiratory Questionnaire</span> (SGRQ).<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">6</span></a> To that end, they studied patients with COPD of varying severity from 2 Latin American cities (Santiago de Chile and Sao Paulo). Although this aspect has been explored before, as the authors themselves mention, we believe that this study is important for 3 reasons. Firstly, it includes patients with COPD of varying severity, which most previous studies had not considered. Secondly, it shows the findings from 2 Latin American populations. Thirdly, and more importantly in our opinion, it shows the association between quality of life and individual BODE scores, noting that even with a BODE score of 0, quality of life in these patients is already impaired.</p><p id="par0020" class="elsevierStylePara elsevierViewall">The BODE group itself has previously published similar results based on the patients in their original cohort.<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">4</span></a> In that study in 1398 COPD patients, of whom almost 40% were GOLD grades 1 and 2, there was a correlation of 0.58 (<span class="elsevierStyleItalic">p</span><.001) between the BODE index and the total SGRQ score, and 0.59 (<span class="elsevierStyleItalic">p</span><.001) between the BODE index and the SGRQ <span class="elsevierStyleItalic">Activity</span> domain. Nonato et al. were able to reproduce these results, albeit with a smaller patient sample, by way of external validation. Similarly, unlike the study by Marín et al.,<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">4</span></a> dividing the BODE index into individual scores revealed that the quality of life of patients with no multidimensional impairment (BODE 0) is already affected,<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">6</span></a> complementing what was already known about quartile-based analysis.<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">4</span></a> This suggests that factors other than those assessed by the BODE index can affect the quality of life of our patients; although these are unlikely to have a direct impact on mortality, they must be identified and corrected. Finally, although the SGRQ is a specific questionnaire for COPD, knowing the score of a non-COPD population with similar demographic characteristics to the BODE 0 sub-group (including comorbidities) could illustrate the real impact of COPD on quality of life.</p><p id="par0025" class="elsevierStylePara elsevierViewall">Similarly, patients in the BODE 0 group reported impaired quality of life in all the domains of the SGRQ, with higher scores in the <span class="elsevierStyleItalic">Activity</span> domain. The findings of Nonato et al. are understandable up to a certain point, as limitations in their ability to carry out activities of daily living is more objective for patients than any perception they may have of their symptoms. It is curious that the scores in the <span class="elsevierStyleItalic">Impact</span> section were not higher. This domain is considered to cover a wide range of psychosocial problems, and correlates in part with respiratory symptoms and exercise capacity,<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">7</span></a> although in both the BODE cohort and this study, the correlation was moderate and slight, respectively.</p><p id="par0030" class="elsevierStylePara elsevierViewall">Another interesting aspect is the non-linear association between SGRQ scores and the BODE index, similar to that observed between the SGRQ and GOLD spirometric stages.<a class="elsevierStyleCrossRefs" href="#bib0090"><span class="elsevierStyleSup">8,9</span></a> The sharp increase in SGRQ scores in certain index values is also noteworthy, especially in patients with BODE 0 and BODE 1. Interestingly, some of these changes do not correspond to the limits established by the BODE quartiles. The authors’ suggestion that this may be due to periods of adaptation up to a critical point seems reasonable.</p><p id="par0035" class="elsevierStylePara elsevierViewall">The evidence presented by Nonato et al. emphasizes that the quality of life of even our asymptomatic or paucisymptomatic COPD patients is already affected, and this deterioration must be identified in order to try to correct it. We must routinely administer questionnaires that assess the quality of life of all our COPD patients, even those with BODE 0. The use of a questionnaire that is easier to administer than the COPD Assessment Test (CAT)<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">10</span></a> could help make this a part of routine clinical practice.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Sanchez-Salcedo P, de Torres JP. El índice BODE: un buen marcador de calidad de vida en pacientes con enfermedad pulmonar obstructiva crónica. Arch Bronconeumol. 2015;51:311–312.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:10 [ 0 => array:3 [ "identificador" => "bib0055" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The body-mass index, airflow obstruction, dyspnea, and exercise capacity index in chronic obstructive pulmonary disease" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "B.R. Celli" 1 => "C.G. Cote" 2 => "J.M. Marin" 3 => "C. Casanova" 4 => "M. Montes de Oca" 5 => "R.A. Mendez" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1056/NEJMoa021322" "Revista" => array:6 [ "tituloSerie" => "N Engl J Med" "fecha" => "2004" "volumen" => "350" "paginaInicial" => "1005" "paginaFinal" => "1012" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14999112" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0060" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Guía española de la EPOC (GesEPOC). Actualización 2014" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "M. Miravitlles" 1 => "J.J. Soler-cataluña" 2 => "M. Calle" 3 => "J. Molina" 4 => "P. Almagro" 5 => "J. Antonio" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/S0300-2896(14)70070-5" "Revista" => array:6 [ "tituloSerie" => "Arch Bronconeumol" "fecha" => "2014" "volumen" => "50" "paginaInicial" => "1" "paginaFinal" => "16" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24507959" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0065" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD executive summary" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J. Vestbo" 1 => "S.S. Hurd" 2 => "A.G. Agustí" 3 => "P.W. Jones" 4 => "C. Vogelmeier" 5 => "A. Anzueto" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1164/rccm.201204-0596PP" "Revista" => array:6 [ "tituloSerie" => "Am J Respir Crit Care Med" "fecha" => "2013" "volumen" => "187" "paginaInicial" => "347" "paginaFinal" => "365" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22878278" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0070" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Prognostic assessment in COPD: health related quality of life and the BODE index" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J.M. Marin" 1 => "C.G. Cote" 2 => "O. Diaz" 3 => "C. Lisboa" 4 => "C. Casanova" 5 => "M.V. Lopez" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.rmed.2011.01.007" "Revista" => array:6 [ "tituloSerie" => "Respir Med" "fecha" => "2011" "volumen" => "105" "paginaInicial" => "916" "paginaFinal" => "921" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21282050" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0075" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Prognostic evaluation of COPD patients: GOLD 2011 versus BODE and the COPD comorbidity index COTE" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J.P. De Torres" 1 => "C. Casanova" 2 => "J.M. Marín" 3 => "V. Pinto-Plata" 4 => "M. Divo" 5 => "J.J. Zulueta" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1136/thoraxjnl-2014-205770" "Revista" => array:6 [ "tituloSerie" => "Thorax" "fecha" => "2014" "volumen" => "69" "paginaInicial" => "799" "paginaFinal" => "804" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24969641" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0080" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Comportamiento de la calidad de vida (SGRQ) en pacientes con EPOC según las puntuaciones BODE" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "N.L. Nonato" 1 => "O. Díaz" 2 => "O.A. Nascimento" 3 => "J. Dreyse" 4 => "J.R. Jardim" 5 => "C. Lisboa" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Arch Bronconeumol" "fecha" => "2015" "volumen" => "51" "paginaInicial" => "315" "paginaFinal" => "321" ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0085" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "St George's Respiratory Questionnaire Manual. Version 2.3" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "P. Jones" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:2 [ "fecha" => "2009" "editorial" => "St. George's University of London" ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0090" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Do GOLD stages of COPD severity really correspond to differences in health status?" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "R. Antonelli-Incalzi" 1 => "C. Imperiale" 2 => "V. Bellia" 3 => "F. Catalano" 4 => "N. Scichilone" 5 => "R. Pistelli" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Eur Respir J" "fecha" => "2003" "volumen" => "22" "paginaInicial" => "444" "paginaFinal" => "449" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14516133" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0095" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Health-related quality of life in patients by COPD severity within primary care in Europe" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "P.W. Jones" 1 => "G. Brusselle" 2 => "R.W. Dal Negro" 3 => "M. Ferrer" 4 => "P. Kardos" 5 => "M.L. Levy" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.rmed.2010.09.004" "Revista" => array:6 [ "tituloSerie" => "Respir Med" "fecha" => "2011" "volumen" => "105" "paginaInicial" => "57" "paginaFinal" => "66" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20932736" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0100" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Development and first validation of the COPD assessment test" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "P.W. Jones" 1 => "G. Harding" 2 => "P. Berry" 3 => "I. Wiklund" 4 => "W-H. Chen" 5 => "N. Kline Leidy" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1183/09031936.00102509" "Revista" => array:6 [ "tituloSerie" => "Eur Respir J" "fecha" => "2009" "volumen" => "34" "paginaInicial" => "648" "paginaFinal" => "654" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19720809" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/15792129/0000005100000007/v1_201506250123/S1579212915001676/v1_201506250123/en/main.assets" "Apartado" => array:4 [ "identificador" => "14568" "tipo" => "SECCION" "es" => array:2 [ "titulo" => "Editorial" "idiomaDefecto" => true ] "idiomaDefecto" => "es" ] "PDF" => "https://static.elsevier.es/multimedia/15792129/0000005100000007/v1_201506250123/S1579212915001676/v1_201506250123/en/main.pdf?idApp=UINPBA00003Z&text.app=https://archbronconeumol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212915001676?idApp=UINPBA00003Z" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 2 | 5 | 7 |
| 2024 October | 101 | 31 | 132 |
| 2024 September | 96 | 31 | 127 |
| 2024 August | 89 | 42 | 131 |
| 2024 July | 80 | 29 | 109 |
| 2024 June | 122 | 38 | 160 |
| 2024 May | 106 | 37 | 143 |
| 2024 April | 64 | 27 | 91 |
| 2024 March | 49 | 16 | 65 |
| 2024 February | 38 | 20 | 58 |
| 2023 March | 4 | 4 | 8 |
| 2023 February | 46 | 19 | 65 |
| 2023 January | 36 | 34 | 70 |
| 2022 December | 39 | 36 | 75 |
| 2022 November | 48 | 31 | 79 |
| 2022 October | 62 | 32 | 94 |
| 2022 September | 29 | 37 | 66 |
| 2022 August | 68 | 43 | 111 |
| 2022 July | 55 | 46 | 101 |
| 2022 June | 27 | 28 | 55 |
| 2022 May | 44 | 44 | 88 |
| 2022 April | 32 | 18 | 50 |
| 2022 March | 36 | 46 | 82 |
| 2022 February | 39 | 35 | 74 |
| 2022 January | 36 | 35 | 71 |
| 2021 December | 38 | 31 | 69 |
| 2021 November | 56 | 48 | 104 |
| 2021 October | 73 | 37 | 110 |
| 2021 September | 45 | 40 | 85 |
| 2021 August | 34 | 23 | 57 |
| 2021 July | 34 | 25 | 59 |
| 2021 June | 50 | 31 | 81 |
| 2021 May | 55 | 32 | 87 |
| 2021 April | 96 | 92 | 188 |
| 2021 March | 57 | 20 | 77 |
| 2021 February | 42 | 29 | 71 |
| 2021 January | 43 | 15 | 58 |
| 2020 December | 43 | 15 | 58 |
| 2020 November | 32 | 22 | 54 |
| 2020 October | 30 | 12 | 42 |
| 2020 September | 18 | 6 | 24 |
| 2020 August | 33 | 28 | 61 |
| 2020 July | 33 | 22 | 55 |
| 2020 June | 25 | 8 | 33 |
| 2020 May | 39 | 12 | 51 |
| 2020 April | 40 | 26 | 66 |
| 2020 March | 26 | 21 | 47 |
| 2020 February | 40 | 26 | 66 |
| 2020 January | 33 | 19 | 52 |
| 2019 December | 41 | 21 | 62 |
| 2019 November | 42 | 29 | 71 |
| 2019 October | 30 | 12 | 42 |
| 2019 September | 27 | 17 | 44 |
| 2019 August | 33 | 17 | 50 |
| 2019 July | 28 | 18 | 46 |
| 2019 June | 32 | 20 | 52 |
| 2019 May | 41 | 31 | 72 |
| 2019 April | 52 | 39 | 91 |
| 2019 March | 43 | 26 | 69 |
| 2019 February | 44 | 22 | 66 |
| 2019 January | 41 | 17 | 58 |
| 2018 December | 41 | 35 | 76 |
| 2018 November | 65 | 17 | 82 |
| 2018 October | 86 | 20 | 106 |
| 2018 September | 29 | 8 | 37 |
| 2018 May | 36 | 5 | 41 |
| 2018 April | 45 | 10 | 55 |
| 2018 March | 64 | 11 | 75 |
| 2018 February | 36 | 10 | 46 |
| 2018 January | 41 | 10 | 51 |
| 2017 December | 41 | 5 | 46 |
| 2017 November | 20 | 6 | 26 |
| 2017 October | 21 | 9 | 30 |
| 2017 September | 30 | 9 | 39 |
| 2017 August | 33 | 12 | 45 |
| 2017 July | 25 | 10 | 35 |
| 2017 June | 36 | 29 | 65 |
| 2017 May | 33 | 19 | 52 |
| 2017 April | 33 | 13 | 46 |
| 2017 March | 34 | 32 | 66 |
| 2017 February | 36 | 12 | 48 |
| 2017 January | 24 | 11 | 35 |
| 2016 December | 41 | 15 | 56 |
| 2016 November | 40 | 16 | 56 |
| 2016 October | 52 | 20 | 72 |
| 2016 September | 50 | 24 | 74 |
| 2016 August | 44 | 16 | 60 |
| 2016 July | 32 | 16 | 48 |
| 2016 March | 2 | 0 | 2 |
| 2016 February | 2 | 0 | 2 |
| 2015 December | 3 | 0 | 3 |
| 2015 October | 23 | 11 | 34 |
| 2015 August | 0 | 1 | 1 |
| 2015 July | 0 | 6 | 6 |
| 2015 June | 1 | 2 | 3 |
Show all
