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UU&#46;&#44; en una serie de pacientes en los servicios de urgencias de Indian&#225;polis&#44; se report&#243; una sobrevida del 7 al 15&#37;<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">12</span></a> en los pacientes con TCE debido a HPAF&#46; La mayor parte de las v&#237;ctimas &#40;cerca del 90&#37;&#41; mueren antes de llegar al servicio de urgencias&#44; se conoce que tan solo el 50&#37; de aquellas que logran llegar sobreviven&#46; Se estima que en EE&#46; UU&#46; anualmente 70&#46;000 personas son v&#237;ctimas de HPAF&#44; dejando como resultado 30&#46;000 muertes<a class="elsevierStyleCrossRefs" href="#bib0225"><span class="elsevierStyleSup">13-16</span></a>&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">Cali&#44; es una de las ciudades con m&#225;s violencia de Latinoam&#233;rica&#44; con una tasa de homicidios de 53&#44;7 por cada 100&#46;000 habitantes en el a&#241;o 2016<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">17</span></a>&#59; para el a&#241;o 1996 se registr&#243; una tasa de 105 homicidios por cada 100&#46;000 habitantes para cerrar en el 2010 con una tasa de 81 por 100&#46;000<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">17</span></a>&#46; La causa de muerte fue provocada en su mayor&#237;a por HPAF lo que genera un grave problema de salud p&#250;blica<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">18</span></a>&#44; sin embargo&#44; hay un d&#233;ficit de an&#225;lisis de las caracter&#237;sticas cl&#237;nicas y desenlaces de los pacientes con TCE por HPAF&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">El prop&#243;sito del estudio es presentar una estad&#237;stica de los pacientes con HPAF en cr&#225;neo que ingresan en la Fundaci&#243;n Valle del Lili en Cali&#44; Colombia&#59; con el fin de caracterizar a la poblaci&#243;n afectada para as&#237; identificar acciones que puedan contribuir a la disminuci&#243;n de la morbimortalidad y contribuyan a mejorar la funcionalidad postrauma&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Materiales y m&#233;todos</span><p id="par0035" class="elsevierStylePara elsevierViewall">Se realiz&#243; un estudio descriptivo&#44; observacional&#44; retrospectivo a trav&#233;s de la revisi&#243;n de historias cl&#237;nicas digitales y f&#237;sicas de los pacientes mayores de 18 a&#241;os con TCE secundario a HPAF en contexto civil que ingresaron en la sala de urgencias de la Fundaci&#243;n Valle del Lili en Cali&#44; Colombia&#44; entre enero del 2010 y febrero del 2016&#46; Los datos se introdujeron en la base de datos de Neurotrauma de la Fundaci&#243;n Valle del Lili del registro general de TCE en adultos y ni&#241;os&#44; la cual cuenta con 364 pacientes ingresados dentro del periodo de tiempo mencionado&#46; Este estudio cuenta con aprobaci&#243;n del comit&#233; de &#233;tica institucional y debido a la obtenci&#243;n retrospectiva de datos no se requiri&#243; obtener consentimiento informado de los pacientes&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">Para el an&#225;lisis estad&#237;stico las variables num&#233;ricas fueron presentadas por medio de medidas de tendencia central y dispersi&#243;n dependiendo de la distribuci&#243;n de los datos&#44; y las variables categ&#243;ricas se presentaron como proporciones&#46; La muestra de pacientes fue luego comparada de acuerdo a los resultados cl&#237;nicos al egreso &#40;muerte y discapacidad&#41;&#46; Se defini&#243; como desenlace cl&#237;nico adverso un puntaje de 3 a 6 de Glasgow Outcome Score Extended &#40;GOSE&#41; al egreso&#46; Se utiliz&#243; la prueba de Chi<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">2</span></a> para evaluar diferencias en variables categ&#243;ricas y de acuerdo a la distribuci&#243;n de los datos continuos&#44; se utiliz&#243; una prueba de Two-sample T-test o un Mann-Whitney U test para las comparaciones realizadas para variables num&#233;ricas&#46; Adicionalmente&#44; se utiliz&#243; el an&#225;lisis de Kaplan-Meier para estimar la sobrevida de la poblaci&#243;n estudiada&#46; Se defini&#243; como estad&#237;sticamente significativo aquellos resultados que presentaran un valor de p&#60;0&#44;05&#46; Para el an&#225;lisis de los datos se utiliz&#243; el programa STATA 12&#46;0&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Resultados</span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Datos Demogr&#225;ficos y Cl&#237;nicos</span><p id="par0045" class="elsevierStylePara elsevierViewall">Un total de 95 pacientes fueron incluidos para el an&#225;lisis&#46; Las caracter&#237;sticas demogr&#225;ficas y cl&#237;nicas est&#225;n resumidas en la <a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a>&#46; La edad promedio de los pacientes fue de 28 a&#241;os &#40;21&#44;9 &#8211; 37&#44;1&#41;&#59; el 91&#44;5&#37; de los pacientes fueron de sexo masculino&#59; la mayor&#237;a de las heridas fueron debidas a asalto &#40;violencia interpersonal&#41; en un 54&#44;7&#37;&#44; seguido por un 26&#44;3&#37; de casos en los que no se conoce el contexto y finalmente un 13&#44;6&#37; de lesiones accidentales &#40;&#171;bala perdida&#47;manipulaci&#243;n de armas&#187;&#41;&#46; Sesenta y cinco pacientes ingresaron en el servicio de Urgencias en ambulancia dentro de la primera hora posterior al trauma &#40;rango de llegada 1-2 h&#41;&#46; El Injury Severity Score &#40;ISS&#41; de los pacientes en el servicio de urgencias tuvo una mediana de 48 &#40;RIQ 22-75&#41; y el GCS en la admisi&#243;n se encontraba de 3-8 en 64&#44;2&#37; de los casos&#44; 9-12 en el 6&#44;3&#37; y 13-15 en el 28&#44;4&#37;&#46; En el 86&#44;3&#37; de los casos se realiz&#243; tomograf&#237;a axial computarizada &#40;TAC&#41; de cr&#225;neo simple la cual se valor&#243; seg&#250;n el Marshall-score&#59; este mostr&#243; que el 36&#44;7&#37; ten&#237;an un puntaje de I-II&#44; el 24&#44;2&#37; III y el 17&#44;8&#37; IV&#44; mientras que solo el 4&#44;2&#37; present&#243; puntajes de V-VI&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Mortalidad</span><p id="par0050" class="elsevierStylePara elsevierViewall">La mortalidad y la escala GOSE se resume en la <a class="elsevierStyleCrossRef" href="#tbl0010">tabla 2</a>&#46; Las variables relacionadas con mayor mortalidad se resumen en la <a class="elsevierStyleCrossRef" href="#tbl0015">tabla 3</a>&#44; destac&#225;ndose que el 97&#44;7&#37; de los pacientes fallecidos ten&#237;an un GCS entre 3 y 8&#44; en comparaci&#243;n a el 37&#44;3&#37; de los sobrevivientes &#40;p&#60;0&#44;001&#41;&#59; por el contrario de los pacientes fallecidos el 0&#37; puntu&#243; 13-15 en GCS versus el 52&#44;9&#37; de los pacientes que sobrevivieron &#40;p&#60;0&#44;001&#41;&#46; De igual forma se encontr&#243; que el valor del ISS y el APACHE II son determinantes en el pron&#243;stico de los pacientes al encontrarse para el primero una mediana de 75 &#40;RIQ 75-75&#41; en el grupo de pacientes fallecidos comparado con una mediana de 26&#44;5 &#40;RIQ 11 - 43&#41; para los sobrevivientes &#40;p&#60;0&#44;001&#41; y para el segundo una mediana de 20 &#40;RIQ 17-23&#41; en los pacientes fallecidos versus una mediana del 10 &#40;RIQ 8 - 15&#41; en los sobrevivientes &#40;p&#60;0&#44;001&#41;&#46; La presi&#243;n de ingreso no mostr&#243; diferencias entre los grupos de pacientes&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0055" class="elsevierStylePara elsevierViewall">Otro hallazgo relevante fue que la incidencia de la midriasis bilateral fue mayor en el grupo de los pacientes que fallecieron &#40;45&#44;2&#37;&#41;&#44; mientras que los pacientes que sobrevivieron solo presentaban este hallazgo en un 4&#37; de los casos &#40;p&#60;0&#44;001&#41;&#46; Por otro lado&#44; los pacientes que presentaron ausencia de respuesta a los reflejos lum&#237;nicos sobrevivieron en un 74&#44;5&#37; de los casos&#44; falleciendo tan solo el 16&#44;7&#37; de quienes ten&#237;an este hallazgo&#46; De los pacientes que fallecieron 71&#44;4&#37; ten&#237;an respuesta pupilar unilateral &#40;p&#60;0&#44;001&#41;&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">Los pacientes que no requirieron intubaci&#243;n en urgencias o debieron ser reintubados tuvieron una mortalidad del 46&#44;5&#37; versus el 78&#44;8&#37; en quienes no requirieron intubaci&#243;n o no fueron reintubados &#40;p&#61;0&#44;001&#41;&#59; por otro lado&#44; los pacientes que fueron intubados en el servicio de urgencias por primera vez tuvieron una mortalidad del 53&#44;5&#37; con una sobrevida de tan solo el 21&#44;2&#37; tras el alta hospitalaria &#40;p&#61;0&#44;001&#41;&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">En la <a class="elsevierStyleCrossRef" href="#tbl0015">tabla 3</a> se muestran los hallazgos de mortalidad versus escala de Marshall en la TAC&#46; El 17&#44;3&#37; de los pacientes que sobrevivieron requirieron craniectom&#237;a&#44; el 21&#44;6&#37; requirieron esquirlectom&#237;a&#44; mientras que solo el 4&#44;7&#37; de los que fallecieron fueron sometidos a manejo quir&#250;rgico&#44; sin embargo&#44; esto no fue estad&#237;sticamente significativo &#40;p&#61;0&#44;055&#41;&#46; En total se operaron 18 pacientes&#44; de los cuales 16 sobrevivieron mientras que tan solo 2 murieron&#46; De los 16 pacientes que se operaron y sobrevivieron tan solo un paciente desarroll&#243; una infecci&#243;n del sitio operatorio &#40;ISO&#41; asociada a la realizaci&#243;n de una craniectom&#237;a para esquirlectom&#237;a y drenaje de hematoma&#59; por otro lado otro paciente &#40;1&#41; desarroll&#243; una ISO asociada a otro tipo de cirug&#237;a&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">En la <a class="elsevierStyleCrossRef" href="#tbl0020">tabla 4</a>&#44; se muestran los datos de estancia hospitalaria y complicaciones&#46; La duraci&#243;n de la estancia hospitalaria fue m&#225;s prolongada en los pacientes que sobrevivieron con una estancia promedio de 7 d&#237;as &#40;RIQ 5 &#8211; 12&#44;5&#41;&#44; mientras que los pacientes que fallecieron tuvieron una estancia promedio de un d&#237;a &#40;RIQ 0 &#8211; 1&#41;&#46; Por otra parte&#44; los requerimientos de Unidad de Cuidados Intensivos &#40;UCI&#41; fueron mayores en los pacientes que sobrevivieron &#40;88&#44;5&#37;&#41; versus &#40;60&#44;5&#37;&#41; en quienes fallecieron &#40;p&#61;0&#44;002&#41;&#46; Al igual que la estancia hospitalaria&#44; la estancia en UCI fue mayor en aquellos que sobrevivieron&#44; con un promedio de 5 d&#237;as &#40;RIQ 2 &#8211; 9&#41;&#44; contra un d&#237;a &#40;RIQ 1 &#8211; 1&#41; en aquellos pacientes que fallecieron &#40;p&#61;0&#44;0002&#41;&#46; Los requerimientos de ventilaci&#243;n mec&#225;nica fueron mayores en el grupo de pacientes fallecidos con un 96&#44;2&#37; del total de pacientes&#44; comparado con un 63&#37; de los pacientes que sobrevivieron &#40;p&#61;0&#44;002&#41;&#46; Entre los sobrevivientes se presentaron infecciones asociadas a los cuidados de la salud&#58; 3&#44;8&#37;&#44; ISO &#40;p&#61;0&#44;502&#41;&#44; 11&#44;5&#37; neumon&#237;a asociada al ventilador &#40;p&#61;0&#44;033&#41;&#44; 3&#44;8&#37; infecci&#243;n de v&#237;as urinarias asociada a cat&#233;ter &#40;p&#61;0&#44;502&#41;&#44; 1&#44;9&#37; bacteriemia &#40;p&#62;0&#44;99&#41; y 5&#44;8&#37; otras infecciones nosocomiales &#40;osteomielitis&#47;traque&#237;tis&#41; &#40;p&#61;0&#44;249&#41;&#46; El 86&#44;5&#37; de los pacientes que sobrevivieron &#40;n&#61;45&#41; recibieron manejo con antibi&#243;tico profil&#225;ctico por lesi&#243;n&#44; hayan sido o no intervenidos quir&#250;rgicamente versus el 17&#44;1&#37; &#40;n&#61;7&#41; de los fallecidos&#46;</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Desenlace cl&#237;nico adverso</span><p id="par0075" class="elsevierStylePara elsevierViewall">Finalmente&#44; se analiz&#243; &#250;nicamente el grupo de supervivientes respecto a la escala GOSE al egreso &#40;<a class="elsevierStyleCrossRef" href="#tbl0025">tabla 5</a>&#41;&#46; Se dividi&#243; en dos grupos&#58; aquellos con discapacidad severa y moderada &#40;3-6&#41; quienes fueron considerados como resultados cl&#237;nicos adversos y aquellos con buenos resultados cl&#237;nicos &#40;7-8&#41;&#46; Dentro de las variables que se compararon se encontr&#243; que el 52&#44;4&#37; de los pacientes con GOSE entre 3-6 ten&#237;an apertura parcialmente cerrada de las cisternas de la base mientras que los pacientes con un GOSE entre 7-8 el 84&#37; presentaron apertura completa de las cisternas de la base&#46; Por otra parte&#44; el APACHE II fue menor en los pacientes con GOSE 7-8 con un promedio de 8 &#40;RIQ 6 &#8211; 13&#41;&#44; comparado con aquellos pacientes con un GOSE de 3-6 cuyo promedio fue de 11 &#40;RIQ 9 &#8211; 13&#41;&#46; Para el resto de variables evaluadas&#44; no se encontraron diferencias estad&#237;sticamente significativas &#40;<a class="elsevierStyleCrossRef" href="#tbl0020">tabla 4</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0025"></elsevierMultimedia><p id="par0080" class="elsevierStylePara elsevierViewall">En la <a class="elsevierStyleCrossRef" href="#fig0005">figura 1</a> se muestra la curva de sobrevida de Kaplan-Meier&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia></span></span></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Discusi&#243;n</span><p id="par0085" class="elsevierStylePara elsevierViewall">A diferencia de la epidemiolog&#237;a observada en otros estudios&#44; en donde la mitad de las muertes por TCE por HPAF se deben a suicidios&#44; en nuestro estudio la proporci&#243;n m&#225;s alta de pacientes sufrieron esta lesi&#243;n en el contexto de violencia interpersonal&#46; Adicionalmente&#44; encontramos como tercera causa las lesiones accidentales lo cual coincide con la literatura revisada<a class="elsevierStyleCrossRefs" href="#bib0255"><span class="elsevierStyleSup">19-21</span></a>&#46; Se puede evidenciar que tanto en nuestro estudio como en la literatura&#44; la mayor incidencia de estas lesiones se presenta en hombres y en poblaci&#243;n joven con una media de edad entre los 28 a 30 a&#241;os<a class="elsevierStyleCrossRefs" href="#bib0260"><span class="elsevierStyleSup">20-28</span></a>&#46; Las lesiones en esta poblaci&#243;n que se encuentra en edad laboral&#44; pueden producir incapacidad para valerse por s&#237; mismos&#44; para desarrollar actividades de la vida diaria y de ejercer un trabajo lo cual genera grandes p&#233;rdidas a nivel socioecon&#243;mico para el pa&#237;s&#46; No hay diferencia en la presente serie respecto a la literatura en cuanto al tiempo de llegada &#40;1 hora&#41; ni al m&#233;todo de transporte&#44; siendo el m&#225;s com&#250;n la ambulancia medicalizada<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">20</span></a>&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">Muchos factores han sido evaluados para definir cu&#225;les dan mayores riesgos de resultados adversos al egreso y muerte en pacientes con TCE debido a HPAF&#46; Hay reportes que refieren que una presi&#243;n arterial sist&#243;lica menor a 90<span class="elsevierStyleHsp" style=""></span>mmHg al ingreso&#44; es un factor de mal pron&#243;stico<a class="elsevierStyleCrossRefs" href="#bib0265"><span class="elsevierStyleSup">21&#44;25</span></a>&#44; sin embargo&#44; en nuestro estudio no se vio una asociaci&#243;n estad&#237;sticamente significativa entre la presi&#243;n arterial de ingreso y la mortalidad&#46; La mortalidad relacionada con el GCS es similar a la reportada<a class="elsevierStyleCrossRefs" href="#bib0260"><span class="elsevierStyleSup">20&#44;24&#44;26&#44;29</span></a>&#46; Debido a que la mayor&#237;a de los pacientes que fallecieron lo hicieron en las primeras 24 h&#44; se asume que este per&#237;odo de tiempo es cr&#237;tico para definir el pron&#243;stico del paciente y el requerimiento de intervenciones m&#233;dico-quir&#250;rgicas agresivas<a class="elsevierStyleCrossRefs" href="#bib0260"><span class="elsevierStyleSup">20-22&#44;30</span></a>&#46; Se puede ver c&#243;mo en pa&#237;ses en v&#237;a de desarrollo como la India&#44; la mortalidad es mucho mayor y alcanza hasta un 87&#44;69&#37;&#44; con una mayor mortalidad en el traslado a los centros m&#233;dicos&#44; lo que podr&#237;a indicar que el pron&#243;stico es influenciado por los recursos econ&#243;micos del pa&#237;s donde ocurran los sucesos<a class="elsevierStyleCrossRef" href="#bib0315"><span class="elsevierStyleSup">31</span></a>&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">Un estudio de 107 casos por Ozkan et al&#46; muestra una mortalidad de tan solo el 21&#37;&#59; al analizar la distribuci&#243;n del GCS de ingreso se puede ver que 35 pacientes presentaban un GCS entre 5-7&#44; de los cuales murieron el 37&#37; y 3 presentaban un GCS de 3 de los cuales el 100&#37; muri&#243;&#59; esto reforzar&#237;a lo encontrado por este estudio&#44; a un menor GCS se presenta una mayor mortalidad<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">20</span></a>&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">Otra variable de mal pron&#243;stico es una respuesta pupilar alterada&#44; la cual suele estar presente en el 50 &#8211; 60&#37; de pacientes con TCE por HPAF&#46; Coincidimos con reportes previos en este aspecto<a class="elsevierStyleCrossRefs" href="#bib0265"><span class="elsevierStyleSup">21&#44;26&#44;30&#44;32</span></a>&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">Las HPAF en cr&#225;neo se consideran heridas contaminadas&#44; tienen tejido cerebral desvitalizado y fragmentos de hueso retenidos que act&#250;an como focos infecciosos&#44; por este motivo estos pacientes requieren profilaxis antibi&#243;tica<a class="elsevierStyleCrossRefs" href="#bib0240"><span class="elsevierStyleSup">16&#44;21</span></a>&#46; La principal complicaci&#243;n infecciosa tras un procedimiento quir&#250;rgico es la infecci&#243;n del sitio operatorio&#46; En el siglo XX se reportaron incidencias entre el 5 y el 23&#37;&#46; En este estudio se evidencia una baja incidencia con tan solo un 3&#44;8&#37; en comparaci&#243;n con lo reportado en la literatura&#44; teniendo en cuenta que a la gran mayor&#237;a de los pacientes no se les realiz&#243; cirug&#237;a&#46; Otro tipo de infecciones documentadas son las del sistema nervioso central&#44; las cuales acarrean una alta tasa de mortalidad<a class="elsevierStyleCrossRefs" href="#bib0260"><span class="elsevierStyleSup">20&#44;21</span></a>&#59; en este estudio no se present&#243; ninguna en los 95 pacientes&#46; Los pacientes que murieron tuvieron una estancia hospitalaria media de un d&#237;a&#44; raz&#243;n por la cual no alcanzaron a desarrollar infecci&#243;n&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">Diversos estudios encontraron como factores de mal pron&#243;stico la lesi&#243;n del sistema ventricular y la lesi&#243;n de ambos hemisferios&#46; Estos dos factores no fueron comparados directamente entre los casos de mortalidad y los sobrevivientes en nuestro estudio&#44; sin embargo&#44; podr&#237;a correlacionar estos hallazgos con puntajes de Marshall<a class="elsevierStyleCrossRefs" href="#bib0255"><span class="elsevierStyleSup">19&#44;20&#44;22&#44;26&#44;27</span></a> entre III y IV&#44; los cuales indican lesi&#243;n difusa con edema cerebral uni- o bilateral y estaban presentes en mayor medida en los pacientes que fallecieron&#46; Puntajes de Marshall de VI se correlacionan con alta mortalidad&#44; lo que podr&#237;a explicarse por la presencia de hematomas no drenados los cuales son un factor de mal pron&#243;stico<a class="elsevierStyleCrossRefs" href="#bib0260"><span class="elsevierStyleSup">20&#44;26</span></a>&#46; Se ha visto que los pacientes que logran sobrevivir suelen cursar con una funcionalidad moderada a buena cuando se les realiza seguimiento con la escala de GOSE<a class="elsevierStyleCrossRefs" href="#bib0260"><span class="elsevierStyleSup">20&#44;22&#44;24</span></a>&#46; Esto se pudo evidenciar en nuestro estudio donde el 54&#44;1&#37; del total de pacientes&#44; obtuvo un puntaje de 7 u 8 &#40;recuperaci&#243;n completa sin d&#233;ficit&#41;&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">Al cruzar los datos de mortalidad con el ISS&#44; podemos observar que aquellos pacientes que presentaron un ISS m&#225;s alto&#44; se asociaron a mayor mortalidad&#44; es decir que aquellos pacientes con m&#225;s de un sistema comprometido&#44; tuvieron un riesgo mayor de fallecer<a class="elsevierStyleCrossRef" href="#bib0320"><span class="elsevierStyleSup">32</span></a>&#46; En cuanto al pron&#243;stico&#44; tras el egreso&#44; en esta serie se observaron dos factores estad&#237;sticamente significativos&#58; la oclusi&#243;n de las cisternas basales y un score APACHE II mayor&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Conclusiones</span><p id="par0120" class="elsevierStylePara elsevierViewall">La mortalidad secundaria a TCE penetrante por HPAF es elevada&#44; principalmente en pa&#237;ses en v&#237;a de desarrollo&#44; como Colombia&#46; Se debe identificar tempranamente qu&#233; pacientes pueden tener un pron&#243;stico neurol&#243;gico favorable con el fin de intensificar las medidas terap&#233;uticas en estos y as&#237; mejorar el pron&#243;stico neurol&#243;gico y disminuir la morbimortalidad&#46; Hacen falta estudios adicionales&#44; para caracterizar apropiadamente a los pacientes que pueden presentar un mejor pron&#243;stico neurol&#243;gico o que requerir&#225;n de intervenciones m&#225;s agresivas posterior a un TCE secundario a HPAF&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Conflicto de intereses</span><p id="par0125" class="elsevierStylePara elsevierViewall">Los autores declaran no tener ning&#250;n conflicto de intereses&#46;</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Agradecimientos</span><p id="par0135" class="elsevierStylePara elsevierViewall">Agradecemos la colaboraci&#243;n de las Dras&#46; Maria Alejandra Posada y Sara Loaiza-Osorio en la redacci&#243;n del manuscrito</p></span></span>"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objetivo</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Este estudio busca describir casos de trauma craneoencef&#225;lico debido a heridas por proyectil de arma de fuego&#44; en poblaci&#243;n civil mayor de 18 a&#241;os&#44; atendidos en un hospital de referencia y realizar una comparaci&#243;n de los pacientes de acuerdo a los resultados cl&#237;nicos al egreso&#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 trata de un estudio descriptivo&#44; observacional&#44; retrospectivo a trav&#233;s de la revisi&#243;n de historias cl&#237;nicas de los pacientes mayores de 18 a&#241;os que ingresaron en la sala de urgencias de la Fundaci&#243;n Valle del Lili en Cali&#44; Colombia con trauma craneoencef&#225;lico secundario a heridas por proyectil de arma de fuego&#44; en contexto civil&#44; entre enero del 2010 y febrero del 2016&#46; Se realiz&#243; un an&#225;lisis univariado para determinar factores asociados a muerte y resultados cl&#237;nicos adversos&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Se incluy&#243; un total de 95 pacientes con trauma craneoencef&#225;lico por heridas por proyectil de arma de fuego en el contexto civil&#46; El 91&#44;6&#37; fue de sexo masculino&#44; el principal contexto fue violencia interpersonal en un 54&#44;7&#37;&#44; el m&#233;todo de transporte m&#225;s com&#250;n fue ambulancia terrestre en un 79&#37;&#44; el puntaje de Glasgow &#40;GCS&#41; al ingreso fue 3-8 &#61; 64&#44;2&#37;&#59; 9-12 &#61; 6&#44;3&#37;&#59; 13-15&#61;28&#44;4&#37;&#46; Al ingreso se le tom&#243; TAC simple a 82 &#40;86&#44;3&#37;&#41; pacientes dentro de la primera hora&#44; encontrando una clasificaci&#243;n de Marshall entre I-III en 60&#44;9&#37;&#44; un valor de IV en el 17&#44;8&#37; y entre V-VI en un 4&#44;1&#37;&#46; La trayectoria era penetrante no transfixiante en el 43&#44;2&#37;&#44; transfixiante en el 27&#44;4&#37; y tangencial en el 9&#44;5&#37;&#46; La mortalidad fue del 45&#44;3&#37;&#44; de esta 39&#37; ocurri&#243; en las primeras 24<span class="elsevierStyleHsp" style=""></span>h&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Un mayor compromiso en el estado general del paciente al ingreso determina un pobre pron&#243;stico y mayor probabilidad de muerte en las primeras 24 h&#46;</p></span>"
        "secciones" => array:4 [
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            "titulo" => "Objetivo"
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            "titulo" => "M&#233;todos"
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            "identificador" => "abst0015"
            "titulo" => "Resultados"
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            "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">This study aims to describe cases of traumatic brain injury due to gunshot wounds in civilian population over 18 years of age&#44; treated at a referral hospital in Cali&#44; Colombia and compare the clinical outcomes at discharge&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Methods</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">An observational&#44; descriptive cross-sectional study was conducted by retrospectively collecting clinical data related to adult patients that presented traumatic brain injury due to civil gunshot-wounds and that consulted to the emergency room at Fundaci&#243;n Valle del Lili Hospital in Cali&#44; Colombia between January 2010 and February of 2016&#46; A univariate analysis was performed to determine factors associated with death and adverse clinical outcomes&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">A total of 95 patients older than 18 years&#44; with traumatic brain injury by gunshot were included in the civil context&#46; The 91&#46;6&#37; were male&#46; The main context was interpersonal violence with 54&#46;7&#37;&#46; The most common method of transportation was by ambulance &#40;79&#37;&#41;&#46; The Glasgow score at admission was 3-8 in 64&#46;2&#37; of cases&#59; 9-12 in 6&#46;32&#37; and 13-15 in 28&#46;4&#37;&#46; On admission&#44; head CT scan was performed in 82 &#40;86&#46;3&#37;&#41; patients within the first hour&#44; finding a Marshall-Score between I-III in 60&#46;9&#37;&#44; of IV in 17&#46;8&#37; of cases and a score between V-VI and in 4&#46;1&#37;&#46; The trajectory was non-transfixing penetrating in 43&#46;2&#37;&#44; transfixing in 27&#46;3&#37; and tangential in 9&#46;5&#37;&#46; Mortality was 45&#46;3&#37; in total&#44; 39&#37; died within the first 24<span class="elsevierStyleHsp" style=""></span>hours&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">A major compromise on admission determines an overall poorer prognosis and a high likelihood of death in the first 24-hours&#46;</p></span>"
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            "titulo" => "Results"
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            "titulo" => "Conclusions"
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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&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Dato al ingreso&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Edad &#40;a&#241;os&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">28 &#40;21&#44;9 - 37&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleItalic">G&#233;nero</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>Femenino&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8 &#40;8&#44;4&#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>Masculino&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">87 &#40;91&#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"><span class="elsevierStyleItalic">Intencionalidad</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></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>Accidental&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">13 &#40;13&#44;6&#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>Autoinflingido&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5 &#40;5&#44;2&#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>Violencia interpersonal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">52 &#40;54&#44;7&#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>Se desconoce&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">25 &#40;26&#44;3&#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="2" 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="2" align="left" valign="top"><span class="elsevierStyleItalic">M&#233;todo de transporte al hospital</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>Ambulancia terrestre&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">75 &#40;78&#44;9&#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>Coche de polic&#237;a&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4 &#40;4&#44;2&#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>Coche particular&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2 &#40;2&#44;1&#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>Ambulancia a&#233;rea&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6 &#40;6&#44;3&#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>Se desconoce&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8 &#40;8&#44;4&#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="elsevierStyleItalic">Tiempo de llegada al hospital &#40;horas</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1 &#40;1-2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Puntaje ISS al ingreso</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">48 &#40;22-75&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleItalic">Escala de Glasgow al ingreso</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>&#8804;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">61 &#40;64&#44;2&#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>9 - 12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6 &#40;6&#44;3&#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>13 -15&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">27 &#40;28&#44;4&#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>Se desconoce&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1 &#40;1&#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="2" 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="2" align="left" valign="top"><span class="elsevierStyleItalic">Intubaci&#243;n orotraqueal previa</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>No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">60 &#40;63&#44;1&#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;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">31 &#40;32&#44;6&#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>Se desconoce&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4 &#40;4&#44;2&#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="elsevierStyleItalic">Toma de TAC al ingreso</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">82 &#40;86&#44;3&#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="2" 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="2" align="left" valign="top"><span class="elsevierStyleItalic">Clasificaci&#243;n de MARSHALL</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>I&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9 &#40;9&#44;4&#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>II&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">26 &#40;27&#44;3&#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>III&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">23 &#40;24&#44;2&#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>IV&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">17 &#40;17&#44;8&#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>V&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1 &#40;1&#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>VI&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3 &#40;3&#44;1&#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>Se desconoce&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">16 &#40;16&#44;8&#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="2" 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="2" align="left" valign="top"><span class="elsevierStyleItalic">Trayectoria del proyectil</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>Penetrante no transfixiante&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">41 &#40;43&#44;1&#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>Transfixiante&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">26 &#40;27&#44;3&#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>Tangencial&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9 &#40;9&#44;4&#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>Se desconoce&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">19 &#40;20&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab1838580.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "es" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Perfil demogr&#225;fico y cl&#237;nico de la poblaci&#243;n estudiada</p>"
        ]
      ]
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        "identificador" => "tbl0010"
        "etiqueta" => "Tabla 2"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at2"
            "detalle" => "Tabla "
            "rol" => "short"
          ]
        ]
        "tabla" => array:1 [
          "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">Datos al egreso&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Total&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">GOSE al egreso</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">n&#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">43 &#40;45&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1 &#40;1&#44;0&#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>3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2 &#40;2&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7 &#40;7&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2 &#40;2&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8 &#40;8&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6 &#40;6&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">26 &#40;27&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Muerte &#40;total&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">n&#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">52 &#40;54&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>S&#237;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">43 &#40;45&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab1838577.png"
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        ]
        "descripcion" => array:1 [
          "es" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Mortalidad general y estado al egreso</p>"
        ]
      ]
      3 => 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"
          ]
        ]
        "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="center" valign="top" scope="col" style="border-bottom: 2px solid black">Sobrevivientes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Fallecidos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Valor de p&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">GCS ingreso</span><a class="elsevierStyleCrossRef" href="#tblfn0005"><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="left" valign="top"><span class="elsevierStyleItalic">n&#61;51&#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">n&#61;43&#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " rowspan="4" align="left" valign="top">&#60;0&#44;001</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>3-8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">19 &#40;37&#44;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">42 &#40;97&#44;7&#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>9-12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5 &#40;9&#44;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1 &#40;2&#44;3&#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>13-15&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">27 &#40;52&#44;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0 &#40;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="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="3" align="left" valign="top"><span class="elsevierStyleItalic">ISS</span><a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">c</span></a></td><td class="td" title="table-entry  " rowspan="2" align="left" valign="top">&#60;0&#44;001</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>Puntaje promedio&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">26&#44;5 &#40;11-43&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">75 &#40;75-75&#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="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="3" align="left" valign="top"><span class="elsevierStyleItalic">APACHE II</span><a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">c</span></a></td><td class="td" title="table-entry  " rowspan="2" align="left" valign="top">&#60;0&#44;001</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>Puntaje promedio&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10 &#40;8-15&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">20 &#40;17-23&#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="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Examen pupilar</span><a class="elsevierStyleCrossRef" href="#tblfn0005"><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="left" valign="top"><span class="elsevierStyleItalic">n&#61;50&#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">n&#61;42&#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " rowspan="4" align="left" valign="top">&#60;0&#44;001</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>Isocoria&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">42 &#40;84&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9 &#40;21&#44;4&#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>Anisocoria&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6 &#40;12&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">14 &#40;33&#44;3&#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>Midriasis bilateral&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2 &#40;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">19 &#40;45&#44;2&#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="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Reflejo pupilar</span><a class="elsevierStyleCrossRef" href="#tblfn0005"><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="left" valign="top"><span class="elsevierStyleItalic">n&#61;51&#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">n&#61;42&#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " rowspan="4" align="left" valign="top">&#60;0&#44;001</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>Respuesta unilateral&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5 &#40;9&#44;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">30 &#40;71&#44;4&#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>Respuesta bilateral&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8 &#40;15&#44;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5 &#40;11&#44;9&#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>Sin respuesta&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">38 &#40;74&#44;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7 &#40;16&#44;7&#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="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="3" align="left" valign="top"><span class="elsevierStyleItalic">Presi&#243;n arterial media</span><a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a></td><td class="td" title="table-entry  " rowspan="2" align="left" valign="top">0&#44;162</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>Presi&#243;n arterial media &#40;PAM&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">124 &#40;114-137&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">120 &#40;90-139&#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="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Intubaci&#243;n</span><a class="elsevierStyleCrossRef" href="#tblfn0005"><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="left" valign="top"><span class="elsevierStyleItalic">n&#61;52&#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">n&#61;43&#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " rowspan="3" align="left" valign="top">0&#44;001</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>No requirieron o necesidad de reintubaci&#243;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">41 &#40;78&#44;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">20 &#40;46&#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"><span class="elsevierStyleHsp" style=""></span>Intubados en urgencias&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">11 &#40;21&#44;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">23 &#40;53&#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="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Marshall</span><a class="elsevierStyleCrossRef" href="#tblfn0005"><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="left" valign="top">n&#61;50&#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">n&#61;29&#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " rowspan="4" align="left" valign="top">0&#44;016</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>I-II-III&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">42 &#40;84&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">16 &#40;55&#44;2&#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>IV&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5 &#40;10&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">12 &#40;41&#44;4&#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>V-VI&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3 &#40;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1 &#40;3&#44;4&#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="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Craniectom&#237;a</span><a class="elsevierStyleCrossRef" href="#tblfn0005"><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="left" valign="top"><span class="elsevierStyleItalic">n&#61;52&#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">n&#61;43&#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " rowspan="3" align="left" valign="top">0&#44;055</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">43 &#40;82&#44;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">41 &#40;95&#44;3&#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;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9 &#40;17&#44;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2 &#40;4&#44;7&#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="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Esquirlectom&#237;a</span><a class="elsevierStyleCrossRef" href="#tblfn0005"><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="left" valign="top"><span class="elsevierStyleItalic">n&#61;51&#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">n&#61;42&#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " rowspan="3" align="left" valign="top">0&#44;001</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">40 &#40;78&#44;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">42 &#40;100&#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;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">11 &#40;21&#44;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0 &#40;0&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " rowspan="2" align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Variables</th><th class="td" title="table-head  " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Muerte</th><th class="td" title="table-head  " rowspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Valor de p</th></tr><tr title="table-row"><th class="td-with-role" title="table-head ; entry_with_role_rowhead " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">No&#44; n&#61;52&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">S&#237;&#44; n&#61;43&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " colspan="3" align="left" valign="top"><span class="elsevierStyleItalic">Duraci&#243;n estancia hospitalaria</span><a class="elsevierStyleCrossRef" href="#tblfn0025"><span class="elsevierStyleSup">b</span></a></td><td class="td" title="table-entry  " rowspan="2" align="left" valign="top">&#60;0&#44;001</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>D&#237;as promedio&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7 &#40;5-12&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1 &#40;0-1&#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="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Requerimiento de UCI</span><a class="elsevierStyleCrossRef" href="#tblfn0020"><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="left" valign="top">n&#61;52&#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">n&#61;43&#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " rowspan="2" align="left" valign="top">0&#44;002</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>Total pacientes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">46 &#40;88&#44;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">26 &#40;60&#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="4" 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="2" align="left" valign="top"><span class="elsevierStyleItalic">Estancia en UCI</span><a class="elsevierStyleCrossRef" href="#tblfn0025"><span class="elsevierStyleSup">b</span></a></td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " rowspan="2" align="left" valign="top">0&#44;0002</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>D&#237;as promedio&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5 &#40;2-9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1 &#40;1-1&#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="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Ventilaci&#243;n mec&#225;nica</span><a class="elsevierStyleCrossRef" href="#tblfn0020"><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="left" valign="top">n&#61;46&#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">n&#61;26&#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " rowspan="2" align="left" valign="top">0&#44;002</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>Total pacientes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">29 &#40;63&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">25 &#40;96&#44;2&#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="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Infecci&#243;n del sitio operatorio &#40;ISO&#41;</span><a class="elsevierStyleCrossRef" href="#tblfn0020"><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="left" valign="top">n&#61;52&#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">n&#61;41&#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " rowspan="2" align="left" valign="top">0&#44;502</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>Total pacientes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2 &#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="left" valign="top">0 &#40;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="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Neumon&#237;a</span><a class="elsevierStyleCrossRef" href="#tblfn0020"><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="left" valign="top"><span class="elsevierStyleItalic">n&#61;52&#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">n&#61;41&#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " rowspan="2" align="left" valign="top">0&#44;033</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>Total pacientes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6 &#40;11&#44;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0 &#40;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="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Infecci&#243;n del tracto urinario &#40;ITU&#41; asociada a cat&#233;ter</span><a class="elsevierStyleCrossRef" href="#tblfn0020"><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="left" valign="top"><span class="elsevierStyleItalic">n&#61;52&#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">n&#61;41&#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " rowspan="2" align="left" valign="top">0&#44;502</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>Total pacientes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2 &#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="left" valign="top">0 &#40;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="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Infecci&#243;n del torrente sangu&#237;neo asociada a cat&#233;teres intravenosos</span><a class="elsevierStyleCrossRef" href="#tblfn0020"><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="left" valign="top"><span class="elsevierStyleItalic">n&#61;52&#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">n&#61;41&#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " rowspan="2" align="left" valign="top">&#62;0&#44;99</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>Total pacientes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1 &#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="left" valign="top">0 &#40;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="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Otra infecci&#243;n nosocomial</span><a class="elsevierStyleCrossRef" href="#tblfn0020"><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="left" valign="top"><span class="elsevierStyleItalic">n&#61;41&#40;&#37;&#41;</span>&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>9-12&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1 &#40;3&#44;8&#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>13-15&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" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Marshall</span><a class="elsevierStyleCrossRef" href="#tblfn0040"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
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Vol. 29. Núm. 5.
Páginas 217-224 (septiembre - octubre 2018)
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Vol. 29. Núm. 5.
Páginas 217-224 (septiembre - octubre 2018)
Investigación clínica
Caracterización de 95 pacientes adultos con trauma craneoencefálico debido a herida por proyectil de arma de fuego en un centro de referencia en Cali, Colombia
Characterization of 95 patients with traumatic brain injury due to gunshot wounds at a referral center in Cali, Colombia
Visitas
22
Daniel Ospina-Delgadoa, Laura Marcela Mosquera Salasa, Alejandro Enríquez-Marulandaa, Jaime Hernández-Moralesa, Robinson Pachecob, Javier Lobato-Poloc,
Autor para correspondencia
jmlobatop@yahoo.com

Autor para correspondencia.
a Facultad de Medicina, Universidad Icesi, Cali, Colombia
b Centro de Investigaciones Clínicas, Cali, Colombia
c Departamento de Neurocirugía, Fundación Valle del Lili, Cali, Colombia
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Estadísticas
Figuras (1)
Tablas (5)
Tabla 1. Perfil demográfico y clínico de la población estudiada
Tabla 2. Mortalidad general y estado al egreso
Tabla 3. Comparación variables sobrevivientes vs. fallecidos
Tabla 4. Factores asociados a muerte relacionados a estancia hospitalaria y complicaciones
Tabla 5. Comparación de los pacientes sobrevivientes de acuerdo a resultado clínico adverso al egreso
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Resumen
Objetivo

Este estudio busca describir casos de trauma craneoencefálico debido a heridas por proyectil de arma de fuego, en población civil mayor de 18 años, atendidos en un hospital de referencia y realizar una comparación de los pacientes de acuerdo a los resultados clínicos al egreso.

Métodos

Se trata de un estudio descriptivo, observacional, retrospectivo a través de la revisión de historias clínicas de los pacientes mayores de 18 años que ingresaron en la sala de urgencias de la Fundación Valle del Lili en Cali, Colombia con trauma craneoencefálico secundario a heridas por proyectil de arma de fuego, en contexto civil, entre enero del 2010 y febrero del 2016. Se realizó un análisis univariado para determinar factores asociados a muerte y resultados clínicos adversos.

Resultados

Se incluyó un total de 95 pacientes con trauma craneoencefálico por heridas por proyectil de arma de fuego en el contexto civil. El 91,6% fue de sexo masculino, el principal contexto fue violencia interpersonal en un 54,7%, el método de transporte más común fue ambulancia terrestre en un 79%, el puntaje de Glasgow (GCS) al ingreso fue 3-8 = 64,2%; 9-12 = 6,3%; 13-15=28,4%. Al ingreso se le tomó TAC simple a 82 (86,3%) pacientes dentro de la primera hora, encontrando una clasificación de Marshall entre I-III en 60,9%, un valor de IV en el 17,8% y entre V-VI en un 4,1%. La trayectoria era penetrante no transfixiante en el 43,2%, transfixiante en el 27,4% y tangencial en el 9,5%. La mortalidad fue del 45,3%, de esta 39% ocurrió en las primeras 24h.

Conclusiones

Un mayor compromiso en el estado general del paciente al ingreso determina un pobre pronóstico y mayor probabilidad de muerte en las primeras 24 h.

Palabras clave:
Trauma craneoencefálico
Herida por proyectil de arma de fuego
Trauma craneano penetrante
Adultos
Abstract
Objective

This study aims to describe cases of traumatic brain injury due to gunshot wounds in civilian population over 18 years of age, treated at a referral hospital in Cali, Colombia and compare the clinical outcomes at discharge.

Methods

An observational, descriptive cross-sectional study was conducted by retrospectively collecting clinical data related to adult patients that presented traumatic brain injury due to civil gunshot-wounds and that consulted to the emergency room at Fundación Valle del Lili Hospital in Cali, Colombia between January 2010 and February of 2016. A univariate analysis was performed to determine factors associated with death and adverse clinical outcomes.

Results

A total of 95 patients older than 18 years, with traumatic brain injury by gunshot were included in the civil context. The 91.6% were male. The main context was interpersonal violence with 54.7%. The most common method of transportation was by ambulance (79%). The Glasgow score at admission was 3-8 in 64.2% of cases; 9-12 in 6.32% and 13-15 in 28.4%. On admission, head CT scan was performed in 82 (86.3%) patients within the first hour, finding a Marshall-Score between I-III in 60.9%, of IV in 17.8% of cases and a score between V-VI and in 4.1%. The trajectory was non-transfixing penetrating in 43.2%, transfixing in 27.3% and tangential in 9.5%. Mortality was 45.3% in total, 39% died within the first 24hours.

Conclusions

A major compromise on admission determines an overall poorer prognosis and a high likelihood of death in the first 24-hours.

Keywords:
Traumatic brain injury
Gunshot
Penetrating brain injury
Adult

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