Validation of a Therapeutic Intervention Scoring System (TISS-28) in critically ill children

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La ecuación de regresión lineal establecida es T76=–0,53828+104398×T28 (R2 0,832)." ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Ana Vivanco-Allende, Corsino Rey, Andrés Concha, Pablo Martínez-Camblor, Alberto Medina, Juan Mayordomo-Colunga" "autores" => array:6 [ 0 => array:2 [ "nombre" => "Ana" "apellidos" => "Vivanco-Allende" ] 1 => array:2 [ "nombre" => "Corsino" "apellidos" => "Rey" ] 2 => array:2 [ "nombre" => "Andrés" "apellidos" => "Concha" ] 3 => array:2 [ "nombre" => "Pablo" "apellidos" => "Martínez-Camblor" ] 4 => array:2 [ "nombre" => "Alberto" "apellidos" => "Medina" ] 5 => array:2 [ "nombre" => "Juan" "apellidos" => "Mayordomo-Colunga" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2341287920300788" "doi" => "10.1016/j.anpede.2019.10.007" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] 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The linear regression equation was T76=−0.53828+104398×T28 (R2=0.832)." ] ] ] "textoCompleto" => "IntroductionThe objective assessment of disease severity is one of the areas of interest in medicine, especially in the field of paediatrics, given the specific characteristics of children.<a class="elsevierStyleCrossRef" href="#bib0090">1</a> In the paediatric intensive care setting, classification schemes are used to attempt to objectively quantify overall severity in critically ill patients; most of them establish severity by estimating the risk of mortality based on the patient's clinical condition. Other classification systems are based on therapeutic interventions, estimating severity based on the number and complexity of procedures performed on the patient.<a class="elsevierStyleCrossRef" href="#bib0095">2</a>The Therapeutic Intervention Scoring System (TISS) was developed in 1974 by Cullen et al.<a class="elsevierStyleCrossRef" href="#bib0100">3</a> and was initially described as a severity index. It measures the intensity of therapeutic interventions and therefore the nursing workload in everyday practice and calculates the appropriate number of nursing staff required to care for the patient. Although the workload can be assessed with several systems,<a class="elsevierStyleCrossRefs" href="#bib0100">3,4</a> the TISS is the most widely used and has been proposed as the international gold standard for this measurement.The TISS was revised and modified in 1983<a class="elsevierStyleCrossRef" href="#bib0105">4</a> and has remained unchanged since. It has several drawbacks, such as reliability problems due to the excessive number of items, the variability in the possible interpretation of some of the items and the time required to calculate the score, which can take experienced raters 2–5min.<a class="elsevierStyleCrossRefs" href="#bib0110">5,6</a> The TISS-76 has been validated for use in several intensive care unit (ICU) settings, including the Paediatric Intensive Care Unit (PICU).In 1996, Miranda et al.<a class="elsevierStyleCrossRef" href="#bib0115">6</a> published a simplified version of the original comprising 28 items and known for that reason as the simplified TISS (TISS-28). The authors reduced the number of items and provided specific guidance and directions to facilitate its application. Completing this version takes approximately 2min, less time than the TISS-76, and is less complicated than the previous version.Previous studies, conducted only in adult patients, found a strong correlation between the TISS-28 and the TISS-76, including the original study by Miranda et al.<a class="elsevierStyleCrossRef" href="#bib0115">6</a> in ICUs in the Netherlands. Moreno and Morais<a class="elsevierStyleCrossRef" href="#bib0120">7</a> published data obtained in a Portuguese ICU and also found a good correlation between both scales. Sánchez-Velázquez et al.<a class="elsevierStyleCrossRef" href="#bib0125">8</a> reported similar results of a multicentric study conducted in Mexico, and Castillo-Lorente et al.<a class="elsevierStyleCrossRef" href="#bib0130">9</a> similar results of a study of ICUs in Spain.The primary objective of this study was to analyse the correlation between the TISS-28 and the TISS-76 in a PICU in Spain and the substitution of the TISS-28 for the TISS-76, as previous studies have only been conducted in adult patients. The secondary objective was to assess the correlation between each of those 2 scores and disease severity in patients.Sample and methodsWe conducted a prospective observational study. We collected data between October 1, 2009 and October 1, 2012. We included all patients admitted to the PICU of a teaching hospital. The exclusion criteria were a length of stay in the PICU of less than 2h and admission to PICU for performance of procedures under sedation.We collected data on the following variables: date of birth, length of stay (days), age (months), sex (male/female), weight (kg), discharge diagnosis, type of disease based on the classification of the American Academy of Pediatrics<a class="elsevierStyleCrossRef" href="#bib0135">10</a> (respiratory, cardiovascular, neurologic, haematology/oncology, renal/metabolic/endocrine, gastrointestinal, surgical, infectious, trauma, monitoring, poisoning, sedation and other). We documented the treatments and techniques used in the first 4 days of hospitalisation using the TISS-76 and TISS-28, so we obtained 4 pairs of measurements per patient.The physician in charge of the patient calculated both TISS scores daily, and before discharge, the results were reviewed by 2 different members of the medical team trained in the use of these scales.We classified patient outcomes in 3 categories (no sequelae, with sequelae and deceased) based on the Pediatric Overall Performance Category scale.<a class="elsevierStyleCrossRef" href="#bib0140">11</a>We performed all the statistical analyses with the R software (<a href="http://www.r-project.org/">www.r-project.org</a>). We summarised continuous variables as mean and standard deviation, median, minimum and maximum, and compared them using the Welch t test if the data were normally distributed and otherwise with the nonparametric Kruskal–Wallis test. We described categorical variables as absolute and relative frequencies, and compared them using the Fisher exact test of independence. We assessed the size of differences by calculating odds ratios (ORs) with the corresponding 95% confidence intervals (CIs) for the crude OR and the adjusted OR, when the latter measure was deemed necessary to account for potential confounders. We calculated crude and adjusted by means of logistic regression. We analysed the association between the mean TISS-76 and TISS-28 scores by simple linear regression. We recorded the obtained Pearson correlation coefficient and the coefficient of determination (R2). We also analysed the consistency of both scales by calculating the intraclass correlation coefficient (ICC) for each pair of scores and for the mean scores in the sample. The analysis also included generation of scatter plots and Bland–Altman plots. We defined statistical significance as a p-value of less than 0.05. We plotted receiver operating characteristics (ROC) curves and calculated the area under the curve (AUC), estimating the optimal threshold using the Youden index.The study was approved by the Regional Clinical Research Ethics Committee of the Principality of Asturias.ResultsDuring the study, we collected data for 935 patients. As can be seen in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>, there was a predominance of the male sex (58.9%). The median age was 33 months (range, 0–256). The most frequent group of diagnoses corresponded to the respiratory system (30.2%). The mean length of stay was 5.25 days. The mean scores of the Pediatric Risk of Mortality III (PRISM III) and the Pediatric Index of Mortality 2 (PIM 2) were 2.8 and 1.36, respectively. The overall mortality in the PICU was 1.9% and the corresponding in-hospital mortality was 0.2%.<elsevierMultimedia ident="tbl0005"></elsevierMultimedia>The mean TISS-76 scores for days 1–4 of admission were 18.27, 14.61, 13.71 and 13.12, respectively. The mean TISS-28 scores for the same days were 18.02, 15.93, 15.26 and 14.78. <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a> presents the scores for the different scales (PRISM III, PIM 2, TISS-76 and TISS-28) for each of the patient outcome groups.<elsevierMultimedia ident="tbl0010"></elsevierMultimedia>We found a good correlation between the TISS-28 and the TISS-76 scores. The Pearson correlation coefficient for these scores in days 1–4 of the stay in the PICU were 0.912, 0.558, 0.919 and 0.918, respectively. <a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a> shows the regression line for the comparison of the TISS-76 versus the TISS-28 scores in day 1 of the PICU stay, along with the linear regression equation. <a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a> shows the Bland–Altman plot for the comparison of the TISS-76 and TISS-28 scores in day 1 at the PICU. The ICC for day 1 was 0.90 (95% CI, 0.89–0.91). We found similar correlations for the remaining days under study, save for day 2, in which the correlation was weaker, with an ICC of 0.52 (95% CI, 0.47–0.57). We calculated the overall correlation of the TISS-28 and TISS-76 scores for the entire 4-day period, with a Pearson correlation coefficient of 0.91, the equation TISS-76=−1.74+1.05×TISS-28 (R2=0.824) and an ICC of 0.75 (95% CI, 0.74–0.77).<elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia>The predictive value of the TISS-76 to discriminate between patients without sequelae and patients with sequelae or that died was good and did not improve in subsequent days. The predictive value of the TISS-28 was similar, and the differences were not statistically significant. <a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a> presents the ROC curves for the TISS-76 and the TISS-28 scores for day 1. The AUC for the TISS-76 score on day 1 was 0.803 (0.728–0.872) compared to 0.759 (0.670–0.842) for the TISS-28 score. The cut-off point for differentiating patients without sequelae from patients with sequelae or that died for scores obtained in day 1 were 27 in the TISS-76 (sensitivity of 55.2% and specificity of 90.4%) and 24 in the TISS-28 (sensitivity of 58.3% and specificity of 87.2%). We prioritised specificity over sensitivity in the selection of cut-off points.<elsevierMultimedia ident="fig0015"></elsevierMultimedia>DiscussionMortality risk scores are commonly used in intensive care to classify patients and care units and to be able to compare the latter, as well as to guide the allocation and management of resources. However, they are not commonly used for clinical decision-making, which should be an objective in the improvement of both the scales themselves and their use by health care professionals. The PRISM III<a class="elsevierStyleCrossRefs" href="#bib0145">12,13</a> and the PIM 2<a class="elsevierStyleCrossRefs" href="#bib0150">13–17</a> are the scales most widely used in the PICU setting. The TISS scales<a class="elsevierStyleCrossRefs" href="#bib0100">3,4</a> have exhibited a good correlation with these mortality scores, despite being mainly based on the care workload. The TISS-76 was published first,<a class="elsevierStyleCrossRef" href="#bib0100">3</a> and it has been validated for use in adult and paediatric ICUs. The updated, simplified version, the TISS-28,<a class="elsevierStyleCrossRef" href="#bib0105">4</a> has been validated in adult care settings but not in the paediatric population. Given the differences in the types and severity of disease and in the bed occupancy rate between the adult and paediatric populations, it is essential that scales be validated in the latter.Our study validated the TISS-28 in a single PICU to be able to use this simplified scale and to compare the data obtained with both scales, the TISS-76 and the TISS-28, to patient outcomes.The scores obtained in both scales in the first 4 days in the PICU were very similar: on day 1, the TISS-76 score was 18.27 and the TISS-28 score was 18.02. Our findings were similar to those of studies conducted in other countries, such as Mexico and Ecuador.<a class="elsevierStyleCrossRef" href="#bib0125">8</a> In subsequent days, the scores in both scales decreased, although they continued to be quite similar. This means that the predictive value of the scales does not increase significantly with passing days, and that the values obtained in the early hours following admission can provide a fairly accurate estimate and good predictions about patient outcomes.We found a good correlation between the scales. The overall correlation coefficient calculated for the first 4 days in the PICU was 0.90. It is a good value, higher than the coefficient of 0.85 reported by Castillo-Lorente et al.,<a class="elsevierStyleCrossRef" href="#bib0130">9</a> although slightly lower than the coefficient of 0.93 reported by Miranda et al.,<a class="elsevierStyleCrossRef" href="#bib0115">6</a> Moreno and Morais<a class="elsevierStyleCrossRef" href="#bib0120">7</a> and Sánchez-Velázquez et al.<a class="elsevierStyleCrossRef" href="#bib0125">8</a>In our study, the TISS-28 explained 82.4% of the variance in the TISS-76 score. This percentage was similar to those reported in the original sample in the Netherlands (86%)<a class="elsevierStyleCrossRef" href="#bib0115">6</a> and the percentage in Mexico and Ecuador<a class="elsevierStyleCrossRef" href="#bib0125">8</a> (86.4%), and higher compared to the percentage reported in the Portuguese ICU study<a class="elsevierStyleCrossRef" href="#bib0120">7</a> (72%). <a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a> compares our results to those of previous studies.<elsevierMultimedia ident="tbl0015"></elsevierMultimedia>In our sample, the difference of the mean TISS-76 and TISS-28 scores (difference of means, 0.25 points) was lower compared to the sample in the Netherlands (difference of means, 4.6 points)<a class="elsevierStyleCrossRef" href="#bib0115">6</a> and the study conducted in Portuguese ICUs (difference of means, 1.3 points).<a class="elsevierStyleCrossRef" href="#bib0120">7</a>The correlation coefficients found for days 1–4 of the stay in the PICU were 0.90, 0.52, 0.91 and 0.90, respectively. We did not find data in the literature to compare these results, as articles on the subject have only reported data for the first 24h,<a class="elsevierStyleCrossRefs" href="#bib0120">7,9</a> the mean of the values obtained throughout the stay or even, in some cases, the TISS score obtained in the shift preceding discharge from the ICU.<a class="elsevierStyleCrossRef" href="#bib0125">8</a>It is worth noting that the correlation for day 2 was lower compared to the other days under study. In days 1, 3 and 4 the correlation was approximately 0.90, while on day 2 it dropped to 0.52. We were unable to compare the results of this specific factor with other studies for reasons noted above, although we could attribute this difference to the absence of some of the TISS-76 items in the TISS-28.In previous studies,<a class="elsevierStyleCrossRefs" href="#bib0115">6,8</a> TISS-76 and TISS-28 scores were used to classify patients in 4 groups based on the care workload. Since disease severity was lower in our patients, we established cut-off points to attempt to predict patient outcomes, discriminating between patients without sequelae and patients that either died or developed sequelae. The cut-off points that we found were 27 for the TISS-76 and 24 for the TISS-28. With these values, the prediction of patient outcomes in our sample was quite accurate. More importantly, we were able to find a cut-off point in the TISS-28 under which there were no errors in the classification of deceased patients.The main limitations of our study were the small sample size, the low mortality and the fact that it was not a multicentric study, in addition to data collection ending in 2012, which is important given how quickly intensive care evolves. Furthermore, we did not document 2 of the most criticised characteristics of the TISS-76, which are the amount of time it takes to complete and the vagueness in the definition of some of its items. The strength of this study is that, to our knowledge, this is the first study devoted to the validation of the TISS-28 in a PICU setting.ConclusionsThe TISS-28 administered in the first 24h from admission has a similar predictive value to the TISS-76, and the predictive value does not improve in subsequent days. Therefore, we propose the use of the TISS-28 in the first day of hospitalisation for quantitative assessment of the intensive care labour effort in critically ill children.Our results show that in our region, the TISS-28 could be used instead of the TISS-76 with no loss in the obtained information.Conflicts of interestThe authors have no conflicts of interest to declare." "textoCompletoSecciones" => array:1 [ "secciones" => array:11 [ 0 => array:3 [ "identificador" => "xres1354638" "titulo" => "Abstract" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Introduction" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Material and method" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusions" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec1245577" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres1354639" "titulo" => "Resumen" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Introducción" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Material y método" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusiones" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec1245578" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:2 [ "identificador" => "sec0010" "titulo" => "Sample and methods" ] 6 => array:2 [ "identificador" => "sec0015" "titulo" => "Results" ] 7 => array:2 [ "identificador" => "sec0020" "titulo" => "Discussion" ] 8 => array:2 [ "identificador" => "sec0025" "titulo" => "Conclusions" ] 9 => array:2 [ "identificador" => "sec0030" "titulo" => "Conflicts of interest" ] 10 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2019-07-21" "fechaAceptado" => "2019-10-17" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec1245577" "palabras" => array:3 [ 0 => "Therapeutic Intervention Scoring System" 1 => "Simplified Therapeutic Intervention Scoring System" 2 => "Paediatric Intensive Care Unit" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec1245578" "palabras" => array:3 [ 0 => "Escala de puntuación de intervenciones terapéuticas" 1 => "Escala simplificada de puntuación de intervenciones terapéuticas" 2 => "Unidad de Cuidados Intensivos Pediátricos" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "IntroductionThere are numerous scales in intensive care units that are used to quantify the severity of patients. Most of them are very useful, although sometimes laborious to complete, thus limiting their use in usual practice. One of these scales, the Therapeutic Intervention Scoring System (TISS-76), has been validated in adult and paediatric units. Its simplified and updated version, the Simplified Therapeutic Intervention Scoring System (TISS-28), has not yet been validated in paediatric units. The aim of this study is to validate TISS-28, in order to have a simple and rapid scale. Material and methodA prospective non-interventional observational study was conducted in a Paediatric Intensive Care Unit (PICU) of a university hospital. Data were collected from 935 consecutive patients admitted to the PICU over a 3-year period. These included the values of TISS-76 and TISS-28 during the first 4 days of admission and the subsequent outcome of the patients. ResultsThe mean values of TISS-76 and TISS-28 for the first day of admission were 18.27 and 18.02, respectively. Values were higher in patients who had sequelae or died (17.58 versus 27.23 and 37.44, respectively for TISS-76 (p<.01); and 17.51 versus 23.80 and 33.44, respectively for TISS-28 (p<.01).A very good correlation was found between TISS-76 and TISS-28, with Pearson correlation and intraclass correlation coefficients >0.9 (except for the 2nd day). The correlation equation for the overall 4 days was: TISS-76=−1.74+1.05×TISS-28. TISS-28 was able to explain 82.4% of variability of TISS-76. The area under the curve with a confidence interval (CI) of 95% for the first day was 0.80 (0.73–0.87) for TISS-76, and 0.76 (0.67–0.84) for TISS-28. ConclusionsOn observing the results obtained, TISS-28 can replace TISS-76 in our PICU, without worsening the information provided. Being a reliable scale and easier to apply, its practical application could be useful." "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Introduction" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Material and method" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusions" ] ] ] "es" => array:3 [ "titulo" => "Resumen" "resumen" => "IntroducciónEn el ámbito de los cuidados intensivos, existen numerosas escalas para cuantificar la gravedad de los pacientes. La mayoría de ellas son muy útiles, aunque en ocasiones laboriosas de completar, por lo que su implantación en la práctica habitual es escasa. Una de ellas es la escala de puntuación de intervenciones terapéuticas (TISS 76), que ha sido validada en unidades de adultos y pediátricas. Su versión simplificada y actualizada, la escala simplificada de puntuación de intervenciones terapéuticas (TISS 28), no ha sido validada en unidades pediátricas, siendo este el objetivo del estudio, con idea de disponer de una escala sencilla y rápida. Material y métodoEstudio observacional prospectivo sin intervención, en la Unidad de Cuidados Intensivos Pediátricos (UCIP) de un hospital universitario. Se recogieron datos de 935 pacientes ingresados consecutivamente en la UCIP durante un periodo de 3 años, incluyendo los valores de TISS 76 y TISS 28 de todos durante los 4 primeros días de ingreso y la posterior evolución de los pacientes. ResultadosLos valores medios de TISS 76 y TISS 28 para el primer día de ingreso fueron de 18,27 y de 18,02, respectivamente, siendo más elevados en los pacientes con secuelas o que fallecían. Se encontró muy buena correlación entre la TISS 76 y la 28, con coeficiente de correlación de Pearson y de correlación intraclase >0,9 (excepto para el segundo día). La ecuación de correlación para los 4 días fue: TISS76=−1,74+1,05×TISS28. La TISS 28 fue capaz de explicar el 82,4% de la variabilidad de la TISS 76. El área bajo la curva con un intervalo de confianza del 95% para el primer día fue de 0,80 para la TISS 76 y de 0,76 para la TISS 28. ConclusionesCon los resultados obtenidos, la TISS 28 puede reemplazar a la TISS 76 en nuestra UCIP, sin empeorar la información proporcionada. Siendo una escala fiable y más sencilla de aplicar, podría ser útil su aplicación práctica." "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Introducción" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Material y método" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusiones" ] ] ] ] "NotaPie" => array:2 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "Please cite this article as: Vivanco-Allende A, Rey C, Concha A, Martínez-Camblor P, Medina A, Mayordomo-Colunga J. Validación de la escala simplificada de puntuación de intervenciones terapéuticas (TISS-28) en niños críticamente enfermos. An Pediatr (Barc). 2020;92:339–344." ] 1 => array:2 [ "etiqueta" => "☆☆" "nota" => "Previous presentations: This study was presented under the title “Validación del TISS-28 en Cuidados Intensivos Pediátricos” at the XXV Congress of the Sociedad Española de Cuidados Intensivos Pediátricos, May 13–15, 2010, Malaga, Spain; and under the title “Validation of TISS-28 in a Pediatric Intensive Care Unit” at the 26th Annual Meeting of the European Society of Paediatric and Neonatal Intensive Care, June 10th–13th, 2015, Vilnius, Lithuania." ] ] "multimedia" => array:6 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1372 "Ancho" => 1519 "Tamanyo" => 104479 ] ] "descripcion" => array:1 [ "en" => "Regression line for the comparison of the TISS-76 and the TISS-28 scores in the first day of admission in the 935 patients under study. The linear regression equation was T76=−0.53828+104398×T28 (R2=0.832)." ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1360 "Ancho" => 1512 "Tamanyo" => 119123 ] ] "descripcion" => array:1 [ "en" => "Bland–Altman plot of the TISS-76 and TISS-28 scores in the first day of hospitalisation. The intraclass correlation coefficient was 0.90 (0.89–0.91)." ] ] 2 => array:7 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 1273 "Ancho" => 1504 "Tamanyo" => 71802 ] ] "descripcion" => array:1 [ "en" => "ROC curve for the TISS-76 (dark line) and TISS-28 (light line) scores in the first day of admission for the disclination of patients without sequelae from patients with sequelae or deceased." ] ] 3 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Table " "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="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">n \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Percentage \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Sex (male) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">542 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">58.1% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Age (months) (median±range) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">33 (0–256) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="3" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="3" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Discharge diagnosis</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Infectious \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">139 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">14.9% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Respiratory \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">282 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">30.2% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Surgical \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">246 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">26.3% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Neurologic \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">88 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">9.4% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Haematology/oncology \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">40 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4.3% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Cardiovascular \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">22 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2.4% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Metabolic/renal \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">40 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4.3% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Gastrointestinal \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">14 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.5% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Poisoning \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.7% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Trauma \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">44 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4.7% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Monitoring \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.7% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Sedation \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.6% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="3" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"></td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">PRISM III score, mean (SD) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2.80 (4.53) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">PIM 2 score, mean (SD) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.36 (2.43) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Length of stay in days, median (range) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 (1–92) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="3" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="3" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Patient outcomes</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Without sequelae \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">886 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">94.6% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">With sequelae \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">30 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">30.2% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Death \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">18 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.9% \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2326245.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Characteristics of the 935 patients in the sample." ] ] 4 => array:8 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at2" "detalle" => "Table " "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="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Mean \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Standard deviation \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">PRISM III (total) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2.80 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4.53 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Without sequelae \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2.42 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3.50 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">With sequelae \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5.17 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6.49 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Death \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">17.39 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">13.05 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="3" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"></td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">PIM 2 (total) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.36 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2.43 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Without sequelae \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.20 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2.04 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">With sequelae \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.95 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2.52 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Death \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8.08 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6.80 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="3" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="3" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">TISS-76/TISS-28</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Day 1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">18.27/18.02 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7.91/6.91 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Day 2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">14.61/15.93 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6.66/9.53 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Day 3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">13.71/15.26 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6.61/5.83 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Day 4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">13.12/14.78 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6.66/6.10 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="3" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="3" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">TISS-76/TISS-28 on day 1 (by patient outcome)</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Without sequelae \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">17.58/17.51 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6.76/6.12 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">With sequelae \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">27.23/23.28 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12.26/11.19 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Death \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">37.44/33.44 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">15.46/11.39 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2326244.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Scale scores by patient outcome." ] ] 5 => array:8 [ "identificador" => "tbl0015" "etiqueta" => "Table 3" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at3" "detalle" => "Table " "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="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Study \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">N (number of patients) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Type of ICU (adult/paediatric) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Intraclass correlation coefficient \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">95% confidence interval \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Percentage of variance explained \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Miranda et al. (1996) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">10,000 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Adult \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.93 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">– \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">86.0% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Moreno et al. (1997) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1094 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Adult \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.93 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.83–0.98 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">72.0% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Castillo-Llorente et al. (1999) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8838 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Adult \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.85 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">– \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">– \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Sánchez-Velázquez et al. (2000) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">385 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Adult \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.93 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">– \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">86.4% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Vivanco-Allende et al. \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">935 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Paediatric \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.90 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.89–0.91 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">83.2% \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2326246.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Comparison of the correlation for day 1 TISS-76 and TISS-28 values found in our study with the findings of previous studies." ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:17 [ 0 => array:3 [ "identificador" => "bib0090" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Validation of a physiologic stability index for use in critically ill infants and children" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "T.S. Yeh" 1 => "M.M. Pollack" 2 => "U.E. Ruttimann" 3 => "P.R. Holbrook" 4 => "A.I. Fields" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1203/00006450-198405000-00011" "Revista" => array:6 [ "tituloSerie" => "Pediatr Res" "fecha" => "1984" "volumen" => "18" "paginaInicial" => "445" "paginaFinal" => "451" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/6728571" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0095" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Sistemas de valoración de gravedad" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "J.A. Medina Villanueva" 1 => "A. Vivanco Allende" 2 => "C. Rey Galán" 3 => "A. 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Validation of a Therapeutic Intervention Scoring System (TISS-28) in critically ill children

Validación de la escala simplificada de puntuación de intervenciones terapéuticas (TISS-28) en niños críticamente enfermos

Ana Vivanco-Allendea,b,

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anaviall@hotmail.com

Corresponding author.

, Corsino Reya,b,c, Andrés Conchaa,b, Pablo Martínez-Camblord, Alberto Medinaa,b,e, Juan Mayordomo-Colungaa,b,e

a Unidad de Cuidados Intensivos Pediátricos, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain

b Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Spain

c Universidad de Oviedo, Spain

d The Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth College, 7 Lebanon Street, Suite 309, Hinman Box 7251, Hanover, NH 03755, USA

e CIBER-Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain

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as previous studies have only been conducted in adult patients&#46; The secondary objective was to assess the correlation between each of those 2 scores and disease severity in patients&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Sample and methods</span><p id="par0035" class="elsevierStylePara elsevierViewall">We conducted a prospective observational study&#46; We collected data between October 1&#44; 2009 and October 1&#44; 2012&#46; We included all patients admitted to the PICU of a teaching hospital&#46; The exclusion criteria were a length of stay in the PICU of less than 2<span class="elsevierStyleHsp" style=""></span>h and admission to PICU for performance of procedures under sedation&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">We collected data on the following variables&#58; date of birth&#44; length of stay &#40;days&#41;&#44; age &#40;months&#41;&#44; sex &#40;male&#47;female&#41;&#44; weight &#40;kg&#41;&#44; discharge diagnosis&#44; type of disease based on the classification of the American Academy of Pediatrics<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">10</span></a> &#40;respiratory&#44; cardiovascular&#44; neurologic&#44; haematology&#47;oncology&#44; renal&#47;metabolic&#47;endocrine&#44; gastrointestinal&#44; surgical&#44; infectious&#44; trauma&#44; monitoring&#44; poisoning&#44; sedation and other&#41;&#46; We documented the treatments and techniques used in the first 4 days of hospitalisation using the TISS-76 and TISS-28&#44; so we obtained 4 pairs of measurements per patient&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">The physician in charge of the patient calculated both TISS scores daily&#44; and before discharge&#44; the results were reviewed by 2 different members of the medical team trained in the use of these scales&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">We classified patient outcomes in 3 categories &#40;no sequelae&#44; with sequelae and deceased&#41; based on the Pediatric Overall Performance Category scale&#46;<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">11</span></a></p><p id="par0055" class="elsevierStylePara elsevierViewall">We performed all the statistical analyses with the R software &#40;<a href="http://www.r-project.org/">www&#46;r-project&#46;org</a>&#41;&#46; We summarised continuous variables as mean and standard deviation&#44; median&#44; minimum and maximum&#44; and compared them using the Welch <span class="elsevierStyleItalic">t</span> test if the data were normally distributed and otherwise with the nonparametric Kruskal&#8211;Wallis test&#46; We described categorical variables as absolute and relative frequencies&#44; and compared them using the Fisher exact test of independence&#46; We assessed the size of differences by calculating odds ratios &#40;ORs&#41; with the corresponding 95&#37; confidence intervals &#40;CIs&#41; for the crude OR and the adjusted OR&#44; when the latter measure was deemed necessary to account for potential confounders&#46; We calculated crude and adjusted by means of logistic regression&#46; We analysed the association between the mean TISS-76 and TISS-28 scores by simple linear regression&#46; We recorded the obtained Pearson correlation coefficient and the coefficient of determination &#40;<span class="elsevierStyleItalic">R</span><span class="elsevierStyleSup">2</span>&#41;&#46; We also analysed the consistency of both scales by calculating the intraclass correlation coefficient &#40;ICC&#41; for each pair of scores and for the mean scores in the sample&#46; The analysis also included generation of scatter plots and Bland&#8211;Altman plots&#46; We defined statistical significance as a <span class="elsevierStyleItalic">p</span>-value of less than 0&#46;05&#46; We plotted receiver operating characteristics &#40;ROC&#41; curves and calculated the area under the curve &#40;AUC&#41;&#44; estimating the optimal threshold using the Youden index&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">The study was approved by the Regional Clinical Research Ethics Committee of the Principality of Asturias&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Results</span><p id="par0065" class="elsevierStylePara elsevierViewall">During the study&#44; we collected data for 935 patients&#46; As can be seen in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#44; there was a predominance of the male sex &#40;58&#46;9&#37;&#41;&#46; The median age was 33 months &#40;range&#44; 0&#8211;256&#41;&#46; The most frequent group of diagnoses corresponded to the respiratory system &#40;30&#46;2&#37;&#41;&#46; The mean length of stay was 5&#46;25 days&#46; The mean scores of the Pediatric Risk of Mortality III &#40;PRISM III&#41; and the Pediatric Index of Mortality 2 &#40;PIM 2&#41; were 2&#46;8 and 1&#46;36&#44; respectively&#46; The overall mortality in the PICU was 1&#46;9&#37; and the corresponding in-hospital mortality was 0&#46;2&#37;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0070" class="elsevierStylePara elsevierViewall">The mean TISS-76 scores for days 1&#8211;4 of admission were 18&#46;27&#44; 14&#46;61&#44; 13&#46;71 and 13&#46;12&#44; respectively&#46; The mean TISS-28 scores for the same days were 18&#46;02&#44; 15&#46;93&#44; 15&#46;26 and 14&#46;78&#46; <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a> presents the scores for the different scales &#40;PRISM III&#44; PIM 2&#44; TISS-76 and TISS-28&#41; for each of the patient outcome groups&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0075" class="elsevierStylePara elsevierViewall">We found a good correlation between the TISS-28 and the TISS-76 scores&#46; The Pearson correlation coefficient for these scores in days 1&#8211;4 of the stay in the PICU were 0&#46;912&#44; 0&#46;558&#44; 0&#46;919 and 0&#46;918&#44; respectively&#46; <a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a> shows the regression line for the comparison of the TISS-76 versus the TISS-28 scores in day 1 of the PICU stay&#44; along with the linear regression equation&#46; <a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a> shows the Bland&#8211;Altman plot for the comparison of the TISS-76 and TISS-28 scores in day 1 at the PICU&#46; The ICC for day 1 was 0&#46;90 &#40;95&#37; CI&#44; 0&#46;89&#8211;0&#46;91&#41;&#46; We found similar correlations for the remaining days under study&#44; save for day 2&#44; in which the correlation was weaker&#44; with an ICC of 0&#46;52 &#40;95&#37; CI&#44; 0&#46;47&#8211;0&#46;57&#41;&#46; We calculated the overall correlation of the TISS-28 and TISS-76 scores for the entire 4-day period&#44; with a Pearson correlation coefficient of 0&#46;91&#44; the equation TISS-76<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#8722;1&#46;74<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>1&#46;05<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>TISS-28 &#40;<span class="elsevierStyleItalic">R</span><span class="elsevierStyleSup">2</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;824&#41; and an ICC of 0&#46;75 &#40;95&#37; CI&#44; 0&#46;74&#8211;0&#46;77&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0080" class="elsevierStylePara elsevierViewall">The predictive value of the TISS-76 to discriminate between patients without sequelae and patients with sequelae or that died was good and did not improve in subsequent days&#46; The predictive value of the TISS-28 was similar&#44; and the differences were not statistically significant&#46; <a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 3</a> presents the ROC curves for the TISS-76 and the TISS-28 scores for day 1&#46; The AUC for the TISS-76 score on day 1 was 0&#46;803 &#40;0&#46;728&#8211;0&#46;872&#41; compared to 0&#46;759 &#40;0&#46;670&#8211;0&#46;842&#41; for the TISS-28 score&#46; The cut-off point for differentiating patients without sequelae from patients with sequelae or that died for scores obtained in day 1 were 27 in the TISS-76 &#40;sensitivity of 55&#46;2&#37; and specificity of 90&#46;4&#37;&#41; and 24 in the TISS-28 &#40;sensitivity of 58&#46;3&#37; and specificity of 87&#46;2&#37;&#41;&#46; We prioritised specificity over sensitivity in the selection of cut-off points&#46;</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Discussion</span><p id="par0085" class="elsevierStylePara elsevierViewall">Mortality risk scores are commonly used in intensive care to classify patients and care units and to be able to compare the latter&#44; as well as to guide the allocation and management of resources&#46; However&#44; they are not commonly used for clinical decision-making&#44; which should be an objective in the improvement of both the scales themselves and their use by health care professionals&#46; The PRISM III<a class="elsevierStyleCrossRefs" href="#bib0145"><span class="elsevierStyleSup">12&#44;13</span></a> and the PIM 2<a class="elsevierStyleCrossRefs" href="#bib0150"><span class="elsevierStyleSup">13&#8211;17</span></a> are the scales most widely used in the PICU setting&#46; The TISS scales<a class="elsevierStyleCrossRefs" href="#bib0100"><span class="elsevierStyleSup">3&#44;4</span></a> have exhibited a good correlation with these mortality scores&#44; despite being mainly based on the care workload&#46; The TISS-76 was published first&#44;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">3</span></a> and it has been validated for use in adult and paediatric ICUs&#46; The updated&#44; simplified version&#44; the TISS-28&#44;<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">4</span></a> has been validated in adult care settings but not in the paediatric population&#46; Given the differences in the types and severity of disease and in the bed occupancy rate between the adult and paediatric populations&#44; it is essential that scales be validated in the latter&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">Our study validated the TISS-28 in a single PICU to be able to use this simplified scale and to compare the data obtained with both scales&#44; the TISS-76 and the TISS-28&#44; to patient outcomes&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">The scores obtained in both scales in the first 4 days in the PICU were very similar&#58; on day 1&#44; the TISS-76 score was 18&#46;27 and the TISS-28 score was 18&#46;02&#46; Our findings were similar to those of studies conducted in other countries&#44; such as Mexico and Ecuador&#46;<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">8</span></a> In subsequent days&#44; the scores in both scales decreased&#44; although they continued to be quite similar&#46; This means that the predictive value of the scales does not increase significantly with passing days&#44; and that the values obtained in the early hours following admission can provide a fairly accurate estimate and good predictions about patient outcomes&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">We found a good correlation between the scales&#46; The overall correlation coefficient calculated for the first 4 days in the PICU was 0&#46;90&#46; It is a good value&#44; higher than the coefficient of 0&#46;85 reported by Castillo-Lorente et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">9</span></a> although slightly lower than the coefficient of 0&#46;93 reported by Miranda et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">6</span></a> Moreno and Morais<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">7</span></a> and S&#225;nchez-Vel&#225;zquez et al&#46;<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">8</span></a></p><p id="par0105" class="elsevierStylePara elsevierViewall">In our study&#44; the TISS-28 explained 82&#46;4&#37; of the variance in the TISS-76 score&#46; This percentage was similar to those reported in the original sample in the Netherlands &#40;86&#37;&#41;<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">6</span></a> and the percentage in Mexico and Ecuador<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">8</span></a> &#40;86&#46;4&#37;&#41;&#44; and higher compared to the percentage reported in the Portuguese ICU study<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">7</span></a> &#40;72&#37;&#41;&#46; <a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a> compares our results to those of previous studies&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0110" class="elsevierStylePara elsevierViewall">In our sample&#44; the difference of the mean TISS-76 and TISS-28 scores &#40;difference of means&#44; 0&#46;25 points&#41; was lower compared to the sample in the Netherlands &#40;difference of means&#44; 4&#46;6 points&#41;<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">6</span></a> and the study conducted in Portuguese ICUs &#40;difference of means&#44; 1&#46;3 points&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">7</span></a></p><p id="par0115" class="elsevierStylePara elsevierViewall">The correlation coefficients found for days 1&#8211;4 of the stay in the PICU were 0&#46;90&#44; 0&#46;52&#44; 0&#46;91 and 0&#46;90&#44; respectively&#46; We did not find data in the literature to compare these results&#44; as articles on the subject have only reported data for the first 24<span class="elsevierStyleHsp" style=""></span>h&#44;<a class="elsevierStyleCrossRefs" href="#bib0120"><span class="elsevierStyleSup">7&#44;9</span></a> the mean of the values obtained throughout the stay or even&#44; in some cases&#44; the TISS score obtained in the shift preceding discharge from the ICU&#46;<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">8</span></a></p><p id="par0120" class="elsevierStylePara elsevierViewall">It is worth noting that the correlation for day 2 was lower compared to the other days under study&#46; In days 1&#44; 3 and 4 the correlation was approximately 0&#46;90&#44; while on day 2 it dropped to 0&#46;52&#46; We were unable to compare the results of this specific factor with other studies for reasons noted above&#44; although we could attribute this difference to the absence of some of the TISS-76 items in the TISS-28&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">In previous studies&#44;<a class="elsevierStyleCrossRefs" href="#bib0115"><span class="elsevierStyleSup">6&#44;8</span></a> TISS-76 and TISS-28 scores were used to classify patients in 4 groups based on the care workload&#46; Since disease severity was lower in our patients&#44; we established cut-off points to attempt to predict patient outcomes&#44; discriminating between patients without sequelae and patients that either died or developed sequelae&#46; The cut-off points that we found were 27 for the TISS-76 and 24 for the TISS-28&#46; With these values&#44; the prediction of patient outcomes in our sample was quite accurate&#46; More importantly&#44; we were able to find a cut-off point in the TISS-28 under which there were no errors in the classification of deceased patients&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">The main limitations of our study were the small sample size&#44; the low mortality and the fact that it was not a multicentric study&#44; in addition to data collection ending in 2012&#44; which is important given how quickly intensive care evolves&#46; Furthermore&#44; we did not document 2 of the most criticised characteristics of the TISS-76&#44; which are the amount of time it takes to complete and the vagueness in the definition of some of its items&#46; The strength of this study is that&#44; to our knowledge&#44; this is the first study devoted to the validation of the TISS-28 in a PICU setting&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Conclusions</span><p id="par0135" class="elsevierStylePara elsevierViewall">The TISS-28 administered in the first 24<span class="elsevierStyleHsp" style=""></span>h from admission has a similar predictive value to the TISS-76&#44; and the predictive value does not improve in subsequent days&#46; Therefore&#44; we propose the use of the TISS-28 in the first day of hospitalisation for quantitative assessment of the intensive care labour effort in critically ill children&#46;</p><p id="par0140" class="elsevierStylePara elsevierViewall">Our results show that in our region&#44; the TISS-28 could be used instead of the TISS-76 with no loss in the obtained information&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Conflicts of interest</span><p id="par0145" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare&#46;</p></span></span>"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Introduction</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">There are numerous scales in intensive care units that are used to quantify the severity of patients&#46; Most of them are very useful&#44; although sometimes laborious to complete&#44; thus limiting their use in usual practice&#46; One of these scales&#44; the Therapeutic Intervention Scoring System &#40;TISS-76&#41;&#44; has been validated in adult and paediatric units&#46; Its simplified and updated version&#44; the Simplified Therapeutic Intervention Scoring System &#40;TISS-28&#41;&#44; has not yet been validated in paediatric units&#46; The aim of this study is to validate TISS-28&#44; in order to have a simple and rapid scale&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Material and method</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">A prospective non-interventional observational study was conducted in a Paediatric Intensive Care Unit &#40;PICU&#41; of a university hospital&#46; Data were collected from 935 consecutive patients admitted to the PICU over a 3-year period&#46; These included the values of TISS-76 and TISS-28 during the first 4 days of admission and the subsequent outcome of the patients&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">The mean values of TISS-76 and TISS-28 for the first day of admission were 18&#46;27 and 18&#46;02&#44; respectively&#46; Values were higher in patients who had sequelae or died &#40;17&#46;58 versus 27&#46;23 and 37&#46;44&#44; respectively for TISS-76 &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;01&#41;&#59; and 17&#46;51 versus 23&#46;80 and 33&#46;44&#44; respectively for TISS-28 &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;01&#41;&#46;</p><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">A very good correlation was found between TISS-76 and TISS-28&#44; with Pearson correlation and intraclass correlation coefficients &#62;0&#46;9 &#40;except for the 2nd day&#41;&#46; The correlation equation for the overall 4 days was&#58; TISS-76<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#8722;1&#46;74<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>1&#46;05<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>TISS-28&#46; TISS-28 was able to explain 82&#46;4&#37; of variability of TISS-76&#46; The area under the curve with a confidence interval &#40;CI&#41; of 95&#37; for the first day was 0&#46;80 &#40;0&#46;73&#8211;0&#46;87&#41; for TISS-76&#44; and 0&#46;76 &#40;0&#46;67&#8211;0&#46;84&#41; for TISS-28&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">On observing the results obtained&#44; TISS-28 can replace TISS-76 in our PICU&#44; without worsening the information provided&#46; Being a reliable scale and easier to apply&#44; its practical application could be useful&#46;</p></span>"
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        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Introducci&#243;n</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">En el &#225;mbito de los cuidados intensivos&#44; existen numerosas escalas para cuantificar la gravedad de los pacientes&#46; La mayor&#237;a de ellas son muy &#250;tiles&#44; aunque en ocasiones laboriosas de completar&#44; por lo que su implantaci&#243;n en la pr&#225;ctica habitual es escasa&#46; Una de ellas es la escala de puntuaci&#243;n de intervenciones terap&#233;uticas &#40;TISS 76&#41;&#44; que ha sido validada en unidades de adultos y pedi&#225;tricas&#46; Su versi&#243;n simplificada y actualizada&#44; la escala simplificada de puntuaci&#243;n de intervenciones terap&#233;uticas &#40;TISS 28&#41;&#44; no ha sido validada en unidades pedi&#225;tricas&#44; siendo este el objetivo del estudio&#44; con idea de disponer de una escala sencilla y r&#225;pida&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Material y m&#233;todo</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Estudio observacional prospectivo sin intervenci&#243;n&#44; en la Unidad de Cuidados Intensivos Pedi&#225;tricos &#40;UCIP&#41; de un hospital universitario&#46; Se recogieron datos de 935 pacientes ingresados consecutivamente en la UCIP durante un periodo de 3 a&#241;os&#44; incluyendo los valores de TISS 76 y TISS 28 de todos durante los 4 primeros d&#237;as de ingreso y la posterior evoluci&#243;n de los pacientes&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Los valores medios de TISS 76 y TISS 28 para el primer d&#237;a de ingreso fueron de 18&#44;27 y de 18&#44;02&#44; respectivamente&#44; siendo m&#225;s elevados en los pacientes con secuelas o que fallec&#237;an&#46; Se encontr&#243; muy buena correlaci&#243;n entre la TISS 76 y la 28&#44; con coeficiente de correlaci&#243;n de Pearson y de correlaci&#243;n intraclase &#62;0&#44;9 &#40;excepto para el segundo d&#237;a&#41;&#46; La ecuaci&#243;n de correlaci&#243;n para los 4 d&#237;as fue&#58; TISS76<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#8722;1&#44;74<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>1&#44;05<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>TISS28&#46; La TISS 28 fue capaz de explicar el 82&#44;4&#37; de la variabilidad de la TISS 76&#46; El &#225;rea bajo la curva con un intervalo de confianza del 95&#37; para el primer d&#237;a fue de 0&#44;80 para la TISS 76 y de 0&#44;76 para la TISS 28&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusiones</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Con los resultados obtenidos&#44; la TISS 28 puede reemplazar a la TISS 76 en nuestra UCIP&#44; sin empeorar la informaci&#243;n proporcionada&#46; Siendo una escala fiable y m&#225;s sencilla de aplicar&#44; podr&#237;a ser &#250;til su aplicaci&#243;n pr&#225;ctica&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0025"
            "titulo" => "Introducci&#243;n"
          ]
          1 => array:2 [
            "identificador" => "abst0030"
            "titulo" => "Material y m&#233;todo"
          ]
          2 => array:2 [
            "identificador" => "abst0035"
            "titulo" => "Resultados"
          ]
          3 => array:2 [
            "identificador" => "abst0040"
            "titulo" => "Conclusiones"
          ]
        ]
      ]
    ]
    "NotaPie" => array:2 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Vivanco-Allende A&#44; Rey C&#44; Concha A&#44; Mart&#237;nez-Camblor P&#44; Medina A&#44; Mayordomo-Colunga J&#46; Validaci&#243;n de la escala simplificada de puntuaci&#243;n de intervenciones terap&#233;uticas &#40;TISS-28&#41; en ni&#241;os cr&#237;ticamente enfermos&#46; An Pediatr &#40;Barc&#41;&#46; 2020&#59;92&#58;339&#8211;344&#46;</p>"
      ]
      1 => array:2 [
        "etiqueta" => "&#9734;&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Previous presentations&#58; This study was presented under the title &#8220;Validaci&#243;n del TISS-28 en Cuidados Intensivos Pedi&#225;tricos&#8221; at the XXV Congress of the Sociedad Espa&#241;ola de Cuidados Intensivos Pedi&#225;tricos&#44; May 13&#8211;15&#44; 2010&#44; Malaga&#44; Spain&#59; and under the title &#8220;Validation of TISS-28 in a Pediatric Intensive Care Unit&#8221; at the 26th Annual Meeting of the European Society of Paediatric and Neonatal Intensive Care&#44; June 10th&#8211;13th&#44; 2015&#44; Vilnius&#44; Lithuania&#46;</p>"
      ]
    ]
    "multimedia" => array:6 [
      0 => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
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        "descripcion" => array:1 [
          "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Regression line for the comparison of the TISS-76 and the TISS-28 scores in the first day of admission in the 935 patients under study&#46; The linear regression equation was T76<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#8722;0&#46;53828<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>104398<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>T28 &#40;<span class="elsevierStyleItalic">R</span><span class="elsevierStyleSup">2</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;832&#41;&#46;</p>"
        ]
      ]
      1 => array:7 [
        "identificador" => "fig0010"
        "etiqueta" => "Figure 2"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr2.jpeg"
            "Alto" => 1360
            "Ancho" => 1512
            "Tamanyo" => 119123
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        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Bland&#8211;Altman plot of the TISS-76 and TISS-28 scores in the first day of hospitalisation&#46; The intraclass correlation coefficient was 0&#46;90 &#40;0&#46;89&#8211;0&#46;91&#41;&#46;</p>"
        ]
      ]
      2 => array:7 [
        "identificador" => "fig0015"
        "etiqueta" => "Figure 3"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr3.jpeg"
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            "Tamanyo" => 71802
          ]
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        "descripcion" => array:1 [
          "en" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">ROC curve for the TISS-76 &#40;dark line&#41; and TISS-28 &#40;light line&#41; scores in the first day of admission for the disclination of patients without sequelae from patients with sequelae or deceased&#46;</p>"
        ]
      ]
      3 => array:8 [
        "identificador" => "tbl0005"
        "etiqueta" => "Table 1"
        "tipo" => "MULTIMEDIATABLA"
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        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at1"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:1 [
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                  \t\t\t\t"><span class="elsevierStyleItalic">Age &#40;months&#41; &#40;median</span><span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">range&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">33 &#40;0&#8211;256&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">139&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">14&#46;9&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">30&#46;2&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Surgical&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">246&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">26&#46;3&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">4&#46;3&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Cardiovascular&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">22&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">2&#46;4&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Metabolic&#47;renal&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">40&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">14&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">1&#46;5&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">0&#46;7&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">44&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#46;7&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Monitoring&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">13&#46;05&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">PIM 2 &#40;total&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1&#46;36&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&#46;08&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&#46;80&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
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                  \t\t\t\t  " colspan="3" align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">TISS-76&#47;TISS-28</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Day 1&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">18&#46;27&#47;18&#46;02&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&#46;91&#47;6&#46;91&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&#46;61&#47;5&#46;83&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Day 4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13&#46;12&#47;14&#46;78&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&#46;66&#47;6&#46;10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="3" align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">TISS-76&#47;TISS-28 on day 1 &#40;by patient outcome&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Without sequelae&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">17&#46;58&#47;17&#46;51&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">6&#46;76&#47;6&#46;12&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>With sequelae&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">27&#46;23&#47;23&#46;28&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">12&#46;26&#47;11&#46;19&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Death&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">37&#46;44&#47;33&#46;44&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">15&#46;46&#47;11&#46;39&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Study&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">N</span> &#40;number of patients&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Type of ICU &#40;adult&#47;paediatric&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">95&#37; confidence interval&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Percentage of variance explained&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Miranda et al&#46; &#40;1996&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">10&#44;000&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">Adult&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">0&#46;93&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#8211;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">86&#46;0&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Moreno et al&#46; &#40;1997&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">1094&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">Adult&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">0&#46;93&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">0&#46;83&#8211;0&#46;98&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">72&#46;0&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Castillo-Llorente et al&#46; &#40;1999&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">8838&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">Adult&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;85&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">&#8211;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">S&#225;nchez-Vel&#225;zquez et al&#46; &#40;2000&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">385&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Adult&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;93&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">86&#46;4&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Vivanco-Allende et al&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">935&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Paediatric&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">0&#46;89&#8211;0&#46;91&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">83&#46;2&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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          "en" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Comparison of the correlation for day 1 TISS-76 and TISS-28 values found in our study with the findings of previous studies&#46;</p>"
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      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Validation of a physiologic stability index for use in critically ill infants and children"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "T&#46;S&#46; Yeh"
                            1 => "M&#46;M&#46; Pollack"
                            2 => "U&#46;E&#46; Ruttimann"
                            3 => "P&#46;R&#46; Holbrook"
                            4 => "A&#46;I&#46; Fields"
                          ]
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                    0 => array:2 [
                      "doi" => "10.1203/00006450-198405000-00011"
                      "Revista" => array:6 [
                        "tituloSerie" => "Pediatr Res"
                        "fecha" => "1984"
                        "volumen" => "18"
                        "paginaInicial" => "445"
                        "paginaFinal" => "451"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/6728571"
                            "web" => "Medline"
                          ]
                        ]
                      ]
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              "identificador" => "bib0095"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Sistemas de valoraci&#243;n de gravedad"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "J&#46;A&#46; Medina Villanueva"
                            1 => "A&#46; Vivanco Allende"
                            2 => "C&#46; Rey Gal&#225;n"
                            3 => "A&#46; Concha Torre"
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                    0 => array:1 [
                      "LibroEditado" => array:6 [
                        "editores" => "J&#46;L&#243;pez-Herce Cid, C&#46;Calvo Rey, A&#46;Baltodano Ag&#252;ero, C&#46;Rey Gal&#225;n, A&#46;Rodr&#237;guez N&#250;&#241;ez, A&#46;Baltodano Ag&#252;ero"
                        "titulo" => "Manual de cuidados intensivos pedi&#225;tricos"
                        "paginaInicial" => "41"
                        "paginaFinal" => "51"
                        "edicion" => "4&#46;&#170; ed&#46;"
                        "serieFecha" => "2013"
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              "etiqueta" => "3"
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                          "etal" => false
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                            0 => "D&#46;J&#46; Cullen"
                            1 => "J&#46;M&#46; Civetta"
                            2 => "B&#46;A&#46; Briggs"
                            3 => "L&#46;C&#46; Ferrara"
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                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Crit Care Med"
                        "fecha" => "1974"
                        "volumen" => "2"
                        "paginaInicial" => "57"
                        "paginaFinal" => "60"
                        "link" => array:1 [
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                      "titulo" => "Therapeutic intervention scoring system&#58; update 1983"
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                            0 => "A&#46;R&#46; Keene"
                            1 => "D&#46;J&#46; Cullen"
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                      "doi" => "10.1097/00003246-198301000-00001"
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Article information

ISSN: 23412879
Original language: English

DOI:10.1016/j.anpede.2019.10.007

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Year/Month	Html	Pdf	Total

2024 November	13	21	34
2024 October	74	76	150
2024 September	72	61	133
2024 August	72	68	140
2024 July	49	52	101
2024 June	53	42	95
2024 May	71	57	128
2024 April	63	57	120
2024 March	47	32	79
2024 February	42	38	80
2024 January	68	31	99
2023 December	62	22	84
2023 November	53	43	96
2023 October	47	50	97
2023 September	54	42	96
2023 August	43	30	73
2023 July	38	40	78
2023 June	50	44	94
2023 May	42	40	82
2023 April	43	23	66
2023 March	63	41	104
2023 February	94	20	114
2023 January	57	33	90
2022 December	70	35	105
2022 November	75	30	105
2022 October	79	56	135
2022 September	58	46	104
2022 August	60	66	126
2022 July	80	66	146
2022 June	53	33	86
2022 May	66	55	121
2022 April	54	58	112
2022 March	79	94	173
2022 February	73	46	119
2022 January	128	62	190
2021 December	74	51	125
2021 November	79	45	124
2021 October	132	85	217
2021 September	86	46	132
2021 August	67	55	122
2021 July	62	35	97
2021 June	69	41	110
2021 May	74	54	128
2021 April	220	52	272
2021 March	255	38	293
2021 February	275	26	301
2021 January	142	28	170
2020 December	87	23	110
2020 November	120	32	152
2020 October	99	20	119
2020 September	77	34	111
2020 August	68	29	97
2020 July	90	49	139
2020 June	79	38	117
2020 May	1	2	3

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