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Sin embargo&#44; existen a&#250;n escasos estudios acerca de su prevalencia e influencia sobre la evoluci&#243;n y la gravedad en los pacientes cr&#237;ticos pedi&#225;tricos<a class="elsevierStyleCrossRefs" href="#bib0245"><span class="elsevierStyleSup">9-12</span></a>&#46; Nuestro objetivo es analizar la prevalencia de VDD en una UCIP andaluza&#44; identificar los factores relacionados con los niveles de VD al ingreso y analizar su asociaci&#243;n con la morbilidad&#44; mortalidad y estancia en UCIP&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Material y m&#233;todos</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Objetivos</span><p id="par0020" class="elsevierStylePara elsevierViewall">Determinar la prevalencia del VDD y analizar su relaci&#243;n con la morbimortalidad y estancia en la UCIP&#46; Objetivos espec&#237;ficos&#58; describir las caracter&#237;sticas cl&#237;nicas y sociodemogr&#225;ficas de estos pacientes&#44; estudiar la correlaci&#243;n de los niveles de 25&#40;OH&#41;D con la puntuaci&#243;n en la escala PRISM-III y analizar la asociaci&#243;n independiente del VDD con las caracter&#237;sticas sociodemogr&#225;ficas&#44; cl&#237;nicas&#44; los par&#225;metros anal&#237;ticos relacionados con el s&#237;ndrome de respuesta inflamatoria sist&#233;mica &#40;SRIS&#41; y la morbimortalidad&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Dise&#241;o</span><p id="par0025" class="elsevierStylePara elsevierViewall">Estudio de cohortes prospectivo&#46; Los pacientes fueron reclutados por orden de ingreso y se clasificaron como VD deficientes &#40;&#60; 20<span class="elsevierStyleHsp" style=""></span>ng&#47;ml&#41; o no deficientes&#46; La segunda fase fue un estudio de prevalencia realizado una vez reclutados todos los pacientes&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Pacientes y &#225;mbito</span><p id="par0030" class="elsevierStylePara elsevierViewall">Ni&#241;os entre los 6 meses y 17 a&#241;os de edad ingresados en una UCIP m&#233;dico-quir&#250;rgica de un hospital universitario de tercer nivel&#46; Criterios de exclusi&#243;n&#58; enfermedad renal cr&#243;nica&#44; trastornos paratiroideos&#44; estados malabsortivos y suplementaci&#243;n con VD&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Variables</span><p id="par0035" class="elsevierStylePara elsevierViewall">Edad &#40;meses&#41;&#44; peso &#40;kg&#41;&#44; &#237;ndice de masa corporal &#40;kg&#47;m<span class="elsevierStyleSup">2</span>&#41;&#44; raza &#40;blanca&#44; negra&#44; asi&#225;tica&#41;&#44; enfermedad de base&#44; ingreso programado&#47;urgente&#44; fecha de ingreso y nivel acad&#233;mico de los padres&#46; Se analiz&#243; la 25&#40;OH&#41;D&#44; PTH&#44; hemograma&#44; prote&#237;na C reactiva &#40;PCR&#41;&#44; procalcitonina &#40;PCT&#41;&#44; calcio total e i&#243;nico&#44; f&#243;sforo&#44; magnesio y gasometr&#237;a venosa en las primeras 48 h del ingreso&#46; En los pacientes intervenidos bajo circulaci&#243;n extracorp&#243;rea &#40;CEC&#41; o que recibieron resucitaci&#243;n volum&#233;trica agresiva se espaci&#243; la extracci&#243;n sangu&#237;nea al menos 12 h para minimizar el posible efecto dilucional&#46; La 25&#40;OH&#41;D se cuantific&#243; mediante inmunoan&#225;lisis de electroquimioluminiscencia &#40;Cobas<span class="elsevierStyleSup">&#174;</span> e-602&#44; Roche&#44; Suiza&#41;&#46; Se registraron d&#237;as de estancia en UCIP&#44; mortalidad&#44; necesidad de VM<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>24 h&#44; uso de f&#225;rmacos vasoactivos &#40;FVA&#41;&#44; necesidad de antibioticoterapia prolongada &#40;&#62; 7 d&#237;as&#41;&#44; nutrici&#243;n parenteral &#40;NP&#41; y t&#233;cnicas continuas de depuraci&#243;n extrarrenal &#40;TCDER&#41;&#44; as&#237; como la duraci&#243;n de estas terapias&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Definiciones</span><p id="par0040" class="elsevierStylePara elsevierViewall">Se defini&#243; el VDD como concentraciones &#60; 20<span class="elsevierStyleHsp" style=""></span>ng&#47;ml<a class="elsevierStyleCrossRefs" href="#bib0210"><span class="elsevierStyleSup">2&#44;13&#44;14</span></a>&#46; Se utiliz&#243; una definici&#243;n operativa de morbilidad&#44; como la necesidad de VM<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>24 h&#44; FVA&#44; TCDER&#44; antibioticoterapia &#62; 7 d&#237;as o NP durante la estancia en la UCIP&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">An&#225;lisis estad&#237;stico</span><p id="par0045" class="elsevierStylePara elsevierViewall">Se realiz&#243; con la colaboraci&#243;n de un experto de la unidad IBIMA-FIMABIS AMEC&#44; con el software R&#46; La prevalencia se calcul&#243; con intervalo de confianza &#40;IC&#41; del 95&#37;&#46; Los estad&#237;sticos descriptivos para variables cuantitativas continuas se expresan como media y desviaci&#243;n est&#225;ndar&#44; o como mediana y rango intercuart&#237;lico&#44; seg&#250;n normalidad de la muestra&#44; y como porcentajes con IC del 95&#37; para las variables categ&#243;ricas&#46; Las asociaciones entre VD&#44; caracter&#237;sticas basales y variables evolutivas se analizaron mediante los test &#967;<span class="elsevierStyleSup"><span class="elsevierStyleItalic">2</span></span> o Fisher para las variables categ&#243;ricas y t de Student&#44; ANOVA&#44; test HDS de Tuckey&#44; Wilcoxon&#44; Mann-Whitney&#44; o Kruskal-Wallis para las variables continuas&#44; seg&#250;n procediera&#46; Se emple&#243; la regresi&#243;n log&#237;stica multivariante para investigar la relaci&#243;n entre el VDD y las caracter&#237;sticas de los pacientes y entre este d&#233;ficit y la morbimortalidad&#46; Para determinar si existe asociaci&#243;n independiente de la 25&#40;OH&#41;D con la estancia&#44; morbimortalidad&#44; se incluyeron en los modelos lineal y de regresi&#243;n log&#237;stica&#44; respectivamente&#44; aquellas variables previamente relacionadas seg&#250;n la literatura revisada&#44; junto con aquellas con un p valor &#60; 0&#44;1 en el an&#225;lisis univariante&#46; Un p valor &#60; 0&#44;05 se consider&#243; estad&#237;sticamente significativo&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Tama&#241;o muestral</span><p id="par0050" class="elsevierStylePara elsevierViewall">Se realiz&#243; utilizando la prevalencia descrita de VDD en ni&#241;os espa&#241;oles sanos del 51&#37;<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">15</span></a>&#46; Para estimar esta proporci&#243;n con una precisi&#243;n del 5&#44;6&#37; y un IC del 95&#37;&#44; se requer&#237;an un m&#237;nimo de 307 pacientes para la segunda fase del estudio&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">Para la primera fase &#40;estudio de cohortes&#41; el c&#225;lculo del tama&#241;o muestral se realiz&#243; en base a un riesgo relativo &#40;RR&#41; de mortalidad a los 90 d&#237;as de 1&#44;27&#46; Para conseguir una precisi&#243;n de 0&#44;20 unidades en la estimaci&#243;n del logaritmo de un RR mediante un IC asint&#243;tico normal al 95&#37; bilateral&#44; asumiendo que el RR esperado es 1&#44;73 &#40;IC &#91;RR&#93;&#58; 1&#44;73&#42;exp&#40;&#8211;0&#44;20&#41;&#59; 1&#44;73&#42;exp&#40;&#43;0&#44;20&#41;&#93; y que la proporci&#243;n de individuos en el grupo de referencia respecto el total es del 50&#37;&#44; ser&#237;a necesario incluir 100 pacientes en el grupo de referencia y 100 pacientes en el grupo experimental&#44; totalizando 200 pacientes en el estudio&#46;</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Aspectos &#233;ticos</span><p id="par0060" class="elsevierStylePara elsevierViewall">El protocolo de estudio fue aprobado por el Comit&#233; de &#201;tica e Investigaci&#243;n regional&#46; Se proporcion&#243; la hoja de informaci&#243;n a familiares y se obtuvo el consentimiento informado en todos los casos antes de ser incluidos en el estudio&#46; Los datos se registraron an&#243;nimamente en una base de datos electr&#243;nica codificada&#46; El proyecto cumple con los principios de la declaraci&#243;n de Helsinki y las normas de buena pr&#225;ctica cl&#237;nica&#46;</p></span></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Resultados</span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Caracter&#237;sticas basales</span><p id="par0065" class="elsevierStylePara elsevierViewall">Durante el periodo de estudio ingresaron 615 pacientes&#44; 466 de los cuales eran elegibles&#59; de estos&#44; 126 no firmaron el consentimiento informado&#44; por lo que finalmente fueron incluidos 340 pacientes&#46; Las caracter&#237;sticas sociodemogr&#225;ficas y cl&#237;nicas basales se muestran en la <a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a>&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">D&#233;ficit de vitamina D</span><p id="par0070" class="elsevierStylePara elsevierViewall">La media de 25&#40;OH&#41;D total fue de 22&#44;28<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>10&#44;55<span class="elsevierStyleHsp" style=""></span>ng&#47;ml &#40;IC del 95&#37;&#44; 21&#44;15-23&#44;41&#41;&#46; La prevalencia del d&#233;ficit fue del 43&#44;8&#37; &#40;IC del 95&#37;&#44; 38&#44;53&#37;-49&#44;07&#37;&#41;&#46; Ciento veintiocho &#40;37&#44;6&#37;&#41; pacientes presentaban insuficiencia de VD &#40;20-30<span class="elsevierStyleHsp" style=""></span>ng&#47;ml&#41;&#44; 41 pacientes &#40;12&#44;1&#37;&#41; tuvieron niveles entre 30-40<span class="elsevierStyleHsp" style=""></span>ng&#47;ml y solo 22 &#40;6&#44;5&#37;&#41; mostraron concentraciones &#243;ptimas &#40;&#62; 40<span class="elsevierStyleHsp" style=""></span>ng&#47;ml&#41;&#46;</p></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0130">Factores de riesgo de d&#233;ficit de vitamina D</span><p id="par0075" class="elsevierStylePara elsevierViewall">En el an&#225;lisis bivariante &#40;<a class="elsevierStyleCrossRefs" href="#tbl0005">tablas 1 y 2</a>&#41;&#44; los pacientes con VDD eran de mayor edad&#44; ingresaron m&#225;s frecuentemente en primavera&#44; obtuvieron puntuaciones m&#225;s altas en la escala PRISM-III y tuvieron una mayor estancia en UCIP&#46; La media de 25&#40;OH&#41;D en primavera fue 20&#44;25<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>9&#44;7<span class="elsevierStyleHsp" style=""></span>ng&#47;ml&#44; mientras que en oto&#241;o fue 26&#44;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>11&#44;7<span class="elsevierStyleHsp" style=""></span>ng&#47;ml&#46; La mayor concentraci&#243;n de 25&#40;OH&#41;D se registr&#243; en agosto &#40;32&#44;42<span class="elsevierStyleHsp" style=""></span>ng&#47;ml&#41; y la menor en abril &#40;17&#44;1<span class="elsevierStyleHsp" style=""></span>ng&#47;ml&#41;&#46; El nivel acad&#233;mico de los padres se asoci&#243; estad&#237;sticamente con el VDD&#46; Las medias de 25&#40;OH&#41;D fueron 24&#44;9&#44; 22&#44;7&#44; 22&#44;6 y 19&#44;6<span class="elsevierStyleHsp" style=""></span>ng&#47;ml en ni&#241;os cuyos padres no ten&#237;an formaci&#243;n acad&#233;mica&#44; estudios primarios&#44; secundarios y terciarios&#44; respectivamente&#46; Mediante regresi&#243;n log&#237;stica bivariante&#44; encontramos que el riesgo de presentar VDD entre los pacientes cuyos padres ten&#237;an estudios terciarios era mayor respecto al de aquellos con estudios primarios &#40;OR 0&#44;498&#44; IC del 95&#37;&#44; 0&#44;26-0&#44;94&#41;&#44; y secundarios &#40;OR 0&#44;37&#44; IC del 95&#37;&#44; 0&#44;2-0&#44;7&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0080" class="elsevierStylePara elsevierViewall">En el an&#225;lisis multivariante &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">tabla 3</a>&#41; se encontr&#243; un riesgo aumentado de presentar VDD en aquellos que ingresaron en invierno frente a oto&#241;o &#40;OR 2&#44;93&#44; IC del 95&#37;&#44; 1&#46;1-8&#44;7&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;04&#41;&#44; as&#237; como entre aquellos que tuvieron una mayor puntuaci&#243;n PRISM-III &#40;OR 1&#44;07&#44; IC del 95&#37;&#44; 1&#44;02-1&#44;13&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;005&#41;&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0085" class="elsevierStylePara elsevierViewall">La concentraci&#243;n de 25&#40;OH&#41;D se asoci&#243; adem&#225;s con diversos par&#225;metros anal&#237;ticos &#40;<a class="elsevierStyleCrossRef" href="#tbl0020">tabla 4</a>&#41;&#46; Los pacientes con VDD tuvieron un mayor recuento leucocitario y de neutr&#243;filos&#44; menor cifra de plaquetas&#44; menor concentraci&#243;n de alb&#250;mina&#44; calcio total e i&#243;nico&#44; menor pH&#44; mayor fosforemia y mayor nivel de PCT&#46; La media de concentraci&#243;n de PTH fue 56<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>49<span class="elsevierStyleHsp" style=""></span>pg&#47;ml en los pacientes VD deficientes y 414<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>34&#44;6<span class="elsevierStyleHsp" style=""></span>pg&#47;ml en los no deficientes &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;004&#41;&#46; Cuarenta y un pacientes &#40;27&#44;5&#37;&#41; en el grupo con VDD tuvieron hiperparatiroidismo &#40;PTH &#62; 60<span class="elsevierStyleHsp" style=""></span>pg&#47;ml&#41;&#44; comparado con 22 pacientes &#40;12&#44;6&#37;&#41; del grupo sin deficiencia &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#46; Los niveles de PTH tuvieron una correlaci&#243;n lineal negativa tanto con la concentraci&#243;n de 25&#40;OH&#41;D &#40;Pearson &#8211;0&#44;22&#44; R<span class="elsevierStyleSup">2</span> 0&#44;047&#44; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41; como con el calcio i&#243;nico &#40;Rho Spearman &#8211;0&#44;33&#44; R<span class="elsevierStyleSup">2</span> 0&#44;18&#44; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#46;</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia></span><span id="sec0075" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0135">Estancia en Unidad de Cuidados Intensivos Pedi&#225;tricos</span><p id="par0090" class="elsevierStylePara elsevierViewall">En el an&#225;lisis bivariante &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a>&#41;&#44; los ni&#241;os con VDD tuvieron una mayor estancia en UCIP&#46; Sin embargo&#44; en el an&#225;lisis multivariante ajustado por la edad&#44; PRISM-III&#44; morbilidad y tipo de ingreso&#44; no encontramos asociaci&#243;n estad&#237;sticamente significativa entre este d&#233;ficit y la estancia en la UCIP&#46;</p></span><span id="sec0080" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0140">Morbilidad</span><p id="par0095" class="elsevierStylePara elsevierViewall">Los pacientes con VDD tuvieron mayor morbilidad en el an&#225;lisis bivariante &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a>&#41;&#46; El porcentaje de pacientes con necesidad de VM<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>24 h fue mayor en el grupo con VDD&#44; as&#237; como la duraci&#243;n de la misma&#46; Los pacientes con VDD necesitaron m&#225;s frecuentemente FVA y por mayor tiempo &#40;mediana de 3 vs&#46; 2 d&#237;as&#44; media 7&#44;5 vs&#46; 3&#44;05&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;24&#41;&#44; aunque esta diferencia no fue estad&#237;sticamente significativa&#46; El requerimiento de TCDER fue mayor en aquellos con VDD&#44; as&#237; como el uso prolongado de antibi&#243;ticos y de NP&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">Entre los pacientes con VDD&#44; aquellos con hiperparatiroidismo secundario tuvieron una mayor morbilidad que aquellos con PTH<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>60<span class="elsevierStyleHsp" style=""></span>pg&#47;ml&#44; 65&#44;9&#37; vs&#46; 59&#44;3&#37;&#44; respectivamente &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">En el an&#225;lisis de regresi&#243;n log&#237;stica multivariante&#44; la OR ajustada para el VDD fue de 5&#44;55 &#40;IC del 95&#37;&#44; 2&#44;64-11&#44;69&#41;&#46; La PCR&#44; PRISM-III y la duraci&#243;n de la estancia en UCIP tambi&#233;n se asociaron con un aumento del riesgo de morbilidad&#44; mientras que el calcio i&#243;nico y la edad se comportaron como factores protectores &#40;<a class="elsevierStyleCrossRef" href="#tbl0025">tabla 5</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0025"></elsevierMultimedia></span><span id="sec0085" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0145">Mortalidad</span><p id="par0110" class="elsevierStylePara elsevierViewall">Aunque la mortalidad fue superior en los pacientes con VDD en el an&#225;lisis bivariante&#44; la diferencia no alcanz&#243; significaci&#243;n estad&#237;stica&#46; La concentraci&#243;n de 25&#40;OH&#41;D fue menor entre los fallecidos en comparaci&#243;n con los supervivientes al alta de UCIP &#40;14<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>8&#44;81<span class="elsevierStyleHsp" style=""></span>ng&#47;ml vs&#46; 22&#44;53<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>10&#44;53<span class="elsevierStyleHsp" style=""></span>ng&#47;ml&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;012&#41;&#46; En la regresi&#243;n log&#237;stica multivariante&#44; los niveles m&#225;s elevados de 25&#40;OH&#41;D se comportan como protectores frente a la mortalidad&#44; OR 0&#44;84 &#40;IC del 95&#37;&#44; 0&#44;70-0&#44;99&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;04&#41;&#46; Este efecto es independiente de la hipocalcemia&#44; tal y como se muestra en el segundo modelo de regresi&#243;n log&#237;stica &#40;<a class="elsevierStyleCrossRef" href="#tbl0030">tabla 6</a>&#41;&#46; En este modelo los niveles de PTH se comportan como factor de riesgo de mortalidad &#40;OR 1&#44;021&#44; IC del 95&#37;&#44; 1&#44;003-1&#44;04&#41;&#46; Sin embargo&#44; al introducir la hipocalcemia en el modelo 2&#44; la asociaci&#243;n de la PTH con la mortalidad se pierde&#44; sugiriendo un sesgo de confusi&#243;n de la calcemia &#40;<a class="elsevierStyleCrossRef" href="#tbl0030">tabla 6</a>&#41;&#46; La puntuaci&#243;n en la escala PRISM-III y el ingreso urgente se asoci&#243; tambi&#233;n a un aumento del riesgo de mortalidad en el an&#225;lisis multivariante &#40;OR 1&#44;32 y 25&#44;95&#44; respectivamente&#41;&#46;</p><elsevierMultimedia ident="tbl0030"></elsevierMultimedia></span></span><span id="sec0090" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0150">Discusi&#243;n</span><p id="par0115" class="elsevierStylePara elsevierViewall">El presente estudio muestra que el VDD est&#225; presente en casi la mitad de los ni&#241;os al ingreso en la UCIP&#46; Adem&#225;s&#44; concentraciones menores de 25&#40;OH&#41;D se asociaron a una mayor puntuaci&#243;n PRISM-III&#44; el nivel acad&#233;mico de los padres y las estaciones m&#225;s fr&#237;as&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">La prevalencia observada es similar a la recientemente comunicada por Madden et al&#46;<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">9</span></a>&#46; McNally et al&#46;<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">10</span></a> publican una mayor prevalencia en un estudio multic&#233;ntrico realizado en ni&#241;os en Canad&#225;&#46; Rey et al&#46;<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">11</span></a> en su estudio realizado en Asturias comparando ni&#241;os sanos con ingresados en UCIP tambi&#233;n encuentran una mayor proporci&#243;n de VDD &#40;15&#44;6&#37; vs&#46; 29&#44;5&#37;&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;01&#41;&#46; Por tanto&#44; est&#225; claro que la hipovitaminosis D es una situaci&#243;n frecuente en la UCIP&#44; aunque la prevalencia var&#237;a ampliamente seg&#250;n las caracter&#237;sticas sociodemogr&#225;ficas&#46; Es conocido que las concentraciones de VD en la poblaci&#243;n pedi&#225;trica disminuyen con la edad<a class="elsevierStyleCrossRefs" href="#bib0245"><span class="elsevierStyleSup">9&#44;11&#44;16</span></a>&#46; En nuestra muestra hemos encontrado una diferencia estad&#237;sticamente significativa en el an&#225;lisis bivariante&#44; pero no podemos asegurar esta relaci&#243;n sobre la base del an&#225;lisis multivariante&#44; lo que puede ser consecuencia de haber excluido a los &#60; 6 meses&#46; La latitud de la ciudad de residencia habitual es tambi&#233;n un factor reconocido que influye en los niveles plasm&#225;ticos de 25&#40;OH&#41;D&#44; lo cual puede parcialmente explicar la alta prevalencia encontrada por McNally&#44; as&#237; como los h&#225;bitos relacionados con la exposici&#243;n solar&#44; la etnia&#44; el tiempo que se permanece al aire libre y la ingesta de VD<a class="elsevierStyleCrossRefs" href="#bib0280"><span class="elsevierStyleSup">16&#44;17</span></a>&#46; Por otro lado&#44; el m&#233;todo utilizado para medir la 25&#40;OH&#41;D puede ser responsable de algunas de estas diferencias&#44; tal y como ha sido comunicado recientemente<a class="elsevierStyleCrossRefs" href="#bib0290"><span class="elsevierStyleSup">18&#44;19</span></a>&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">A diferencia de otros autores&#44; no encontramos mayor prevalencia de VDD en los pacientes postoperatorios cirug&#237;a cardiovascular &#40;POCCV&#41;<a class="elsevierStyleCrossRefs" href="#bib0260"><span class="elsevierStyleSup">12&#44;20</span></a>&#46; Aunque existen otros factores implicados en la fisiopatolog&#237;a&#44; el efecto dilucional tras la CEC sugerido por algunos autores<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">20</span></a> puede haber sido minimizado en nuestro estudio debido a que se retras&#243; la extracci&#243;n de la muestra al menos 12 h desde su ingreso o expansi&#243;n en&#233;rgica de la volemia&#46; Adem&#225;s&#44; no todos los pacientes POCCV fueron con CEC&#44; por lo que la prevalencia no es comparable con la encontrada en estudios previos<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">12</span></a>&#46; Por otro lado&#44; los &#60; 6 meses fueron excluidos&#44; debido a la profilaxis rutinaria con VD&#46; Los &#60; 6 meses POCCV suelen ser de mayor complejidad quir&#250;rgica y nuestra muestra no es&#44; por tanto&#44; totalmente representativa de este colectivo&#44; por lo que es necesario llevar a cabo un estudio focalizado en estos pacientes para poder estimar la prevalencia real del VDD en el POCCV&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">La relaci&#243;n entre el alto nivel educacional de los padres y el estado de VD de los pacientes es un hallazgo curioso&#46; Un menor tiempo de estancia al aire libre&#44; la utilizaci&#243;n de filtros solares UVB y su factor de protecci&#243;n&#44; el bajo estatus socioecon&#243;mico y los ingresos familiares se han relacionado con una mayor prevalencia de VDD<a class="elsevierStyleCrossRefs" href="#bib0305"><span class="elsevierStyleSup">21-23</span></a>&#46; En adultos j&#243;venes&#44; se ha descrito una asociaci&#243;n entre la hipovitaminosis D y el alto nivel acad&#233;mico de los padres<a class="elsevierStyleCrossRefs" href="#bib0320"><span class="elsevierStyleSup">24&#44;25</span></a>&#46; Debido a que no registramos un cuestionario espec&#237;fico de valoraci&#243;n nutricional y de actividades diarias&#44; no podemos ser asertivos acerca de la verdadera raz&#243;n de dicha asociaci&#243;n&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">En nuestro estudio los niveles de 25&#40;OH&#41;D al ingreso se correlacionan con el recuento plaquetario&#44; la concentraci&#243;n de alb&#250;mina y el pH e inversamente con la cifra de leucocitos&#44; neutr&#243;filos y PCT&#46; Estas correlaciones han sido observadas por otros autores<a class="elsevierStyleCrossRefs" href="#bib0255"><span class="elsevierStyleSup">11&#44;19</span></a>&#44; sugiri&#233;ndose un importante papel de la VD en el SRIS&#44; en especial en sepsis<a class="elsevierStyleCrossRefs" href="#bib0230"><span class="elsevierStyleSup">6&#44;26&#44;27</span></a>&#46; La PCT es un biomarcador importante en la respuesta del hu&#233;sped frente a la infecci&#243;n y a otras situaciones cl&#237;nicas<a class="elsevierStyleCrossRefs" href="#bib0340"><span class="elsevierStyleSup">28&#44;29</span></a>&#46; Bas&#225;ndonos en las diferencias de los par&#225;metros anal&#237;ticos comentadas&#44; hipotetizamos que la PCT est&#225; m&#225;s elevada en los pacientes con VDD debido a una mayor respuesta inflamatoria frente a estos diferentes est&#237;mulos&#46; Entre las acciones no cl&#225;sicas de la VD destaca su efecto sobre el sistema inmunitario<a class="elsevierStyleCrossRefs" href="#bib0210"><span class="elsevierStyleSup">2&#44;6</span></a>&#59; el VDD compromete la capacidad del sistema inmunitario de suprimir la infecci&#243;n bacteriana y la respuesta inflamatoria&#44; llevando as&#237; a un incremento de los niveles de PCT circulante<a class="elsevierStyleCrossRef" href="#bib0350"><span class="elsevierStyleSup">30</span></a>&#46;</p><p id="par0140" class="elsevierStylePara elsevierViewall">En nuestro estudio&#44; los niveles bajos de 25&#40;OH&#41;D est&#225;n asociados a la morbilidad y su concentraci&#243;n parece comportarse como factor protector para la mortalidad&#44; aunque el n&#250;mero de fallecimientos fue bajo&#46; Estos hallazgos son plausibles desde el punto de vista biol&#243;gico y concuerdan con otros estudios cl&#237;nicos y experimentales previos<a class="elsevierStyleCrossRefs" href="#bib0215"><span class="elsevierStyleSup">3&#44;9&#44;10&#44;31-33</span></a> que revelan la VD como una hormona y citocina de efectos pleiotr&#243;picos importantes para el adecuado funcionamiento del sistema inmunitario y otros &#243;rganos centrales en la patofisiolog&#237;a de la enfermedad cr&#237;tica<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">3</span></a>&#46;</p><p id="par0145" class="elsevierStylePara elsevierViewall">En t&#233;rminos generales&#44; la VD aumenta la concentraci&#243;n de calcio s&#233;rico&#44; lo cual ha sido vinculado cl&#225;sicamente con la morbimortalidad<a class="elsevierStyleCrossRefs" href="#bib0220"><span class="elsevierStyleSup">4&#44;34</span></a>&#46; En el estr&#233;s agudo y la patolog&#237;a cr&#237;tica&#44; la hipocalcemia es com&#250;n y puede llevar a un aumento compensatorio de la PTH para mantener la homeostasis del calcio&#46; En el presente trabajo&#44; el calcio se asoci&#243; de forma independiente a una disminuci&#243;n del riesgo de morbilidad y con el VDD&#44; pero no encontramos una relaci&#243;n estad&#237;sticamente significativa con la mortalidad&#46; Los niveles de PTH ajustados por la presencia o no de hipocalcemia tampoco se tradujeron en un aumento del riesgo de mortalidad&#46;</p><p id="par0150" class="elsevierStylePara elsevierViewall">La mayor morbilidad observada en pacientes con VDD e hiperparatiroidismo secundario en comparaci&#243;n con aquellos que presentaban &#60; 60<span class="elsevierStyleHsp" style=""></span>pg&#47;ml concuerda con la hip&#243;tesis de Nair et al&#46;&#58; la falta de respuesta de la PTH a concentraciones bajas de 25&#40;OH&#41;D podr&#237;a reflejar un mejor estado tisular de VD&#44; lo cual est&#225; asociado a una mejor evoluci&#243;n cl&#237;nica<a class="elsevierStyleCrossRefs" href="#bib0210"><span class="elsevierStyleSup">2&#44;4</span></a>&#46; Adem&#225;s&#44; los niveles de calcitriol se correlacionan positivamente con la concentraci&#243;n de 25&#40;OH&#41;D y est&#225;n hasta un 50&#37; m&#225;s bajos en pacientes cr&#237;ticamente enfermos<a class="elsevierStyleCrossRef" href="#bib0375"><span class="elsevierStyleSup">35</span></a>&#46; El VDD en la enfermedad cr&#237;tica puede&#44; por tanto&#44; representar un desequilibrio entre la disponibilidad de substrato y los requerimientos tisulares&#44; en el que&#44; pese a una m&#225;xima estimulaci&#243;n de la 1-&#945;-hidroxilasa por la PTH&#44; a nivel tisular es incapaz de generar una cantidad adecuada de 1&#44;25&#40;OH&#41;<span class="elsevierStyleInf">2</span>D<a class="elsevierStyleCrossRef" href="#bib0380"><span class="elsevierStyleSup">36</span></a>&#46; La resistencia a la PTH puede comprometer as&#237; la formaci&#243;n de 1&#44;25&#40;OH&#41;<span class="elsevierStyleInf">2</span>D<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">2</span></a>&#46; El fallo en la regulaci&#243;n de la PTH debido a la insuficiencia de VD circulante puede conducir al escenario cl&#237;nico denominado como insuficiencia funcional<a class="elsevierStyleCrossRefs" href="#bib0210"><span class="elsevierStyleSup">2&#44;36</span></a>&#46;</p><p id="par0155" class="elsevierStylePara elsevierViewall">Si la naturaleza de estas asociaciones es causal o la VD desciende como consecuencia del SRIS y un aumento de los requerimientos tisulares queda a&#250;n por esclarecer&#46; Es posible que la medici&#243;n de la 25&#40;OH&#41;D no represente adecuadamente el estado previo a la enfermedad&#44; debido al SRIS e intervenciones asociadas &#40;expansi&#243;n volum&#233;trica&#44; TCDER&#41; que pueden reducir sus niveles s&#233;ricos<a class="elsevierStyleCrossRefs" href="#bib0300"><span class="elsevierStyleSup">20&#44;27&#44;37&#44;38</span></a>&#46; Tal como hemos observado&#44; una menor concentraci&#243;n de alb&#250;mina se asoci&#243; de forma estad&#237;sticamente significativa con el VDD&#46; Sin embargo&#44; Reid et al&#46; demostraron que el descenso de la concentraci&#243;n plasm&#225;tica de 25&#40;OH&#41;D tras un insulto inflamatorio no se explicaba por la cifra de prote&#237;nas transportadoras y no repercuti&#243; en el calcio corregido ni en la concentraci&#243;n de PTH<a class="elsevierStyleCrossRef" href="#bib0395"><span class="elsevierStyleSup">39</span></a>&#46;</p><p id="par0160" class="elsevierStylePara elsevierViewall">Un hecho que apoyar&#237;a la hip&#243;tesis de causalidad ser&#237;a la demostraci&#243;n de beneficio cl&#237;nico con la suplementaci&#243;n de VD&#44; lo cual ha sido recientemente investigado en adultos<a class="elsevierStyleCrossRef" href="#bib0400"><span class="elsevierStyleSup">40</span></a>&#46; Este y otros aspectos merecen continuar con la investigaci&#243;n para clarificar el papel de la VD en la patofisiolog&#237;a de diferentes situaciones cl&#237;nicas relacionadas con la enfermedad cr&#237;tica y dise&#241;ar una estrategia de intervenci&#243;n para mejorar la evoluci&#243;n de estos pacientes&#46;</p></span><span id="sec0095" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0155">Conclusiones</span><p id="par0165" class="elsevierStylePara elsevierViewall">El VDD es frecuente en pacientes cr&#237;ticos pedi&#225;tricos y est&#225; asociado con mayor puntuaci&#243;n en escalas de gravedad&#44; la estaci&#243;n del a&#241;o y el nivel educativo de los padres&#46; La concentraci&#243;n de VD est&#225; relacionada con diversos par&#225;metros anal&#237;ticos del SRIS&#46; El VDD est&#225; asociado a un incremento del riesgo de morbimortalidad&#44; no pudiendo asegurar su relaci&#243;n con la estancia en UCIP&#46; Destacamos el inter&#233;s de conocer el estado en VD de estos pacientes&#44; as&#237; como la necesidad de nuevos estudios que investiguen acerca del papel de esta vitamina en pacientes cr&#237;ticos&#46;</p></span><span id="sec0100" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0160">Conflicto de intereses</span><p id="par0170" class="elsevierStylePara elsevierViewall">Los autores declaran no tener ning&#250;n conflicto de intereses&#46;</p></span></span>"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objetivos</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Determinar la prevalencia y factores de riesgo del d&#233;ficit de vitamina D &#40;VDD&#41; en una unidad de cuidados intensivos pedi&#225;tricos &#40;UCIP&#41;&#44; as&#237; como su relaci&#243;n con la morbimortalidad durante el ingreso&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Material y m&#233;todos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Estudio observacional prospectivo realizado en la UCIP de un hospital terciario en 2 fases&#58; <span class="elsevierStyleSmallCaps">i</span>&#58; estudio de cohortes&#44; y <span class="elsevierStyleSmallCaps">ii</span>&#58; estudio de prevalencia&#46; Se incluy&#243; a 340 ni&#241;os &#62; 6 meses&#44; excluyendo a aquellos con enfermedad renal cr&#243;nica&#44; trastornos paratiroideos y suplementaci&#243;n con vitamina D&#46; Se realiz&#243; medici&#243;n de 25-hidroxivitamina D total &#40;25&#91;OH&#93;D&#41; en las primeras 48 h del ingreso&#44; parathormona &#40;PTH&#41;&#44; calcio&#44; f&#243;sforo&#44; gasometr&#237;a venosa&#44; hemograma&#44; prote&#237;na C reactiva y procalcitonina&#46; Se registraron datos sociodemogr&#225;ficos&#44; caracter&#237;sticas del episodio y complicaciones&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">La prevalencia de VDD &#40;&#60; 20<span class="elsevierStyleHsp" style=""></span>ng&#47;ml&#41; fue del 43&#44;8&#37;&#44; con media de 22&#44;28 &#40;IC del 95&#37;&#44; 21&#44;15-23&#44;41&#41; ng&#47;ml&#46; Los pacientes con d&#233;ficit fueron de mayor edad &#40;61 vs&#46; 47 meses&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;039&#41;&#44; sus padres ten&#237;an un mayor nivel acad&#233;mico &#40;36&#44;5&#37; vs&#46; 20&#37;&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;016&#41;&#44; ingresaron m&#225;s frecuentemente en invierno y primavera&#44; obtuvieron mayor puntuaci&#243;n PRISM-III &#40;6&#44;8 vs&#46; 5&#44;1&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;037&#41;&#44; mayor estancia &#40;3 vs&#46; 2 d&#237;as&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41; y morbilidad &#40;61&#44;1&#37; vs&#46; 30&#44;4&#37;&#44; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41; que los pacientes con niveles suficientes &#40;&#8805; 20<span class="elsevierStyleHsp" style=""></span>ng&#47;ml&#41;&#46; Los pacientes fallecidos tuvieron niveles inferiores de 25&#40;OH&#41;D &#40;14<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>8&#44;81<span class="elsevierStyleHsp" style=""></span>ng&#47;ml vs&#46; 22&#44;53<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>10&#44;53<span class="elsevierStyleHsp" style=""></span>ng&#47;ml&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;012&#41;&#46; La OR ajustada para la morbilidad fue 5&#44;44 &#40;IC del 95&#37;&#44; 2&#44;5-11&#44;6&#41;&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">El VDD es frecuente en pacientes cr&#237;ticos pedi&#225;tricos y est&#225; relacionado con la morbimortalidad en UCIP&#44; aunque queda por esclarecer si se trata de una relaci&#243;n causal o es simplemente un marcador de gravedad en diferentes situaciones cl&#237;nicas&#46;</p></span>"
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          ]
          1 => array:2 [
            "identificador" => "abst0010"
            "titulo" => "Material y m&#233;todos"
          ]
          2 => array:2 [
            "identificador" => "abst0015"
            "titulo" => "Resultados"
          ]
          3 => array:2 [
            "identificador" => "abst0020"
            "titulo" => "Conclusiones"
          ]
        ]
      ]
      "en" => array:3 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Objectives</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">To determine the prevalence and risks factors of vitamin D deficiency&#44; as well as its relationship with morbidity and mortality in a PICU&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Material and methods</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">An observational prospective study in a tertiary children&#39;s University Hospital PICU conducted in two phases&#58; <span class="elsevierStyleSmallCaps">i&#58;</span> cohorts study&#44; and <span class="elsevierStyleSmallCaps">ii&#58;</span> prevalence study&#46; The study included 340 critically ill children with ages comprising 6 months to 16 years old&#46; Exclusion criteria&#58; Chronic kidney disease&#44; known parathyroid disorders&#44; and vitamin D supplementation&#46; Total 25-hydroxyvitamin D &#91;25&#40;OH&#41;D&#93; was measured in the first 48<span class="elsevierStyleHsp" style=""></span>hours of admission to a PICU&#46; Parathormone&#44; calcium&#44; phosphate&#44; blood gases&#44; blood count&#44; C-reactive protein&#44; and procalcitonin were also analysed&#46; A record was also made of demographic features&#44; characteristics of the episode&#44; and complications during the PICU stay&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">The overall prevalence rate of vitamin D deficiency was 43&#46;8&#37;&#44; with a mean of 22&#46;28 &#40;95&#37; CI 21&#46;15&#8211;23&#46;41&#41; ng&#47;ml&#46; Patients with vitamin D deficiency were older &#40;61 vs 47 months&#44; <span class="elsevierStyleItalic">P</span>&#61;&#46;039&#41;&#44; had parents with a higher level of academic studies &#40;36&#46;5&#37; vs 20&#37;&#44; <span class="elsevierStyleItalic">P</span>&#61;&#46;016&#41;&#44; were admitted more often in winter and spring&#44; had a higher PRISM-III &#40;6&#46;8 vs 5&#46;1&#44; <span class="elsevierStyleItalic">P</span>&#61;&#46;037&#41;&#44; a longer PICU stay &#40;3 vs 2 days&#44; <span class="elsevierStyleItalic">P</span>&#61;&#46;001&#41;&#44; and higher morbidity &#40;61&#46;1&#37; vs 30&#46;4&#37;&#44; <span class="elsevierStyleItalic">P</span>&#60;<span class="elsevierStyleHsp" style=""></span>001&#41; than the patients with sufficient levels of 25&#40;OH&#41;D&#46; Patients who died had lower levels of 25&#40;OH&#41;D &#40;14<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>8&#46;81<span class="elsevierStyleHsp" style=""></span>ng&#47;ml versus 22&#46;53<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>10&#46;53<span class="elsevierStyleHsp" style=""></span>ng&#47;ml&#44; <span class="elsevierStyleItalic">P</span>&#61;&#46;012&#41;&#46; Adjusted OR for morbidity was 5&#46;44 &#40;95&#37;CI&#59; 2&#46;5-11&#46;6&#41;&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Vitamin D deficiency is frequent in critically ill children&#44; and it is related to both morbidity and mortality&#44; although it remains unclear whether it is a causal relationship or it is simply a marker of severity in different clinical situations&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0025"
            "titulo" => "Objectives"
          ]
          1 => array:2 [
            "identificador" => "abst0030"
            "titulo" => "Material and methods"
          ]
          2 => array:2 [
            "identificador" => "abst0035"
            "titulo" => "Results"
          ]
          3 => array:2 [
            "identificador" => "abst0040"
            "titulo" => "Conclusions"
          ]
        ]
      ]
    ]
    "multimedia" => array:6 [
      0 => array:8 [
        "identificador" => "tbl0005"
        "etiqueta" => "Tabla 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at1"
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        "tabla" => array:3 [
          "leyenda" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">DE&#58; desviaci&#243;n est&#225;ndar del peso e IMC respecto a curvas de Fern&#225;ndez et al&#46;&#44; 2011&#59; IMC&#58; &#237;ndice de masa corporal&#59; TCDER&#58; terapia continua de depuraci&#243;n extrarrenal&#59; VM&#58; ventilaci&#243;n mec&#225;nica&#46;</p>"
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            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Caracter&#237;sticas&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Total &#40;N<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>340&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Vitamina D deficientes &#40;&#60; 20<span class="elsevierStyleHsp" style=""></span>ng&#47;ml&#41; &#40;N<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>149&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">No deficientes &#40;&#8805; 20<span class="elsevierStyleHsp" style=""></span>ng&#47;ml&#41; &#40;N<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>191&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">p&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Edad &#40;meses&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">60 &#40;23-117&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">61 &#40;24-122&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">47 &#40;18-102&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;039<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">G&#233;nero masculino</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">185 &#40;54&#44;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">112 &#40;58&#44;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">73 &#40;49&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;076&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Peso &#40;kg&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">16 &#40;11-31&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">18 &#40;12-35&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">15 &#40;10-28&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;041<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">DE peso</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;0&#44;51 &#40;&#8211;1&#44;28&#44; 0&#44;57&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;0&#44;39 &#40;&#8211;1&#44;22&#44; 0&#44;56&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;0&#44;56 &#40;&#8211;1&#44;43&#44; 0&#44;57&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;97&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">IMC &#40;kg&#47;m</span><span class="elsevierStyleSup"><span class="elsevierStyleItalic">2</span></span><span class="elsevierStyleItalic">&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">15&#44;85 &#40;14&#44;12-19&#44;51&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">15&#44;70 &#40;14&#44;17-19&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">15&#44;67 &#40;13&#44;91-19&#44;48&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;26&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">DE IMC</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;0&#44;42 &#40;&#8211;1&#44;34&#44; 0&#44;85&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;0&#44;36 &#40;&#8211;1&#44;2&#44; 0&#44;61&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;0&#44;46 &#40;&#8211;1&#44;53&#44; 0&#44;92&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;835&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleItalic">Raza</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Blanca&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">319 &#40;93&#44;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">138 &#40;92&#44;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">182 &#40;95&#44;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Negra&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">18 &#40;5&#44;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9 &#40;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9 &#40;4&#44;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Asi&#225;tica&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2 &#40;0&#44;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2 &#40;1&#44;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0 &#40;0&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;016<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleItalic">Nivel acad&#233;mico parental</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Ninguno&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">25 &#40;9&#44;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10 &#40;8&#44;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">15 &#40;9&#44;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Estudios primarios&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">81 &#40;29&#44;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">32 &#40;27&#44;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">49 &#40;30&#44;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Estudios secundarios&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">95 &#40;34&#44;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">31 &#40;27&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">64 &#40;40&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Estudios terciarios&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">74 &#40;26&#44;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">42 &#40;36&#44;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">32 &#40;20&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;032<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleItalic">Estaci&#243;n</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Primavera&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">130 &#40;38&#44;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">66 &#40;44&#44;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">64 &#40;33&#44;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Verano&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">35 &#40;0&#44;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">13 &#40;8&#44;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">22 &#40;11&#44;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Oto&#241;o&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">51 &#40;15&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">14 &#40;9&#44;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">37 &#40;19&#44;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Invierno&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">124 &#40;36&#44;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">56 &#40;37&#44;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">68 &#40;35&#44;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;78&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Enfermedad de base</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">258 &#40;75&#44;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">112 &#40;75&#44;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">146 &#40;76&#44;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;59&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleItalic">Diagn&#243;stico</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>M&#233;dico&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">100 &#40;29&#44;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">60 &#40;40&#44;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">40 &#40;20&#44;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Quir&#250;rgico&#44; cardiaco&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">97 &#40;28&#44;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">49 &#40;32&#44;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">48 &#40;25&#44;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Quir&#250;rgico&#44; no cardiaco&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">143 &#40;42&#44;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">40 &#40;26&#44;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">103 &#40;53&#44;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">PRISM-III</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5 &#40;0-8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;008<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">140 &#40;41&#44;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">86 &#40;57&#44;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">54 &#40;28&#44;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60; 0&#44;001<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">58 &#40;17&#44;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">36 &#40;24&#44;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">22 &#40;11&#44;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;002<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">80 &#40;23&#44;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">48 &#40;32&#44;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">32 &#40;16&#44;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;001<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9 &#40;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2 &#40;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;01<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">18 &#40;5&#44;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">14 &#40;9&#44;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4 &#40;2&#44;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;003<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2 &#40;1-3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;001<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">149 &#40;43&#44;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">91 &#40;61&#44;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">58 &#40;30&#44;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7 &#40;4&#44;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3 &#40;1&#44;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">ORL &#40;11&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">28&#44;53<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>12&#44;49&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">27&#44;3&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top">Genitourinario &#40;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">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="table-entry ; entry_with_role_rowhead " align="left" valign="top">Quemado &#40;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">25&#44;69<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>16&#44;17&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">37&#44;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="table-entry ; entry_with_role_rowhead " align="left" valign="top">Traumatol&#243;gico &#40;18&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">21&#44;69<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>10&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">44&#44;4&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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              "identificador" => "tblfn0005"
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            1 => array:3 [
              "identificador" => "tblfn0010"
              "etiqueta" => "b"
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          "es" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Niveles de vitamina D y prevalencia del d&#233;ficit seg&#250;n el motivo de ingreso</p>"
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " rowspan="2" align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Variables independientes</th><th class="td" title="table-head  " rowspan="2" align="left" valign="top" scope="col" style="border-bottom: 2px solid black">OR ajustada</th><th class="td" title="table-head  " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">IC del 95&#37; para OR</th><th class="td" title="table-head  " rowspan="2" align="left" valign="top" scope="col" style="border-bottom: 2px solid black">p</th></tr><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">L&#237;mite inferior&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Edad &#40;meses&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;99&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;01&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;07&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">G&#233;nero &#40;masculino&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;49&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;39&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;48&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">IMC &#40;kg&#47;m<span class="elsevierStyleSup">2</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;97&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;89&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;05&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;53&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Enfermedad de base&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;84&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;46&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;52&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;56&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Invierno vs&#46; oto&#241;o&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#44;93&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8&#44;70&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;04<a class="elsevierStyleCrossRef" href="#tblfn0020"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Primavera vs&#46; oto&#241;o&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#44;17&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;93&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#44;36&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;081&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Verano vs&#46; oto&#241;o&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;26&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;39&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&#44;05&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;69&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Sin estudios vs&#46; estudios terciarios&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;55&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;18&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;67&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;29&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Estudios primarios vs&#46; terciarios&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;49&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;22&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;076&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;076&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Estudios secundarios vs&#46; terciarios&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;28&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;13&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;63&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;002<a class="elsevierStyleCrossRef" href="#tblfn0020"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">PRISM-III&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;13&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;05&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;19&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;005<a class="elsevierStyleCrossRef" href="#tblfn0020"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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              "nota" => "<p class="elsevierStyleNotepara" id="npar0020">Diferencias estad&#237;sticamente significativas&#46;</p>"
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          ]
        ]
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          "es" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Regresi&#243;n log&#237;stica multivariante que estudia el riesgo de d&#233;ficit de vitamina D &#40;s&#237;&#47;no&#41; en funci&#243;n de las caracter&#237;sticas basales de los pacientes incluidos</p>"
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Vitamina D deficientes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">No deficientes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">p&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Hemoglobina &#40;g&#47;dl&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">11&#44;50<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;91&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">11&#44;52<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;90&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Leucocitos &#40;mm<span class="elsevierStyleSup">&#8211;3</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">12&#46;540 &#40;9&#46;050-17&#46;305&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">11&#46;415 &#40;8&#46;865-14&#46;810&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;044<a class="elsevierStyleCrossRef" href="#tblfn0025"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Neutr&#243;filos &#40;mm<span class="elsevierStyleSup">&#8722;3</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9&#46;860 &#40;6&#46;600-13&#46;800&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8&#46;300 &#40;5&#46;265-11&#46;300&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;006<a class="elsevierStyleCrossRef" href="#tblfn0025"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Plaquetas &#40;mm<span class="elsevierStyleSup">&#8722;3</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">214&#46;000 &#40;160&#46;000-274&#46;000&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">257&#46;000 &#40;199&#46;750-341&#46;250&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60; 0&#44;001<a class="elsevierStyleCrossRef" href="#tblfn0025"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">56&#44;01<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>49&#44;21&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">41&#44;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>34&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;004<a class="elsevierStyleCrossRef" href="#tblfn0025"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Glucosa &#40;mg&#47;dl&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">133 &#40;106&#44;25-166&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">127 &#40;107-159&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;51&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Creatinina &#40;mg&#47;dl&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;39 &#40;0&#44;29-0&#44;55&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;37 &#40;0&#44;26-0&#44;49&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;023<a class="elsevierStyleCrossRef" href="#tblfn0025"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Alb&#250;mina &#40;g&#47;dl&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#44;8 &#40;2&#44;3-3&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&#44;1 &#40;2&#44;8-3&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60; 0&#44;001<a class="elsevierStyleCrossRef" href="#tblfn0025"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Calcio total &#40;mg&#47;dl&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8&#44;3 &#40;7&#44;9-8&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8&#44;6 &#40;8&#44;2-8&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60; 0&#44;001<a class="elsevierStyleCrossRef" href="#tblfn0025"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Calcio ionizado &#40;mmol&#47;l&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;23 &#40;1&#44;19-1&#44;27&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;27 &#40;1&#44;23-1&#44;30&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60; 0&#44;001<a class="elsevierStyleCrossRef" href="#tblfn0025"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">F&#243;sforo &#40;mg&#47;dl&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&#44;64<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;08&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&#44;39<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;01&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;032<a class="elsevierStyleCrossRef" href="#tblfn0025"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Magnesio &#40;mg&#47;dl&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;9 &#40;1&#44;7-2&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2 &#40;1&#44;77-2&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;20&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Lactato &#40;mmol&#47;l&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;7 &#40;1&#44;2&#8211;2&#44;22&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;5 &#40;1&#44;2-1&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;148&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">pH&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7&#44;31<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;07&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7&#44;33<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;07&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;035<a class="elsevierStyleCrossRef" href="#tblfn0025"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">PCR &#40;mg&#47;l&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9&#44;6 &#40;2&#44;9-47&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&#44;9 &#40;2&#44;9-31&#44;55&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;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="table-entry ; entry_with_role_rowhead " align="left" valign="top">PCT &#40;ng&#47;ml&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;4 &#40;0&#44;05-3&#44;27&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;07 &#40;0&#44;05-0&#44;46&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60; 0&#44;001<a class="elsevierStyleCrossRef" href="#tblfn0025"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " rowspan="2" align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Variables independientes</th><th class="td" title="table-head  " rowspan="2" align="left" valign="top" scope="col" style="border-bottom: 2px solid black">p</th><th class="td" title="table-head  " rowspan="2" align="left" valign="top" scope="col" style="border-bottom: 2px solid black">OR</th><th class="td" title="table-head  " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">IC del 95&#37; para OR</th></tr><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Inferior&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Superior&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Edad &#40;meses&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;985&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;977&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;993&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">G&#233;nero &#40;masculino&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;079&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;882&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;929&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&#44;813&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Ingreso programado&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;091&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;503&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;227&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;115&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">PCR &#40;mg&#47;l&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60; 0&#44;001<a class="elsevierStyleCrossRef" href="#tblfn0030"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;013&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;006&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;019&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Calcio ionizado &#40;mmol&#47;l&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;012<a class="elsevierStyleCrossRef" href="#tblfn0030"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;221&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#44;554&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#44;639&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">11&#44;691&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">PRISM-III&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;109&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;338&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;635&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " rowspan="2" align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Variables independientes</th><th class="td" title="table-head  " rowspan="2" align="left" valign="top" scope="col" style="border-bottom: 2px solid black">p</th><th class="td" title="table-head  " rowspan="2" align="left" valign="top" scope="col" style="border-bottom: 2px solid black">OR</th><th class="td" title="table-head  " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">IC del 95&#37; para OR</th></tr><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Inferior&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;583&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Tipo de ingreso &#40;urgente&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">31&#44;306&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;441&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">680&#44;236&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>G&#233;nero &#40;masculino&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;200&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#44;447&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;409&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">72&#44;620&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Edad &#40;meses&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;991&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;971&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;013&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;837&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;706&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;992&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;003&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;040&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">25&#44;951&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>PTH &#40;pg&#47;ml&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;133&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;016&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Hipocalcemia &#40;Ca<span class="elsevierStyleInf">i</span> &#8804; 1&#44;1<span class="elsevierStyleHsp" style=""></span>mmol&#47;l&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7&#44;078&#183;10<span class="elsevierStyleSup">9</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
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          "es" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">An&#225;lisis de regresi&#243;n log&#237;stica multivariante&#46; Variable dependiente&#58; mortalidad</p>"
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