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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">The prevalence of chronic kidney disease &#40;CKD&#41; in Spain has increased by 20&#37; in the last ten years and it increases progressively with age&#46;<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">1</span></a> According to data from the 2016 Spanish Registry of Renal Patients&#44; the prevalence of CKD in people aged over 64 is 25&#37; and it is 22&#37; in those older than 75 years&#46;<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">2</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">In addition to the ageing of the population&#44; high prevalent diseases such as hypertension &#40;HTN&#41;&#44; diabetes and cardiovascular disease are contribute to the increase in CKD<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">3</span></a>&#59; this means that it tends to occur in patients with significant comorbidity&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">We are therefore increasingly faced with the clinical decision of whether to start renal replacement therapy &#40;RRT&#41; or conservative kidney management &#40;CKM&#41;&#44; having to weigh up the benefits of each intervention&#44; in older patients with high comorbidity&#46;<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">4</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">Although overall survival tends to be higher in patients who undergo dialysis versus those who do not&#44; the advantage is lost in patients over 80 with a greater comorbidity&#44; especially if patients have coronary heart disease&#46;<a class="elsevierStyleCrossRefs" href="#bib0220"><span class="elsevierStyleSup">5&#44;6</span></a> In addition&#44; the burden of symptoms &#40;pain&#44; fatigue&#44; anorexia&#44; dyspnoea&#41; that these patients have on dialysis is high&#44;<a class="elsevierStyleCrossRefs" href="#bib0230"><span class="elsevierStyleSup">7&#44;8</span></a> their health-related quality of life &#40;HRQoL&#41; is often deficient&#44;<a class="elsevierStyleCrossRefs" href="#bib0240"><span class="elsevierStyleSup">9&#44;10</span></a> and many have progressive secondary functional deterioration&#46;<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">11</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">In view of the evident limitations of RRT for these patients&#44; there is currently increasing interest in determining whether CKM or active management without dialysis of advanced CKD &#40;ACKD&#41; is a valid therapeutic option&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">CKM is a comprehensive way of managing the patient which should include&#58; interventions to delay the progression of kidney disease and minimise the risk of adverse events&#59; shared decision making&#59; active management of symptoms&#59; detailed communication&#59; advanced care planning&#59; psychological support&#59; and social&#44; family and spiritual support&#46;<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">12</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">It can be difficult for us&#44; as nephrologists&#44; to initiate these conversations&#44;<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">13</span></a> in part due to the lack of prognostic information to help us advise our patients in the decision-making process&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">The majority of studies report that patients on CKM have a worse prognosis&#44; shorter survival<a class="elsevierStyleCrossRefs" href="#bib0265"><span class="elsevierStyleSup">14&#44;15</span></a> and reduced HRQoL&#46; Most of these studies are cross-sectional and retrospective&#46;<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">16</span></a></p><p id="par0045" class="elsevierStylePara elsevierViewall">In order to provide information about the utility of CKM to patients and healthcare professionals and facilitate the process of shared decision making&#44; we carried out a detailed analysis of patients choosing CKM&#46; Our aims were&#58;<ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005"><span class="elsevierStyleLabel">1&#46;</span><p id="par0050" class="elsevierStylePara elsevierViewall">To identify variables predictive of mortality in patients opting for CKM&#46;</p></li><li class="elsevierStyleListItem" id="lsti0010"><span class="elsevierStyleLabel">2&#46;</span><p id="par0055" class="elsevierStylePara elsevierViewall">To analyse the changes in HRQoL in this population on conservative management&#46;</p></li></ul></p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Material and methods</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Design</span><p id="par0060" class="elsevierStylePara elsevierViewall">This was a prospective&#44; observational&#44; analytical cohort study of patients seen at the Nephrology Department of the <span class="elsevierStyleItalic">Hospital Universitario Miguel Servet</span> &#91;Miguel Servet University Hospital&#93; in Zaragoza&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Inclusion criteria</span><p id="par0065" class="elsevierStylePara elsevierViewall">Over the age of 75&#44; incident patients on CKM&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">The decision-making process was carried out by the nephrologist responsible for the patient&#44; taking into account the following criteria&#58;<ul class="elsevierStyleList" id="lis0010"><li class="elsevierStyleListItem" id="lsti0015"><span class="elsevierStyleLabel">&#8211;</span><p id="par0075" class="elsevierStylePara elsevierViewall">Diagnosis of ACKD with glomerular filtration rate &#40;GFR&#41; of less than 20<span class="elsevierStyleHsp" style=""></span>ml&#47;min&#47;1&#46;73<span class="elsevierStyleHsp" style=""></span>m<span class="elsevierStyleSup">2</span> &#40;in 2 separate laboratory tests 3 months apart&#41;&#46;</p></li><li class="elsevierStyleListItem" id="lsti0020"><span class="elsevierStyleLabel">&#8211;</span><p id="par0080" class="elsevierStylePara elsevierViewall">Patients in whom there was no clinical indication of active replacement treatment by their treating physician&#46;</p></li></ul></p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Exclusion criteria</span><p id="par0085" class="elsevierStylePara elsevierViewall">Patients who were unable to take part in the clinical interview and those who had no family support were not included&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Follow-up</span><p id="par0090" class="elsevierStylePara elsevierViewall">The recruitment took place from 1 January 2015 to 1 May 2017&#46; The follow-up concluded with the death of the patient or with the date of closure of the study on 31 December 2017&#46; Scheduled visits were made at 0&#44; 12 and 24 months of follow-up&#44; with collection of analytical values and specific tests that analyse different areas of health&#58; comorbidity&#44; functional&#44; cognitive&#44; nutritional and social status&#44; frailty and HRQoL&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Data sources</span><p id="par0095" class="elsevierStylePara elsevierViewall">The assessments were made by the research team by conducting a clinical interview&#46; The personal history&#44; analytical data and date and cause of death were collected from the patient&#39;s hospital medical records and electronic medical record&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Ethical considerations</span><p id="par0100" class="elsevierStylePara elsevierViewall">The study was approved by the <span class="elsevierStyleItalic">Comit&#233; &#201;tico de Investigaci&#243;n Cl&#237;nica de Arag&#243;n</span> &#40;CEICA&#41; &#91;Aragon Independent Ethics Committee&#93; and all patients signed an informed consent form before they were included in the study&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Recorded variables</span><p id="par0105" class="elsevierStylePara elsevierViewall"><ul class="elsevierStyleList" id="lis0015"><li class="elsevierStyleListItem" id="lsti0025"><span class="elsevierStyleLabel">&#8211;</span><p id="par0110" class="elsevierStylePara elsevierViewall">Demographic variables&#58; age and gender&#46;</p></li><li class="elsevierStyleListItem" id="lsti0030"><span class="elsevierStyleLabel">&#8211;</span><p id="par0115" class="elsevierStylePara elsevierViewall">Clinical variables&#58;</p></li></ul><ul class="elsevierStyleList" id="lis0020"><li class="elsevierStyleListItem" id="lsti0035"><span class="elsevierStyleLabel">&#8226;</span><p id="par0120" class="elsevierStylePara elsevierViewall">Weight and height with calculation of body mass index &#40;BMI&#41;&#58; weight&#40;kg&#41;&#47;height&#40;m&#41;<span class="elsevierStyleSup">2</span>&#46;</p></li><li class="elsevierStyleListItem" id="lsti0040"><span class="elsevierStyleLabel">&#8226;</span><p id="par0125" class="elsevierStylePara elsevierViewall">Previous medical history&#58; HTN&#44; diabetes&#44; cause of CKD&#44; previous vascular event &#40;history of coronary heart disease&#44; cerebrovascular disease or peripheral vascular disease&#41;&#46;</p></li><li class="elsevierStyleListItem" id="lsti0045"><span class="elsevierStyleLabel">&#8226;</span><p id="par0130" class="elsevierStylePara elsevierViewall">Comorbidity&#58; Charlson index&#46;</p></li><li class="elsevierStyleListItem" id="lsti0050"><span class="elsevierStyleLabel">&#8226;</span><p id="par0135" class="elsevierStylePara elsevierViewall">Functional status&#58; Barthel index&#46;</p></li><li class="elsevierStyleListItem" id="lsti0055"><span class="elsevierStyleLabel">&#8226;</span><p id="par0140" class="elsevierStylePara elsevierViewall">Cognitive status&#58; Pfeiffer test&#46;</p></li><li class="elsevierStyleListItem" id="lsti0060"><span class="elsevierStyleLabel">&#8226;</span><p id="par0145" class="elsevierStylePara elsevierViewall">Frailty&#58; FRAIL Questionnaire&#46;</p></li><li class="elsevierStyleListItem" id="lsti0065"><span class="elsevierStyleLabel">&#8226;</span><p id="par0150" class="elsevierStylePara elsevierViewall">Nutritional assessment&#58; Mini-Nutritional Assessment Short-Form&#46;</p></li><li class="elsevierStyleListItem" id="lsti0070"><span class="elsevierStyleLabel">&#8226;</span><p id="par0155" class="elsevierStylePara elsevierViewall">CVRS&#58; The SF-36 Health Survey Questionnaire v2&#46;</p></li><li class="elsevierStyleListItem" id="lsti0075"><span class="elsevierStyleLabel">&#8226;</span><p id="par0160" class="elsevierStylePara elsevierViewall">Social status&#58; Gij&#243;n scale&#46;</p></li></ul><ul class="elsevierStyleList" id="lis0025"><li class="elsevierStyleListItem" id="lsti0080"><span class="elsevierStyleLabel">&#8211;</span><p id="par0165" class="elsevierStylePara elsevierViewall">Analytical variables&#58; eGFR &#40;CKD-EPI ml&#47;min&#47;1&#46;73<span class="elsevierStyleHsp" style=""></span>m<span class="elsevierStyleSup">2</span>&#41;&#44; Proteinuria &#40;g&#47;l&#41;&#44; Albumin &#40;mg&#47;dl&#41;&#44; High-sensitivity C-reactive protein &#40;&#91;hs-CRP&#93; mg&#47;dl&#41;&#44; NT-proBNP &#40;pg&#47;ml&#41;&#44; Potassium &#40;mEq&#47;l&#41;&#44; Haemoglobin &#40;g&#47;l&#41;&#44; PTH &#40;pg&#47;ml&#41;&#44; Calcium &#40;mg&#47;dl&#41; and Phosphorus &#40;mg&#47;dl&#41;&#46;</p></li></ul></p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Description of the measurement tools used</span><p id="par0170" class="elsevierStylePara elsevierViewall"><ul class="elsevierStyleList" id="lis0030"><li class="elsevierStyleListItem" id="lsti0085"><span class="elsevierStyleLabel">&#8211;</span><p id="par0175" class="elsevierStylePara elsevierViewall">Comorbidity was classified using the Charlson index adjusted to age&#44;<a class="elsevierStyleCrossRefs" href="#bib0280"><span class="elsevierStyleSup">17&#44;18</span></a> according to the definitions established in the original article published in 1987&#44; and adding one point for each decade over the age of 50 to the value obtained&#46; Scores of 6&#8211;7 are considered high and scores of 8 or over very high&#46;</p></li><li class="elsevierStyleListItem" id="lsti0090"><span class="elsevierStyleLabel">&#8211;</span><p id="par0180" class="elsevierStylePara elsevierViewall">Functional status for basic activities of daily living was assessed using the Barthel index&#46;<a class="elsevierStyleCrossRefs" href="#bib0285"><span class="elsevierStyleSup">18&#8211;20</span></a> This classifies patients as independent &#40;score 91&#8211;100&#41;&#44; minor dependency &#40;61&#8211;90&#41;&#44; moderate dependency &#40;41&#8211;60&#41;&#44; severe dependency &#40;21&#8211;40&#41; or total dependency &#40;20 points or below&#41;&#46;</p></li><li class="elsevierStyleListItem" id="lsti0095"><span class="elsevierStyleLabel">&#8211;</span><p id="par0185" class="elsevierStylePara elsevierViewall">Cognitive assessment was performed using the Pfeiffer test&#46;<a class="elsevierStyleCrossRefs" href="#bib0285"><span class="elsevierStyleSup">18&#44;21</span></a> This is a rapid screening test in which a score of three points or higher indicates that there may be cognitive impairment&#46;</p></li><li class="elsevierStyleListItem" id="lsti0100"><span class="elsevierStyleLabel">&#8211;</span><p id="par0190" class="elsevierStylePara elsevierViewall">To identify frailty&#44; we used the FRAIL Questionnaire&#46;<a class="elsevierStyleCrossRef" href="#bib0305"><span class="elsevierStyleSup">22</span></a> This consists of five simple questions related to fatigue&#44; resistance&#44; ambulation&#44; illness&#44; and loss of weight&#59; each is scored with one point&#46; Unlike the Fried frailty criteria&#44; it does not require a dynamometer to assess muscle strength&#44; and like those criteria&#44; patients are classified as frail when they score 3&#8211;5 points&#46;</p></li><li class="elsevierStyleListItem" id="lsti0105"><span class="elsevierStyleLabel">&#8211;</span><p id="par0195" class="elsevierStylePara elsevierViewall">The Mini-Nutritional Assessment Short-Form test &#40;MNA-SF&#41; was used to assess nutritional status&#46;<a class="elsevierStyleCrossRef" href="#bib0310"><span class="elsevierStyleSup">23</span></a> The MNA is a validated screening tool that helps identify older people who are malnourished or at risk of malnutrition&#46; A total score of 12 or above indicates that the person is well nourished&#44; from 8 to 11 reflects that the person is at risk of malnutrition&#44; and 7 or below means that the person is malnourished&#46;</p></li><li class="elsevierStyleListItem" id="lsti0110"><span class="elsevierStyleLabel">&#8211;</span><p id="par0200" class="elsevierStylePara elsevierViewall">Social status was identified through the Gij&#243;n Socio-family Scale &#40;Barcelona abbreviated version&#41;<a class="elsevierStyleCrossRef" href="#bib0315"><span class="elsevierStyleSup">24</span></a>&#58; a score of less than 7 points indicates a good social situation&#59; between 8 and 9 points&#44; intermediate situation&#59; and more than 10 points&#44; social deterioration&#46;</p></li><li class="elsevierStyleListItem" id="lsti0115"><span class="elsevierStyleLabel">&#8211;</span><p id="par0205" class="elsevierStylePara elsevierViewall">Quality of life was assessed using the 36-item Short Form &#40;SF-36&#41; Health Survey v2&#46;<a class="elsevierStyleCrossRef" href="#bib0320"><span class="elsevierStyleSup">25</span></a> This is a generic instrument for assessing HRQoL&#44; translated into Spanish&#44; which consists of 36 items grouped into eight dimensions&#58; physical functioning &#40;PF&#41;&#44; role limitations due to physical problems &#40;RP&#41;&#44; bodily pain &#40;BP&#41;&#44; general health perception &#40;GH&#41;&#44; vitality &#40;VT&#41;&#44; social role functioning &#40;SF&#41;&#44; role limitations due to emotional problems &#40;RE&#41; and mental health &#40;MH&#41;&#46;</p></li></ul></p><p id="par0210" class="elsevierStylePara elsevierViewall">For each dimension the items are coded&#44; added together and transformed into a scale from 0 &#40;worst possible health state&#41; to 100 &#40;best possible health state&#41;&#46; It allows the calculation of two summary scores&#58; one on physical health status and another on mental health&#46; The scores were obtained using QualityMetric Incorporated Health Outcomes Scoring Software 5&#46;0&#46;</p><p id="par0215" class="elsevierStylePara elsevierViewall">The internal consistency &#40;Cronbach&#39;s alpha&#41; of the different scales ranged from 0&#46;71 to 0&#46;95&#46;</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Statistical methods</span><p id="par0220" class="elsevierStylePara elsevierViewall">Quantitative variables are described with their mean and standard deviation &#40;SD&#41; or with their median and interquartile range &#40;IQR&#41;&#44; while the qualitative variables are expressed with their frequency distribution&#46; The quantitative variables were compared with Student&#39;s <span class="elsevierStyleItalic">t</span>-test or the non-parametric Mann&#8211;Whitney <span class="elsevierStyleItalic">U</span> test&#46; The <span class="elsevierStyleItalic">&#967;</span><span class="elsevierStyleSup">2</span> test was used for the comparison of qualitative variables with linear trend estimation in variables with ordered categories&#46; The statistical significance of the change in the quantitative variables at the different time points was determined with Friedman&#39;s non-parametric test&#46;</p><p id="par0225" class="elsevierStylePara elsevierViewall">The total number of deaths was considered as primary endpoint&#46; Patients were followed up from their inclusion until they left the study because the study closure date had been reached or as a result of death or loss to follow-up&#46; Mortality rates are expressed per 1000 patient-months&#46; We determined survival functions &#40;with Kaplan&#8211;Meier method&#41; and risk &#40;evaluation of mortality dynamics&#41;&#46; The comparison of rates between groups was made with the log rank test&#46;</p><p id="par0230" class="elsevierStylePara elsevierViewall">Assessment of the independent contribution of the initial variables to mortality rates was confirmed in Cox regression models&#44; with estimation of hazard ratios &#40;HR&#41; and 95&#37; confidence intervals &#40;CI&#41;&#46; The variables to be introduced in the multivariate models were chosen according to their clinical meaning or their statistical association in univariate analysis with <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;1&#46; Lastly&#44; the best mortality prediction model was selected using the sequential exclusion procedure&#46;</p><p id="par0235" class="elsevierStylePara elsevierViewall">Associations with <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05 were considered significant&#46; The SPSS software package version 22&#46;0 was used&#46;</p></span></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0130">Results</span><p id="par0240" class="elsevierStylePara elsevierViewall">A total of 82 patients on CKM were included&#58; 56 patients in 2015&#44; 23 in 2016 and three in 2017&#46; Over the course of the follow-up&#44; one patient was excluded from the analysis after deciding to abandon CKM and start haemodialysis and two patients because of loss to follow-up&#46;</p><p id="par0245" class="elsevierStylePara elsevierViewall">The causes of ACKD were&#58; nephroangiosclerosis &#40;57&#46;4&#37;&#41;&#59; diabetic nephropathy &#40;25&#46;7&#37;&#41;&#59; chronic tubulointerstitial nephropathy &#40;6&#46;1&#37;&#41;&#59; cardiorenal syndrome &#40;4&#46;9&#37;&#41;&#59; glomerulonephritis &#40;2&#46;4&#37;&#41;&#59; and other &#40;3&#46;7&#37;&#41;&#46;</p><p id="par0250" class="elsevierStylePara elsevierViewall">Of the 82 patients in the study&#44; the main reason for opting for CKM was&#58; a serious illness unlikely to improve with RRT in 61 patients&#59; severe functional dependence in eight patients&#59; advanced cognitive impairment in five patients&#59; own decision in five patients&#59; limiting psychiatric disease in two patients&#59; and metastatic cancer in one patient&#46;</p><p id="par0255" class="elsevierStylePara elsevierViewall">The baseline characteristics of the sample overall and of the deceased and non-deceased patients are shown in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0260" class="elsevierStylePara elsevierViewall">The mean age was 84&#46;79<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#46;99 years&#44; 50&#37; of the patients were male and 56&#37; had history of previous vascular event&#46; A Charlson index score above 8 shows a high degree of comorbidity&#46;</p><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0135">Analysis of mortality rates and factors predicting death</span><p id="par0265" class="elsevierStylePara elsevierViewall">During the follow-up period 38 patients died&#58; 26 &#40;68&#46;4&#37;&#41; in hospital and 12 &#40;31&#46;6&#37;&#41; at home&#46; The causes of death were cardiovascular disorders in 15 patients &#40;39&#46;5&#37;&#41;&#44; progression of ACKD in 14 patients &#40;36&#46;8&#37;&#41;&#44; infections in four patients &#40;10&#46;5&#37;&#41;&#44; metastatic cancer in three patients &#40;7&#46;9&#37;&#41;&#44; trauma in one patient &#40;2&#46;6&#37;&#41; and unknown in one patient &#40;2&#46;6&#37;&#41;&#46;</p><p id="par0270" class="elsevierStylePara elsevierViewall">We analysed the difference between patients who died and those who were still living after the follow-up period&#46; Patients who died had a higher prevalence of previous vascular events&#44; lower eGFR and albumin&#44; and higher NT-proBNP levels&#46; They also had a higher degree of dependence and frailty&#44; a worse score in the physical component of the SF-36 and&#44; at the limit of statistical significance&#44; a poorer nutritional status and a higher Charlson comorbidity score&#46;</p><p id="par0275" class="elsevierStylePara elsevierViewall">The total mortality rate was 23&#47;1000 patient-months &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46; <a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a> shows the mean monthly mortality rate by semesters over the course of the follow-up&#59; after the first six months the mortality rate remained uniform for the rest of the follow-up period&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0280" class="elsevierStylePara elsevierViewall">Median survival was 26&#46;9 &#40;95&#37; CI&#58; 19&#46;6&#8211;34&#46;2&#41; months&#46; There were significant differences &#40;<a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 3</a>&#41; in patient survival depending on whether or not they had a previous vascular event &#40;mortality rate 36&#46;7 vs 14&#46;8&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;028&#41;&#44; Charlson score &#8805;10 versus &#60;10 &#40;mortality rate 42 vs 17&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;002&#41;&#44; and a high degree of functional dependence &#40;mortality rate 48&#46;4 vs 19&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;002&#41;&#44; and whether or not they were frail &#40;mortality rate 27 vs 10&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#41;&#46;</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0285" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a> shows the variables significantly associated with increased mortality rates by univariate analysis&#46; The variables cognitive impairment by the Pfeiffer test and frailty were at the limit of statistical significance&#46; Renal involvement parameters &#40;GFR and proteinuria&#41;&#44; a previous vascular event&#44; the Charlson comorbidity index&#44; malnutrition-inflammation parameters &#40;albumin and MNA score&#41;&#44; degree of dependency&#44; physical quality of life&#44; and phosphorus and calcium metabolism parameters &#40;increase in PTH&#41; were all predictors of mortality&#46; In multivariate analysis&#44; a previous vascular event&#44; comorbidity measured by the Charlson index&#44; descending albumin and elevation of PTH were independent predictive variables related to mortality in older patients receiving CKM&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0140">Analysis of health-related quality of life and changes over the course of the study</span><p id="par0290" class="elsevierStylePara elsevierViewall">For cognitive reasons or because of physical limitations&#44; 16 patients &#40;19&#46;5&#37;&#41; in the baseline assessment&#44; 26 patients &#40;41&#46;2&#37;&#41; at 12 months and 12 patients &#40;40&#37;&#41; at 24 months were unable to complete the test&#46; Of the 64 patients who completed the baseline study&#44; 37 were assessed at baseline and 12 months&#44; and 18 at baseline&#44; 12 and 24 months&#46;</p><p id="par0295" class="elsevierStylePara elsevierViewall">At the beginning of the study the physical dimensions were affected &#40;physical functioning&#44; role limitations due to physical problems&#44; bodily pain and general health perception&#41; with better preservation of mental health in the role limitations due to emotional problems and mental health dimensions &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0300" class="elsevierStylePara elsevierViewall">As significant findings&#44; the patients experienced a more marked feeling of fatigue in the first 12 months of treatment &#40;VT 0 months 43&#46;45<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>16&#46;90 vs VT 12 months 41&#46;89<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>14&#46;84&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;03&#41;&#46; They also felt restrictions in their usual social relationships throughout the 24 months of follow-up &#40;SF 0 months 46&#46;88<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>18&#46;90 vs SF 12 months 42&#46;23<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>17&#46;51&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;001 and SF 0 months 46&#46;88<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>18&#46;90 vs SF 24 months 41&#46;67<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>17&#46;67&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;015&#41;&#46;</p><p id="par0305" class="elsevierStylePara elsevierViewall">However&#44; patients reported less limitation in daily activities due to emotional problems during the treatment &#40;RE 0 months 58&#46;07<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>29&#46;91 vs RE 24 months 75&#46;01<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>25&#46;72&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;05 and RE 12 months 65&#46;55<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>27&#46;85 vs RE 24 months 75&#46;01<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>25&#46;72&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#41; along with an improvement in perception of mental health&#44; although that was not statistically significant&#46;</p><p id="par0310" class="elsevierStylePara elsevierViewall">We analysed changes in HRQoL at different points during follow-up using the Friedman test&#46; We found that quality of life remained stable and the change in time was not significant&#44; with improvement in the limitation in the daily activities due to emotional problems and a good perception in terms of mental health&#46;</p></span></span><span id="sec0075" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0145">Discussion</span><p id="par0315" class="elsevierStylePara elsevierViewall">We found in our study that the patients treated with CKM were patients whose kidney disease had become chronic and who had multiple problems<a class="elsevierStyleCrossRef" href="#bib0325"><span class="elsevierStyleSup">26</span></a> due to associated comorbidity &#40;56&#37; of patients had had a previous vascular event&#44; 38&#37; were diabetic and the mean Charlson comorbidity index score was 9&#41;&#46; Many of these patients were complex chronic patients as&#44; in addition to having different progressive illnesses&#44; they were also on polypharmacy&#44; were dependent for basic activities of daily living and had poor social status &#40;13&#46;4&#37; of our patients had moderate dependence&#44; 2&#46;4&#37; severe and 9&#46;8&#37; total&#44; and 20&#37; had socio-family problems&#41;&#46; CKM should not mean &#8220;no treatment&#8221; or less specialised care&#46; It must provide comprehensive care which aims to delay the progression of the kidney disease&#44; manage the symptoms and&#44; when the time comes&#44; plan advanced palliative care&#46;<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">6</span></a></p><p id="par0320" class="elsevierStylePara elsevierViewall">Our results show that the median survival in CKM patients was 26 months&#46; Wong et al&#46;<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">15</span></a> reported a survival time of 23&#46;4 months&#44; but included patients with GFR below 30<span class="elsevierStyleHsp" style=""></span>ml&#47;min&#47;1&#46;73<span class="elsevierStyleHsp" style=""></span>m<span class="elsevierStyleSup">2</span>&#46; Chanda et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0330"><span class="elsevierStyleSup">27</span></a> reported mean survival of 21&#46;2 months&#44; Murtagh et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">5</span></a> 18 months and Ellam et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">14</span></a> 21 months&#44; but in these studies the GFR was 15<span class="elsevierStyleHsp" style=""></span>ml&#47;min&#47;1&#46;73<span class="elsevierStyleHsp" style=""></span>m<span class="elsevierStyleSup">2</span>&#46;</p><p id="par0325" class="elsevierStylePara elsevierViewall">The above studies&#44; all with similar heterogeneous inclusion criteria&#44; analysed the survival of older people on CKM compared to RRT&#46; The majority showed that dialysis increased survival compared to conservative management&#44; but being over 80&#44;<a class="elsevierStyleCrossRef" href="#bib0335"><span class="elsevierStyleSup">28</span></a> having comorbidity<a class="elsevierStyleCrossRefs" href="#bib0330"><span class="elsevierStyleSup">27&#44;29</span></a> and coronary heart disease<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">5</span></a> substantially reduced these differences&#46;</p><p id="par0330" class="elsevierStylePara elsevierViewall">The mortality rate was consistent throughout the follow-up period&#46; The fact that the mortality rate did not increase in a given period&#44; particularly during the first months of treatment&#44; and that the main causes of death were cardiovascular and progressive deterioration in kidney function underline that these patients did have the benefit of adequate follow-up and multidisciplinary care&#44; without resorting to other more aggressive interventions&#46;</p><p id="par0335" class="elsevierStylePara elsevierViewall">The geriatric assessment<a class="elsevierStyleCrossRefs" href="#bib0345"><span class="elsevierStyleSup">30&#8211;33</span></a> provides an overall approach to older people through clinical assessment &#40;with identification of chronic diseases and nutritional aspects&#41;&#44; functional assessment&#44; cognitive assessment&#44; psychosocial assessment and frailty&#44; and is becoming increasingly important in patients with CKD&#46;<a class="elsevierStyleCrossRef" href="#bib0285"><span class="elsevierStyleSup">18</span></a> Assessment and treatment require a multidisciplinary approach in patients with CKD&#44; with strategies that identify factors for worse prognosis which can help in decision making&#46;</p><p id="par0340" class="elsevierStylePara elsevierViewall">In our study&#44; we found that the patients with the shortest survival were those who were frail&#44; with the greatest initial comorbidity&#44; a previous vascular event and the greatest degree of dependence&#46; In the univariate analysis&#44; eGFR&#44; proteinuria&#44; albumin&#44; nutritional status and increased PTH were also associated with mortality&#46; In the final multivariate analysis&#44; a high degree of comorbidity&#44; a previous vascular event&#44; a decrease in albumin and an increase in PTH all maintained statistical significance&#46;</p><p id="par0345" class="elsevierStylePara elsevierViewall">Although the mean albumin and PTH values in our patients were adequate&#44; our analysis shows that the higher the albumin levels and the lower the PTH levels&#44; the better the prognosis&#46;</p><p id="par0350" class="elsevierStylePara elsevierViewall">Previous studies describe comorbidity as a prognostic factor for mortality&#46;<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">15</span></a> Ellam et al&#46;<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">14</span></a> found that albumin levels above 3&#46;5<span class="elsevierStyleHsp" style=""></span>mg&#47;dl were associated with longer survival&#46; Joly et al&#46;<a class="elsevierStyleCrossRef" href="#bib0365"><span class="elsevierStyleSup">34</span></a> analysed patients over 80 on CKM and RRT and found that octogenarians who did not go on dialysis differed from those on RRT in terms of degree of dependence&#44; comorbidity and diabetes&#46; In the Cox analysis&#44; the independent predictors of death on dialysis were nutritional status&#44; functional dependence and the presence of macroangiopathy defined by peripheral vascular disease&#46;</p><p id="par0355" class="elsevierStylePara elsevierViewall">The prevalence of vascular calcification is documented in patients with ACKD&#46;<a class="elsevierStyleCrossRef" href="#bib0370"><span class="elsevierStyleSup">35</span></a> It is possible that it has a multifactorial aetiology and is due to ageing&#44; comorbidity and mineral and bone metabolism &#40;MBM&#41; disorders&#46; MBM disorders also lead to abnormal bone architecture&#44;<a class="elsevierStyleCrossRef" href="#bib0375"><span class="elsevierStyleSup">36</span></a> fractures<a class="elsevierStyleCrossRef" href="#bib0380"><span class="elsevierStyleSup">37</span></a> and decreased mobility in these patients&#44; which could explain the relationship we found between elevated PTH levels and mortality&#46;</p><p id="par0360" class="elsevierStylePara elsevierViewall">Frailty was not an independent predictor of mortality in our study&#44; but the results were at the limit of statistical significance&#46; One explanation could be the limited number of patients&#44; which subtracts statistical power&#44; and the superposition of comorbidity and dependence already described in previous studies in a cohort of dialysis patients&#46;<a class="elsevierStyleCrossRef" href="#bib0385"><span class="elsevierStyleSup">38</span></a></p><p id="par0365" class="elsevierStylePara elsevierViewall">Most of the studies that analyse quality of life in patients with ACKD are focused on patients on dialysis&#44; especially haemodialysis&#44; and are of a cross-sectional observational design&#46;<a class="elsevierStyleCrossRefs" href="#bib0240"><span class="elsevierStyleSup">9&#44;10</span></a> We analysed the changes in HRQoL in CKM patients and our results show that the most affected areas were the physical dimensions and the difficulty with their social relationships&#46; However&#44; the patients perceived less limitation in daily activities due to emotional problems and had a good perception of their mental health from the point of view of a feeling of well-being and being calm&#46;</p><p id="par0370" class="elsevierStylePara elsevierViewall">In a recent study of survival and changes in HRQoL<a class="elsevierStyleCrossRef" href="#bib0390"><span class="elsevierStyleSup">39</span></a> conducted with patients on CKM and RRT&#44; physical quality of life in conservative management was sustained or improved after 12 months of treatment in less than half of the patients&#44; but mental health was sustained or improved in somewhat more than half&#46; Our results show that patients on CKM do perceive the physical limitations due to the passage of time and progression of their disease&#44; but they also feel continued greater satisfaction in psychological dimensions&#44; with a quality of life that does not worsen over time but remains stable&#44; which is the primary aim of CKM&#46;</p><p id="par0375" class="elsevierStylePara elsevierViewall">As far as the contributions made by our study are concerned&#44; we would like to emphasise that it was a prospective study which included assessment of renal function parameters&#44; functional status&#44; frailty&#44; nutritional status and HRQoL&#46; Our analysis of survival and quality of life in patients who have already made the decision to have conservative management may provide a useful tool for informing and guiding the patient in the shared decision process&#46; We also performed a comprehensive analysis of older patients&#44; with this being an increasingly numerous but not very visible group because of a lack of registries on conservative management&#46;<a class="elsevierStyleCrossRef" href="#bib0295"><span class="elsevierStyleSup">20</span></a></p><p id="par0380" class="elsevierStylePara elsevierViewall">The limitations of our study include the lack of a comparative group&#44; in which we could have analysed survival and quality of life in patients recommended for dialysis&#44; and the small sample size&#44; which reduces the statistical power of our results&#46; We used version 2 of the SF-36 instrument which includes improvements in the metric characteristics of two dimensions&#44; some simpler statements to facilitate reading and completion and a calculation programme which makes it easier to estimate missing responses&#46; However&#44; although it is translated into Spanish and its use enables greater cultural comparability&#44; it has not been validated for the Spanish population&#44; so we cannot compare our results with the general population in Spain&#46;</p><p id="par0385" class="elsevierStylePara elsevierViewall">In conclusion&#44; in our group of patients on CKM we found the mortality rate to be high and uniform over time&#44; independent predictors of which were a previous vascular event&#44; comorbidity measured by the Charlson index&#44; descending albumin levels and elevated PTH&#46; We also found that quality of life remained stable during treatment&#46; We therefore believe that adequate CKM could be a recommended therapeutic option in these patients&#44; who will also receive active treatment of hyperparathyroidism and prevention and treatment of malnutrition&#44; and autonomy and physical rehabilitation will be encouraged&#46;</p><p id="par0390" class="elsevierStylePara elsevierViewall">We consider necessary to have multidisciplinary teams &#40;palliative care teams &#91;doctors and nurses&#93;&#44; geriatricians&#44; nutritionists&#44; physiotherapists and primary care&#41; in place to provide better care in CKM patients&#46; Also necessary is more coordination with palliative care and home support teams&#44; especially in the later stages of the disease&#44; in order to maintain or even improve HRQoL for these patients and their families&#46;</p></span><span id="sec0080" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0150">Conflicts of interest</span><p id="par0395" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interest&#46;</p></span></span>"
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        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Introduction</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Conservative Management &#40;CM&#41; has become a therapeutic option in Advanced Chronic Kidney Disease in the elderly&#46; However&#44; there is a lack of evidence about prognosis of these patients in terms of survival and health related quality of life &#40;HRQoL&#41;&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Objective</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Establish predictive variables associated with mortality and analyse HRQoL in CM patients&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Patients and methods</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Prospective cohort study&#46; An assessment of renal function parameters and a comprehensive geriatric assessment were made&#44; including&#58; analysis of comorbidity&#44; functional&#44; cognitive&#44; fragility&#44; nutritional&#44; social and HRQoL status&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Results</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">82 patients with a mean age of 84 years and significant pluripathology were studied&#58; 56&#37; had history of vascular event and Charlson &#62;8&#46; The mortality rate was 23&#47;1000 patients per month&#44; with a homogeneous mortality rate after 6 months&#46;</p><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Survival differed significantly depending on whether they presented with a previous vascular event &#40;36&#46;7 vs&#46; 14&#46;8&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;028&#41;&#44; Charlson score<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>10 &#40;42 vs&#46; 17&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;002&#41;&#44; functional status &#40;48&#46;4 vs&#46; 19&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;002&#41; and fragility &#40;27 vs&#46; 10&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#41;&#46; Mortality predictors included eGFR and proteinuria&#44; the presence of previous vascular events&#44; Charlson comorbidity score&#44; malnutrition-inflammation parameters &#40;albumin and MNA score&#41;&#44; degree of dependency&#44; physical HRQoL and increase of PTH level&#46; The presence of previous vascular event&#44; comorbidity&#44; decreased albumin and elevated PTH were independent predictors of mortality&#46; HRQoL remained stable over time and no significant worsening occurred during treatment&#46;</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Conclusions</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Having knowledge of the factors associated with mortality and HRQoL assessment can be a useful tool to helping decision making during CM&#46; Previous vascular events&#44; comorbidity&#44; decreased albumin and increased PTH were independent predictors of mortality&#46;</p></span>"
        "secciones" => array:5 [
          0 => array:2 [
            "identificador" => "abst0005"
            "titulo" => "Introduction"
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          1 => array:2 [
            "identificador" => "abst0010"
            "titulo" => "Objective"
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          2 => array:2 [
            "identificador" => "abst0015"
            "titulo" => "Patients and methods"
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          3 => array:2 [
            "identificador" => "abst0020"
            "titulo" => "Results"
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          4 => array:2 [
            "identificador" => "abst0025"
            "titulo" => "Conclusions"
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      "es" => array:3 [
        "titulo" => "Resumen"
        "resumen" => "<span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Introducci&#243;n</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">El tratamiento renal conservador &#40;TRC&#41; se ha convertido en una opci&#243;n terap&#233;utica en la enfermedad renal cr&#243;nica avanzada en ancianos&#46; Se sabe poco sobre la evoluci&#243;n pron&#243;stica de estos pacientes en t&#233;rminos de supervivencia y calidad de vida relacionada con la salud &#40;CVRS&#41;&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Objetivo</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Establecer variables predictivas de mortalidad y analizar la CVRS en los pacientes en TRC&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Pacientes y m&#233;todos</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Estudio de cohortes prospectivo&#46; Se realiz&#243; una valoraci&#243;n de par&#225;metros de funci&#243;n renal y evaluaci&#243;n geri&#225;trica integral&#58; an&#225;lisis de comorbilidad&#44; situaci&#243;n funcional&#44; cognitiva&#44; fragilidad&#44; nutricional&#44; social y CVRS&#46;</p></span> <span id="abst0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Resultados</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Se evaluaron 82 pacientes&#44; con una edad media de 84 a&#241;os e importante pluripatolog&#237;a&#58; el 56&#37; ten&#237;a antecedentes de evento vascular y Charlson &#62;<span class="elsevierStyleHsp" style=""></span>8&#46; La tasa de mortalidad fue de 23&#47;1&#46;000 pacientes-mes&#44; con un ritmo de mortalidad homog&#233;neo a partir de los 6 meses&#46;</p><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">La supervivencia difiri&#243; significativamente si presentaban evento vascular previo &#40;36&#44;7 vs&#46; 14&#44;8&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;028&#41;&#44; Charlson<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>10 &#40;42 vs&#46; 17&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;002&#41;&#44; grado de dependencia &#40;48&#44;4 vs&#46; 19&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;002&#41; y fragilidad &#40;27 vs&#46; 10&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#41;&#46;</p><p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Fueron predictores de mortalidad&#58; eFG y proteinuria&#44; presencia de evento vascular previo&#44; comorbilidad de Charlson&#44; par&#225;metros de malnutrici&#243;n-inflamaci&#243;n &#40;alb&#250;mina y puntuaci&#243;n MNA&#41;&#44; grado de dependencia&#44; CVRS f&#237;sica y aumento de PTH&#46; La presencia de evento vascular previo&#44; comorbilidad&#44; alb&#250;mina descendida y elevaci&#243;n de PTH fueron predictores independientes de mortalidad&#46; La CVRS se mantuvo estable y no se produjo empeoramiento significativo durante el tratamiento&#46;</p></span> <span id="abst0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Conclusiones</span><p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">El conocimiento de los factores asociados con mortalidad y la evaluaci&#243;n de la CVRS puede ser &#250;til como herramienta en la toma de decisiones en TRC&#46; La presencia de evento vascular previo&#44; comorbilidad&#44; alb&#250;mina disminuida y el aumento de PTH fueron predictores independientes de mortalidad&#46;</p></span>"
        "secciones" => array:5 [
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            "titulo" => "Introducci&#243;n"
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            "identificador" => "abst0035"
            "titulo" => "Objetivo"
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          2 => array:2 [
            "identificador" => "abst0040"
            "titulo" => "Pacientes y m&#233;todos"
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          3 => array:2 [
            "identificador" => "abst0045"
            "titulo" => "Resultados"
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          4 => array:2 [
            "identificador" => "abst0050"
            "titulo" => "Conclusiones"
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      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Rubio Rubio MV&#44; Lou Arnal LM&#44; Gimeno Orna JA&#44; Mungu&#237;a Navarro P&#44; Guti&#233;rrez-Dalmau A&#44; Lamb&#225;n Ibor E&#44; et al&#46; Supervivencia y calidad de vida en pacientes ancianos en tratamiento renal conservador&#46; Nefrologia&#46; 2019&#59;39&#58;141&#8211;150&#46;</p>"
      ]
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          "en" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Survival curve of the cohort over the course of follow-up&#46;</p>"
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        "etiqueta" => "Fig&#46; 2"
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          "en" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Mean monthly mortality rate by semester over the course of follow-up&#46;</p>"
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        "etiqueta" => "Fig&#46; 3"
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          "en" => "<p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">Survival of patients according to previous vascular event&#44; Charlson Comorbidity Index&#44; degree of functional dependency and frailty&#46;</p>"
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                  \t\t\t\t\tvoid\n
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                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Whole group &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>82&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Non-deceased &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>44&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Deceased &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>38&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span>&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">Gender &#40;male &#37;&#41;</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">43&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">57&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;18&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">Age &#40;years&#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">84&#46;79<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#46;99&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">84&#46;06<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&#46;52&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">97&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;35&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">DM &#40;&#37;&#41;</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">52&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;28&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">45&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">68&#46;4&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;6&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">eGFR CKD-EPI &#40;ml&#47;min&#47;1&#46;73</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">m</span><span class="elsevierStyleSup"><span class="elsevierStyleItalic">2</span></span><span class="elsevierStyleItalic">&#41;</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">15&#46;46<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#46;28&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;02&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Proteinuria &#40;g&#47;l&#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">0&#46;72<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;34&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;41<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;69&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="elsevierStyleItalic">UPCR &#40;mg&#47;dl&#41;</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">2&#46;91<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>6&#46;71&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="elsevierStyleItalic">ProBNP &#40;pg&#47;ml&#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">8034&#46;11<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>9000&#46;88&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2075&#46;0<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1280&#46;20&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10&#44;588&#46;0<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>9818&#46;26&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;008&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">Albumin &#40;mg&#47;dl&#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">3&#46;82<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;49&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&#46;95<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;40&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&#46;60<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;54&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;02&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">PTH &#40;pg&#47;ml&#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">223&#46;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>148&#46;96&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">211&#46;04<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>114&#46;42&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">239&#46;85<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>184&#46;93&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;8&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">Phosphorus &#40;mg&#47;dl&#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">3&#46;70<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;64&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&#46;70<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;59&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&#46;87<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;68&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;3&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">Calcium &#40;mg&#47;dl&#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">9&#46;39<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;63&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;51<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;46&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;24<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;78&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;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"><span class="elsevierStyleItalic">Potassium &#40;mEq&#47;l&#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">4&#46;61<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;56&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&#46;73<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;69&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&#46;68<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;63&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;7&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">Haemoglobin &#40;g&#47;l&#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">11&#46;56<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;44&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;75<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;36&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;33<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;51&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;13&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">Charlson Index</span>&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;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;40&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;6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;29&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;2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;46&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;06&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">Barthel index &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " rowspan="6" align="char" valign="top">0&#46;029</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>Independent&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#46;6&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>Slight dependency&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">69&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">75&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">63&#46;2&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>Moderate dependency&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">13&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">13&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">13&#46;2&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>Severe dependency&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#46;3&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>Total dependency&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;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">15&#46;8&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">Pfeiffer more than 3 mistakes &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">26&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">20&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">33&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;19&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Frailty &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">78&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">68&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">88&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;02&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">MNA test &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " rowspan="4" align="char" valign="top">0&#46;07</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>Malnutrition&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">17&#46;3&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;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">24&#46;3&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>Malnutrition risk&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">50&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">50&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">51&#46;4&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>Normal nutritional status&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">32&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">38&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">24&#46;3&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">Gij&#243;n socio-family assessment scale &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " rowspan="4" align="char" valign="top">0&#46;7</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>Good&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">79&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">81&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">76&#46;3&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>Intermediate&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">17&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">15&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">18&#46;1&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>Decline&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#46;3&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">SF-36 physical component</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">37&#46;11<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>8&#46;30&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">38&#46;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>7&#46;67&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">34&#46;48<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>8&#46;62&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;02&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">SF-36 mental component</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">43&#46;81<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>10&#46;23&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">44&#46;12<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>11&#46;13&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">43&#46;36<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>8&#46;94&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;46&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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          "en" => "<p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">Baseline characteristics of the sample overall and of the deceased and non-deceased patients&#46;</p>"
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                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Univariate analysis</th><th class="td" title="table-head  " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Multivariate analysis</th></tr><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">HR &#40;95&#37; CI&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">HR &#40;95&#37; CI&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span>&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">eGFR &#40;ml&#47;min&#47;1&#46;73<span class="elsevierStyleHsp" style=""></span>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="char" valign="top">0&#46;81 &#40;0&#46;72&#8211;0&#46;91&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001&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><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">Proteinuria &#40;g&#47;l&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;50 &#40;1&#46;26&#8211;1&#46;92&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001&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><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">Albumin &#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="char" valign="top">0&#46;34 &#40;0&#46;17&#8211;0&#46;68&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;002&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;23 &#40;0&#46;10&#8211;0&#46;52&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">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="char" valign="top">1&#46;002 &#40;1&#46;000&#8211;1&#46;005&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;05&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;004 &#40;1&#46;001&#8211;1&#46;007&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;007&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">Previous vascular event &#40;presence&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#46;11 &#40;1&#46;06&#8211;4&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;03&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#46;70 &#40;1&#46;05&#8211;6&#46;92&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;028&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">Charlson comorbidity index &#40;points&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;40 &#40;1&#46;11&#8211;1&#46;77&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;004&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;56 &#40;1&#46;14&#8211;2&#46;12&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;005&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">Barthel index &#40;points 0&#8211;100&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;98 &#40;0&#46;97&#8211;0&#46;99&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;005&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><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">Pfeiffer &#40;points&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;08 &#40;0&#46;99&#8211;1&#46;19&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;07&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><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">Frailty &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;37 &#40;0&#46;13&#8211;1&#46;05&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;06&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><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">MNA &#40;points&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;86 &#40;0&#46;75&#8211;0&#46;99&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;04&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><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">SF-36 physical component&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;94 &#40;0&#46;89&#8211;1&#46;00&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;05&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><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">SF-36 mental component&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;99 &#40;0&#46;96&#8211;1&#46;03&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;84&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><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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          "en" => "<p id="spar0090" class="elsevierStyleSimplePara elsevierViewall">Variables associated with higher mortality rates&#58; univariate and multivariate analysis&#46;</p>"
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        "etiqueta" => "Table 3"
        "tipo" => "MULTIMEDIATABLA"
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          "leyenda" => "<p id="spar0100" class="elsevierStyleSimplePara elsevierViewall">SF-36 v2&#58; scores of 50 &#40;10&#41;&#44; the reference population has a mean of 50 with a standard deviation of 10&#44; so values greater than or less than 50 indicate a better or worse health status&#44; respectively&#46;</p>"
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                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">0 months &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>64&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">12 months &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>37&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">24 months &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>18&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span> Friedman&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">Physical functioning &#40;PF&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">40&#46;70<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>31&#46;65&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">44&#46;60<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>30&#46;03&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">47&#46;78<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>31&#46;54&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;63&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">Role limitations due to physical problems &#40;RP&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">36&#46;04<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>24&#46;31&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">37&#46;67<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>24&#46;45&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">38&#46;89<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>22&#46;23&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;89&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">Bodily pain &#40;BP&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">66&#46;04<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>23&#46;07&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">67&#46;01<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>25&#46;55&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">69&#46;22<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>26&#46;71&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;22&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">General health perception &#40;GH&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">38&#46;51<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>17&#46;51&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">41&#46;86<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>14&#46;02&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">46&#46;44<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>9&#46;12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;40&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">Vitality &#40;VT&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">43&#46;45<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>16&#46;90&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">46&#46;53<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>15&#46;04&nbsp;\t\t\t\t\t\t\n
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