Congestive heart failure as a determinant of postoperative delirium | Revista Portuguesa de Cardiologia (English edition)

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"titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "Insuficiência cardíaca congestiva como determinante de delirium pós-operatório" ] ] "textoCompleto" => "IntroductionPostoperative delirium (POD) is recognized as an important post-surgical complication. Delirium is defined as acute and fluctuating change of attention and cognition caused by a coexisting general medical condition.<a class="elsevierStyleCrossRef" href="#bib0005">1</a> It is more frequent among older adults.<a class="elsevierStyleCrossRefs" href="#bib0010">2–4</a> Wide variations in POD incidence have been reported, from 5.1% to 52.2%.<a class="elsevierStyleCrossRef" href="#bib0010">2</a> This variability may be explained by differences in diagnostic criteria and study populations, as well as varying surgical procedures and differing methods of surveillance.POD is not a benign syndrome<a class="elsevierStyleCrossRef" href="#bib0025">5</a>; it is associated with increased mortality and with poor patient outcomes.<a class="elsevierStyleCrossRefs" href="#bib0020">4,6,7</a> It increases hospital length of stay (LOS) and hence hospital costs, and carries high postoperative complication rates. In addition, POD may be related to later functional and cognitive decline.<a class="elsevierStyleCrossRefs" href="#bib0020">4,8–10</a> However, most strategies for dealing with POD are symptom-related only. Thus, prevention and early recognition are essential; it is vital to identify patients at risk to modify and control all possible modifiable risk factors.<a class="elsevierStyleCrossRef" href="#bib0055">11</a>POD is a complex and heterogeneous disorder with multiple risk factors.<a class="elsevierStyleCrossRefs" href="#bib0010">2,12</a> Comorbidities and perioperative conditions appear to be involved in its genesis,<a class="elsevierStyleCrossRef" href="#bib0065">13</a> and elderly patients are at greatest risk.<a class="elsevierStyleCrossRefs" href="#bib0010">2,14</a> Higher rates of POD are also seen in patients with impaired mobility,<a class="elsevierStyleCrossRef" href="#bib0050">10</a> comorbidities (American Society of Anesthesiologists [ASA] ≥3),<a class="elsevierStyleCrossRefs" href="#bib0010">2,5,10,14,15</a> and lower cognitive function or reduction in sensory function.<a class="elsevierStyleCrossRefs" href="#bib0020">4,16,17</a> The incidence of POD may be higher in patients taking benzodiazepines preoperatively,<a class="elsevierStyleCrossRef" href="#bib0075">15</a> and preoperative pain may increase the risk of POD.<a class="elsevierStyleCrossRef" href="#bib0090">18</a> Other possible risk factors have been reported, among them a history of alcohol abuse and chronic narcotic use.<a class="elsevierStyleCrossRefs" href="#bib0020">4,16</a> Recently, Radtke et al.<a class="elsevierStyleCrossRef" href="#bib0070">14</a> reported that preoperative fluid fasting exceeding six hours was an independent risk factor for POD.Perioperative conditions can also have a pronounced impact on POD, and major surgery is a known risk factor<a class="elsevierStyleCrossRef" href="#bib0100">19</a> including cardiac surgery,<a class="elsevierStyleCrossRefs" href="#bib0105">20,21</a> non-cardiac thoracic procedures,<a class="elsevierStyleCrossRefs" href="#bib0070">14,22</a> and intra-abdominal surgery,<a class="elsevierStyleCrossRef" href="#bib0070">14</a> but emergency procedures also raise the risk.<a class="elsevierStyleCrossRef" href="#bib0040">8</a> Pain, blood loss, hemodynamic changes, and exposure to medications are potential risk factors.<a class="elsevierStyleCrossRefs" href="#bib0060">12,23</a> Hematocrit <30% has also been reported as a risk factor for POD.<a class="elsevierStyleCrossRef" href="#bib0115">22</a> However, there appears to be no difference in risk level between general or local and regional anesthesia.<a class="elsevierStyleCrossRefs" href="#bib0090">18,24</a> Duration of mechanical ventilation has also been identified as an independent predictor of POD.<a class="elsevierStyleCrossRef" href="#bib0110">21</a>Postoperative factors are also important. One of the key factors is pain control, because acute pain is associated with POD.<a class="elsevierStyleCrossRefs" href="#bib0025">5,9,13,18,25,26</a> Early development of POD in the recovery room predicts later POD occurrence in the ward.<a class="elsevierStyleCrossRef" href="#bib0070">14</a>The risk of POD increases with each additional risk factor.<a class="elsevierStyleCrossRefs" href="#bib0050">10,14</a> As populations age, the number of older surgical patients is set to rise, and POD is likely to remain a common condition.<a class="elsevierStyleCrossRefs" href="#bib0050">10,15,18,27</a>The aim of this study was to evaluate the incidence of POD in a post-anesthesia care unit (PACU) and to identify risk factors for the development of POD.MethodsPatient selectionThe institutional review board and the Ethics Committee of Hospital de São João approved this study and informed consent was obtained preoperatively from all study participants. This prospective study was carried out in the multidisciplinary PACU at Hospital São João, a 1100-bed community teaching hospital in Porto, Portugal. All patients admitted to the PACU over a five-day period (start date September 6, 2010) were evaluated. The inclusion criteria were adult Portuguese-speaking patients undergoing major elective non-cardiac and non-neurological surgery who required anesthesia for which they were expected to remain in the hospital postoperatively for more than 48 hours. We excluded patients who did not provide or were incapable of providing informed consent, and those with a history of central nervous system disease, Parkinson's disease, neurological or cardiac surgery, delirium, or use of antipsychotic medication.Patient assessmentThe following variables were recorded on admission to the PACU: age, gender, temperature, body mass index, fasting time before surgery, and anesthesia-related data (specifically duration and type of anesthesia, and fluids and blood products used).We calculated the patients’ Revised Cardiac Risk Index (RCRI) scores as described by Lee et al.,<a class="elsevierStyleCrossRef" href="#bib0145">28</a> assigning 1 point for each of the following risk factors: high-risk surgery, ischemic heart disease, cerebrovascular disease, diabetes requiring insulin therapy, and renal failure.In accordance with Lee et al.,<a class="elsevierStyleCrossRef" href="#bib0145">28</a> patients were considered to have a history of ischemic heart disease if they had a history of myocardial infarction, had current positive exercise test or ischemic chest pain, used nitrate therapy, or had an ECG with pathological Q waves. A history of congestive heart failure included patients with a history of heart failure, pulmonary edema, or paroxysmal nocturnal dyspnea. Congestive heart failure was also considered present if physical examination revealed bilateral rales or S3 gallop, or if a chest radiograph revealed pulmonary vascular redistribution. Cerebrovascular disease was defined as a history of transient ischemic attack or stroke.PACU data, hospital LOS, and in-hospital mortality were also recorded for all patients.Evaluation of deliriumEach patient included in the study was evaluated for delirium using the Intensive Care Delirium Screening Checklist (ICDSC).<a class="elsevierStyleCrossRef" href="#bib0150">29</a> According to the ICDSC, patients are defined as having developed delirium if they have a test score of 4 or more points.Trained research assistants assessed patients in the recovery room after patients were formally declared ‘ready for discharge’ by the anesthesiologist in charge of the recovery room. The research team did not interfere with the typical recovery room protocol, and recovery room physicians and nurses were blinded to all study results. Regular recovery room staff did not diagnose delirium for any of the patients in this study.Statistical analysisDescriptive analyses of variables were used to summarize data, and the Mann–Whitney U test was used to compare continuous variables; the chi-square or Fisher's exact test was used to compare proportions between the two subject groups (POD vs. non-POD).Univariate analysis was performed to evaluate the determinants of POD; these comprised simple binary logistic regression with odds ratios (OR) and 95% confidence intervals (95% CI) and were carried out for the following independent variables: age, gender, body mass index, ASA physical status (ASA-PS), comorbidities and RCRI score, type and duration of anesthesia, intraoperative fluid administration, and body temperature at PACU admission.To reduce the risk of type II error, the significance level for multiple comparisons was controlled by applying the Bonferroni correction for multiple comparisons (test-wise significance level divided by the number of tests performed). Variables were deemed significant if p≤0.0025. Data were analyzed using SPSS for Windows version 19.0 (SPSS, Chicago, IL, USA).ResultsWe screened 105 patients who were admitted to the PACU during the study period. Four patients were excluded because of history of central nervous system disease; two were excluded because of delirium and antipsychotic medication; one because he did not speak Portuguese; and one because he had undergone neurosurgery.Thus, 97 patients were included in the study. The baseline characteristics of all patients are listed in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>. Patients’ median age was 56 years (range, 18–82 years), with 71% of subjects aged less than 65 years. The gender proportions were similar (45% men and 55% women). Forty-five percent of patients underwent general surgery, 14% had orthopedic surgery, 12% urological surgery, and 11% vascular surgery; the remaining patients underwent plastic and reconstructive surgery, or gynecological procedures. Of these, 37% were classified as high-risk surgery.<elsevierMultimedia ident="tbl0005"></elsevierMultimedia>Overall, six of the 97 patients (6.2%) developed delirium during their PACU stay. <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a> shows the measured variables comparing patients who developed POD with those who did not. Patients who developed delirium were older (median 71 years vs. 55 years, p=0.008), had higher ASA-PS scores (83% vs. 22% with ASA III/IV, p=0.004) and longer duration of anesthesia (median 225 min vs. 120 min, p=0.012), were more likely to have a history of congestive heart failure (50% vs. 3%, p=0.003), had higher RCRI scores (33% vs. 6% with RCRI ≥2, p=0.039), and had a higher use of crystalloids (median volume, 3000 ml vs. 1000 ml, p<0.001), colloids, and erythrocytes. There were no significant differences in the type of anesthesia used (local and regional vs. general) or in preoperative fasting time (median 14.5 hours vs. 14.0 hours, p=0.730).<elsevierMultimedia ident="tbl0010"></elsevierMultimedia>Patients who developed POD had longer PACU LOS (median duration, 540 min vs. 95 min, p=0.002) and hospital LOS (median duration, 22 days vs. 3 days, p=0.003); they also had higher in-hospital mortality (33% vs. 1%, p=0.009).Simple binary logistic regressions were used to examine the covariate effects of each factor on POD development (<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>); this was done using a significance level of p≤0.0025, and our analysis showed that congestive heart disease was an independent risk factor for POD (OR 29.3, 95% CI: 4.1–210.6; p<0.001).<elsevierMultimedia ident="tbl0015"></elsevierMultimedia>DiscussionTo the best of our knowledge, this is the first study to show that congestive heart failure is an independent risk factor for POD. The main finding of our study is that patients who develop POD more often have congestive heart failure and that this condition may be a risk factor for POD. Hutt et al.<a class="elsevierStyleCrossRef" href="#bib0155">30</a> reported a higher prevalence of delirium in patients with heart failure (35.3% of 156 patients in a nursing home); that study also found an association with a 3-fold increase in 60-day mortality. Furthermore, a study by Uthamalingam et al.<a class="elsevierStyleCrossRef" href="#bib0160">31</a> investigating a congestive heart disease population also demonstrated that delirium was independently associated with increased 30- and 90-day readmission and short-term mortality after adjusting for potential confounders; these authors did not, however, demonstrate that congestive heart disease was a risk factor for delirium.In the study by Uthamalingam et al.,<a class="elsevierStyleCrossRef" href="#bib0160">31</a> delirium was associated with increased heart rate, increased serum B-type natriuretic peptide levels, and increased rales in the lung base, all of which are associated with activation of the sympathetic nervous and renin–angiotensin systems, and with increased release of cytokines. This presentation observed in delirious patients stemming from increased angiotensin and aldosterone may impair cerebral metabolism and perfusion and thus help explain the pathophysiology of delirium in patients with congestive heart failure.POD is thought to be the result of an interaction between multiple risk factors.<a class="elsevierStyleCrossRefs" href="#bib0010">2,10,12</a> Some authors have reported an incidence as high as 60%.<a class="elsevierStyleCrossRef" href="#bib0045">9</a> However, although we used the ICDSC, a highly sensitive delirium screening tool, we still only determined a POD incidence of 6.2%; this is slightly lower than found by other authors.<a class="elsevierStyleCrossRefs" href="#bib0020">4,6,7,10,14,16,22</a> The lower incidence in our study may be explained by the use of the ICDSC, which some claim is less sensitive than other screening tools.<a class="elsevierStyleCrossRef" href="#bib0165">32</a> Although the ICDSC is less sensitive than other methods for delirium screening, we used it because of its user-friendly checklist which is easy to administer in environments with relatively high patient flow; the ICDSC also has high sensitivity and reliability and can be completed rapidly.<a class="elsevierStyleCrossRef" href="#bib0170">33</a>Another possible cause of the low POD incidence in our study is the demographic characteristics of our study population, with a higher proportion of younger patients and better preoperative status (patients with lower ASA-PS and lower RCRI). Surgical factors may also have contributed to this lower incidence because all of our patients underwent scheduled surgery and only 37% of the procedures were classified as high risk. Additionally, we excluded all patients undergoing cardiac and neurological surgery from this study, and these procedures are frequently associated with higher POD incidence.<a class="elsevierStyleCrossRefs" href="#bib0010">2,20–22</a>This study compared patients who developed POD with those who did not. As in previous studies, we found that delirious patients were older than non-delirious patients. In addition, patients with congestive heart disease had a higher risk of developing POD, and our study showed that congestive heart disease was independently associated with POD (OR 29.3). These patients have lower cardiac reserve; this could have led to a higher risk of intraoperative hemodynamic complications and may have contributed to POD development. The majority (83%) of patients who developed POD in our study had an ASA-PS of III/IV, in contrast with only 22% of the non-delirious patients. Thus it appears that worse ASA status may lead to a higher risk of developing POD.Although we did not distinguish between fluid and solid fasting in our study, we found no significant difference in the risk of POD development and fasting time between the POD and non-POD groups; this differs from the results of Radtke et al.,<a class="elsevierStyleCrossRef" href="#bib0070">14</a> who concluded that the duration of preoperative fluid fasting was an independent risk factor for POD.On the other hand, the results of the present study agreed with those of earlier studies in that we failed to find any significant differences in POD development according to the type of anesthesia used (local and regional vs. general).<a class="elsevierStyleCrossRefs" href="#bib0090">18,24</a> However, patients who developed POD in our study had a longer duration of anesthesia, which may be explained by the need for longer anesthesia in cases of prolonged surgery. This in turn can be considered a possible indicator of increased operative complexity and of a higher risk of neurological complications.<a class="elsevierStyleCrossRef" href="#bib0105">20</a>Dehydration has been labeled a risk factor for POD.<a class="elsevierStyleCrossRef" href="#bib0185">34</a> In this study, delirious patients received greater volumes of crystalloids, colloids, and erythrocytes than non-delirious patients. However, there may have been an observation bias in the present study, because the worse the general condition of a patient, the higher the volumes needed to stabilize that patient.As reported by other authors, our findings demonstrated that patients who developed delirium had longer stay in both the PACU and the hospital, and also had higher in-hospital mortality.<a class="elsevierStyleCrossRefs" href="#bib0020">4,8,9</a> This indicates that POD leads to more post-surgical complications and worse outcomes.This study has several limitations. First, the number of patients included in our analysis was low; the sample may be too small to draw statistically significant conclusions. This small sample size may also be linked to another important limitation, in that only a small number of patients with a prior history of congestive heart disease were included. This is even more important given that congestive heart disease was considered an independent risk factor for delirium. It should also be taken into account that the patients studied were not critical care patients. However, despite our relatively small sample size, the percentage of patients with postoperative delirium was similar to the percentages seen in other studies involving patients undergoing major surgery.<a class="elsevierStyleCrossRef" href="#bib0150">29</a>Another limitation of our study is that the patients were screened for delirium only in the PACU and many of these patients stayed in this unit for a short time only. As a result, we may have missed delirium which developed at a later stage. Some authors have stated that most cases of POD arise on the second day after surgery.<a class="elsevierStyleCrossRefs" href="#bib0020">4,35</a>POD can be prevented in some patients, and prevention programs have been applied with some success.<a class="elsevierStyleCrossRef" href="#bib0100">19</a> It is important for hospital teams to be aware of the need for screening and prevention of POD. This study adds to the growing body of evidence demonstrating that POD is an important post-surgical complication and one that can result in worse outcomes for surgical patients. We also found that congestive heart disease was an independent risk factor for POD. In addition, POD appears to be more common in older patients and in patients with worse ASA-PS and worse RCRI scores. Longer anesthesia times, major surgery, and the presence of comorbidities may all increase the risk of POD.Ethical disclosuresProtection of human and animal subjectsThe authors declare that no experiments were performed on humans or animals for this study.Confidentiality of dataThe authors declare that they have followed the protocols of their work center on the publication of patient data and that all the patients included in the study received sufficient information and gave their written informed consent to participate in the study.Right to privacy and informed consentThe authors have obtained the written informed consent of the patients or subjects mentioned in the article. The corresponding author is in possession of this document.Conflicts of interestThe authors have no conflicts of interest to declare." "textoCompletoSecciones" => array:1 [ "secciones" => array:12 [ 0 => array:2 [ "identificador" => "xres296946" "titulo" => array:5 [ 0 => "Abstract" 1 => "Background" 2 => "Methods" 3 => "Results" 4 => "Conclusions" ] ] 1 => array:2 [ "identificador" => "xpalclavsec280611" "titulo" => "Keywords" ] 2 => array:2 [ "identificador" => "xres296947" "titulo" => array:5 [ 0 => "Resumo" 1 => "Introdução" 2 => "Métodos" 3 => "Resultados" 4 => "Conclusões" ] ] 3 => array:2 [ "identificador" => "xpalclavsec280612" "titulo" => "Palavras-chave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:3 [ "identificador" => "sec0010" "titulo" => "Methods" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "sec0015" "titulo" => "Patient selection" ] 1 => array:2 [ "identificador" => "sec0020" "titulo" => "Patient assessment" ] 2 => array:2 [ "identificador" => "sec0025" "titulo" => "Evaluation of delirium" ] 3 => array:2 [ "identificador" => "sec0030" "titulo" => "Statistical analysis" ] ] ] 6 => array:2 [ "identificador" => "sec0035" "titulo" => "Results" ] 7 => array:2 [ "identificador" => "sec0040" "titulo" => "Discussion" ] 8 => array:3 [ "identificador" => "sec0045" "titulo" => "Ethical disclosures" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0050" "titulo" => "Protection of human and animal subjects" ] 1 => array:2 [ "identificador" => "sec0055" "titulo" => "Confidentiality of data" ] 2 => array:2 [ "identificador" => "sec0060" "titulo" => "Right to privacy and informed consent" ] ] ] 9 => array:2 [ "identificador" => "sec0065" "titulo" => "Conflicts of interest" ] 10 => array:2 [ "identificador" => "xack69455" "titulo" => "Acknowledgement" ] 11 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2012-05-08" "fechaAceptado" => "2012-12-07" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec280611" "palabras" => array:3 [ 0 => "Postoperative delirium" 1 => "Congestive heart failure" 2 => "Postoperative complications" ] ] ] "pt" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palavras-chave" "identificador" => "xpalclavsec280612" "palabras" => array:3 [ 0 => "Delirium pós-operatório" 1 => "Insuficiência cardíaca congestiva" 2 => "Complicações pós-operatórias" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "BackgroundPostoperative delirium (POD) is a frequent post-surgical complication that is associated with increased mortality and poor patient outcomes. POD is a complex disorder with multiple risk factors such as pre-existing patient comorbidities and perioperative complications. The aim of this study was to evaluate the incidence of POD and to identify risk factors for the development of POD in a post-anesthesia care unit (PACU). MethodsWe enrolled 97 adult patients admitted to a PACU over a five-day period (start date September 6, 2010). Patient demographics and intraoperative and postoperative data were collected. Patients were followed for the development of delirium using the Intensive Care Delirium Screening Checklist. Descriptive analyses of variables were used to summarize data, and the Mann–Whitney U test was used to compare continuous variables; the chi-square or Fisher's exact test was used for comparisons. Univariate analysis was performed using simple binary logistic regression with odds ratios (OR) and 95% confidence intervals (95% CI). The significance level for multiple comparisons was controlled by applying the Bonferroni correction for multiple comparisons and variables were deemed significant if p≤0.0025. ResultsSix percent of patients developed POD. These patients were older and more likely to have higher American Society of Anesthesiologists (ASA) physical status (83 vs. 22% with ASA III/IV, p=0.004) as well as a higher frequency of congestive heart failure (50 vs. 3%, p=0.003) and a higher Revised Cardiac Risk Index (RCRI) score (33 vs. 6% with RCRI ≥2, p=0.039). The duration of anesthesia for patients with POD was also longer and they received a greater volume of crystalloids, colloids, and erythrocytes during surgery. Congestive heart disease was an independent risk factor for POD (OR 29.3, 95% CI 4.1–210.6; p<0.001). In addition, patients who developed POD had higher in-hospital mortality and longer PACU and hospital stays. ConclusionsPatients who developed POD had longer hospital and PACU stays and higher in-hospital mortality. Congestive heart disease was considered an independent risk factor for POD." ] "pt" => array:2 [ "titulo" => "Resumo" "resumen" => "IntroduçãoO delirium pós-operatório (DPO) é uma complicação frequente após a cirurgia. Está associado a um aumento da mortalidade e a piores resultados. O DPO é um distúrbio complexo, com múltiplos fatores de risco que incluem a existência de comorbilidades e complicações per operatórias. O objetivo deste estudo foi avaliar a incidência de DPO e identificar fatores de risco para o seu desenvolvimento numa unidade pós-anestésica. MétodosForam incluídos no estudo 97 doentes adultos, internados na unidade de cuidados pós-anestésica (UCPA), após seis de setembro de 2010, durante um período de cinco dias. Foram registados dados demográficos, dados intraoperatórios e pós-operatórios. Os doentes foram seguidos para o desenvolvimento de delirium usando o Intensive Care Delirium Screening Checklist. Foi efetuada a análise descritiva para descrever as diferentes variáveis e o teste de Mann-Whitney foi utilizado para comparar variáveis contínuas; o teste do qui-quadrado ou o teste exato de Fisher foram usados para comparações. A análise univariada foi realizada por meio de regressão logística binária simples com odds ratio (OR) e seu intervalo de confiança de 95% (CI95%). O nível de significância para as comparações múltiplas foi controlado aplicando a correção de Bonferroni para comparações múltiplas e todas as variáveis foram consideradas significativas se p≤0,0025. ResultadosSeis por cento dos doentes desenvolveram DPO. Os doentes que desenvolveram DPO eram mais velhos, tinham maior probabilidade de apresentar estado físico da American Society of Anesthesiologists (ASA) III/IV (83 versus 22%, p=0,004), tinham insuficiência cardíaca congestiva em maior frequência (50 versus 3%, p=0,003) e um maior score no Revised Cardiac Risk Index (RCRI) (33 versus 6% para RCRI≥2, p=0,039). Os doentes com DPO tiveram uma maior duração da anestesia e receberam um maior volume de cristaloides, coloides e eritrócitos durante a cirurgia. A doença cardíaca congestiva foi um fator de risco independente para DPO (OR 29,3, IC 95% 4,1-210,6, p<0,001). Os doentes que desenvolveram DPO tiveram maior mortalidade hospitalar e maior tempo de internamento na UCPA e no hospital. ConclusõesOs doentes que desenvolveram DPO tiveram maior tempo de internamento no hospital e na UCPA e tiveram maiores taxas de mortalidade hospitalar. A existência de doença cardíaca congestiva prévia foi considerado fator de risco independente para a ocorrência de DPO." ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "Please cite this article as: Parente D, Luís C, Veiga D, Silva H, Abelha F. Insuficiência cardíaca congestiva como determinante de delirium pós-operatório 2012. http://dx.doi.org/." ] ] "multimedia" => array:3 [ 0 => array:7 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:2 [ "leyenda" => "ASA: American Society of Anesthesiologists; CI: confidence interval; COPD: chronic obstructive pulmonary disease; IQR: interquartile range; PACU: post-anesthesia care unit; RCRI: Revised Cardiac Risk Index." "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Variable \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">All (n=97) \t\t\t\t\t\t\n \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Age in years, median (IQR) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">56 (48–67) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Age group, n (%)</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">≥65 years \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">28 (29) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><65 years \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">69 (71) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Gender, n (%)</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Male \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">44 (45) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Female \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">53 (55) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">ASA physical status, n (%)</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">I/II \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">72 (74) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">III/IV \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">25 (26) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Body mass index in kg/m2, median (IQR) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">26 (23–30) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Hypertension, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">59 (61) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">COPD, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 (3) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">High-risk surgery, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">36 (37) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Ischemic heart disease, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">9 (9) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Congestive heart disease, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6 (6) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Cerebrovascular disease, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5 (5) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Renal failure, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6 (6) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Insulin therapy for diabetes, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">9 (9) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Total RCRI, n (%)</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">≤2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">89 (92) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">>2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7 (8) \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab433145.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Patient characteristics." ] ] 1 => array:7 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:2 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Variable \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Non-delirium (n=91) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Delirium (n=6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">p \t\t\t\t\t\t\n \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Age in years, median (IQR) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">55 (47–66) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">71 (64–75) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.008<a class="elsevierStyleCrossRef" href="#tblfn0005">a</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="4" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Age group, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.056<a class="elsevierStyleCrossRef" href="#tblfn0010">b</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><65 years \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">67(74) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 (33) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">≥65 years \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">24 (26) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 (67) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="4" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Gender, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.569<a class="elsevierStyleCrossRef" href="#tblfn0010">b</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Male \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">41(45) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 (50) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Female \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">50 (55) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 (50) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="4" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">ASA physical status, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.004<a class="elsevierStyleCrossRef" href="#tblfn0010">b</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">I/II \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">71 (78) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (17) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">III/IV \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">20 (22) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5 (83) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="4" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Body mass index in kg/m2, median (IQR) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">26 (23–30) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">26 (25–30) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.505<a class="elsevierStyleCrossRef" href="#tblfn0005">a</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Duration of anesthesia (min), median (IQR) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">120 (70–180) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">225 (143–480) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.012<a class="elsevierStyleCrossRef" href="#tblfn0005">a</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="4" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Type of anesthesia, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.763<a class="elsevierStyleCrossRef" href="#tblfn0010">b</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">General/combined general and local and regional \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">71 (78) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5 (83) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Local and regional \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">20 (22) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (17) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="4" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Temperature at PACU admission, median (IQR) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">35.0 (34.5–35.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">34.7 (34.1–35.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.559<a class="elsevierStyleCrossRef" href="#tblfn0005">a</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Hypertension, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">54 (59) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5 (83) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.238<a class="elsevierStyleCrossRef" href="#tblfn0010">b</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">COPD, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 (2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (17) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.176<a class="elsevierStyleCrossRef" href="#tblfn0010">b</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">High-risk surgery, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">32 (35) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 (67) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.124<a class="elsevierStyleCrossRef" href="#tblfn0010">b</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Ischemic heart disease, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7(8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 (33) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.095<a class="elsevierStyleCrossRef" href="#tblfn0010">b</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Congestive heart disease, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 (3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 (50) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.003<a class="elsevierStyleCrossRef" href="#tblfn0010">b</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Cerebrovascular disease, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 (4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (17) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.452<a class="elsevierStyleCrossRef" href="#tblfn0010">b</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Renal failure, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5 (6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (17) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.325<a class="elsevierStyleCrossRef" href="#tblfn0010">b</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Insulin therapy for diabetes, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8 (9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (17) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.561<a class="elsevierStyleCrossRef" href="#tblfn0010">b</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="4" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Total RCRI, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.039<a class="elsevierStyleCrossRef" href="#tblfn0010">b</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">≤2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">87 (96) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5 (83) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">>2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 (4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (17) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="4" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Crystalloids, median (IQR) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1000 (1000–2000) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3000 (2300–4125) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><0.001<a class="elsevierStyleCrossRef" href="#tblfn0005">a</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Colloids, median (IQR) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 (0–0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 (0–125) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.049<a class="elsevierStyleCrossRef" href="#tblfn0005">a</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Erythrocytes, median (IQR) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 (0–0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 (0–2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><0.001<a class="elsevierStyleCrossRef" href="#tblfn0005">a</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Platelets, median (IQR) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 (0–0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 (0–0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1<a class="elsevierStyleCrossRef" href="#tblfn0005">a</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Fasting time (hours), median (IQR) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">14.0 (10.1–16.0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">14.5 (12.8–15.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.730<a class="elsevierStyleCrossRef" href="#tblfn0005">a</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">PACU length of stay (hours), median (IQR) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">95 (69–141) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">540(331–540) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.002<a class="elsevierStyleCrossRef" href="#tblfn0005">a</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Hospital length of stay (days), median (IQR) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 (2–8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">22 (12–125) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.003<a class="elsevierStyleCrossRef" href="#tblfn0005">a</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">In-hospital mortality, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 (33) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.009<a class="elsevierStyleCrossRef" href="#tblfn0010">b</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab433146.png" ] ] ] "notaPie" => array:2 [ 0 => array:3 [ "identificador" => "tblfn0005" "etiqueta" => "a" "nota" => "Mann–Whitney U test." ] 1 => array:3 [ "identificador" => "tblfn0010" "etiqueta" => "b" "nota" => "Fisher's exact test. ASA: American Society of Anesthesiologists; CI: confidence interval; COPD: chronic obstructive pulmonary disease; IQR: interquartile range; PACU: post-anesthesia care unit; RCRI: Revised Cardiac Risk Index." ] ] ] "descripcion" => array:1 [ "en" => "Delirium vs. non-delirium characteristics and outcome." ] ] 2 => array:7 [ "identificador" => "tbl0015" "etiqueta" => "Table 3" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:2 [ "leyenda" => "ASA: American Society of Anesthesiologists; CI: confidence interval; COPD: chronic obstructive pulmonary disease; IQR: interquartile range; PACU: post-anesthesia care unit; RCRI: Revised Cardiac Risk Index." "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Variable \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Delirium/non-delirium (n=91)/(n=6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Odds ratio (95% CI) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">p \t\t\t\t\t\t\n \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Age in years, median (IQR) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">71 (64–75)/55 (47–66) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.11 (1.01–1.21) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.028 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="4" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Gender, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.814 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Male \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 (50)/41(45) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.22 (0.23–6.64) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Female \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 (50)/50 (55) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="4" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">ASA physical status, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.011 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">I/II \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (17)/71 (78) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">III/IV \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5 (83)/20 (22) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">17.75 (1.96–160.77) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="4" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Body mass index in kg/m2, median (IQR) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">26 (25–30)/26 (23–30) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.02 (0.90–1.15) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.786 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Duration of anesthesia (min), median (IQR) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">225 (143–480)/120 (70–180) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.00 (1.00–1.01) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.050 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="4" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Type of anesthesia, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.761 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">General/combined general and local and regional \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5 (83)/71 (78) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.41 (0.16–12.76) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Local and regional \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1(17)/20 (22) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="4" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Temperature at PACU admission, median (IQR) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">34.7 (34.1–35.9)/35.0 (34.5–35.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.82 (0.29–2.32) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.703 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Hypertension, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5 (83)/54 (59) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3.43 (0.38–30.53) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.270 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">COPD, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (17)/2 (2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8.90 (0.69–115.58) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.095 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">High-risk surgery, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 (67)/32 (35) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3.69 (0.64–21.24) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.144 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Ischemic heart disease, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 (33)/7(8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6.00 (0.93–38.71) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.060 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Congestive heart disease, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 (50)/3 (3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">29.33 (4.09–210.57) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Cerebrovascular disease, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (17)/4 (4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4.35 (0.41–46.51) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.224 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Renal failure, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (17)/5 (6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3.44 (0.34–35.31) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.298 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Insulin therapy for diabetes, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (17)/8 (9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2.08 (0.22–20.01) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.528 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="4" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Total RCRI, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.028 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">≤2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5 (83)/87 (96) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">>2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (17)/4(4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8.60 (1.26–58.78) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="4" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Crystalloids, median (IQR) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3000 (2300–4125)/1000 (1000–2000) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.00 (1.00–1.00) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.003 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Colloids, median (IQR) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 (0–125)/0 (0–0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.00 (1.00–1.01) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.095 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Erythrocytes, median (IQR) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 (0–2)/0 (0–0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.00 (1.00–1.01) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.048 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Fasting time (hours), median (IQR) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">14.5 (12.8–15.4)/14.0 (10.1–16.0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.99 (0.91–1.07) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.773 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab433147.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Univariate analysis for determinants of delirium." ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:35 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Diagnostic and statistical manual of mental disorders: DSM-IV-TR" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "American Psychiatric Association" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:3 [ "fecha" => "2000" "editorial" => "American Psychiatric Association" "editorialLocalizacion" => "Washington, DC" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Preoperative risk assessment for delirium after noncardiac surgery: a systematic review" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "M. 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Original article

Congestive heart failure as a determinant of postoperative delirium

Insuficiência cardíaca congestiva como determinante de delirium pós-operatório

Daniela Parentea, Clara Luísa, Dalila Veigaa, Hugo Silvab, Fernando Abelhaa,b,

Corresponding author

abelha@me.com

Corresponding author.

a Department of Anesthesiology, Centro Hospitalar São João, Porto, Portugal

b Anesthesiology and Perioperative Care Unit, Surgical Department of Medical School of Porto, Porto, Portugal

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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Postoperative delirium &#40;POD&#41; is recognized as an important post-surgical complication&#46; Delirium is defined as acute and fluctuating change of attention and cognition caused by a coexisting general medical condition&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> It is more frequent among older adults&#46;<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2&#8211;4</span></a> Wide variations in POD incidence have been reported&#44; from 5&#46;1&#37; to 52&#46;2&#37;&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> This variability may be explained by differences in diagnostic criteria and study populations&#44; as well as varying surgical procedures and differing methods of surveillance&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">POD is not a benign syndrome<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a>&#59; it is associated with increased mortality and with poor patient outcomes&#46;<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">4&#44;6&#44;7</span></a> It increases hospital length of stay &#40;LOS&#41; and hence hospital costs&#44; and carries high postoperative complication rates&#46; In addition&#44; POD may be related to later functional and cognitive decline&#46;<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">4&#44;8&#8211;10</span></a> However&#44; most strategies for dealing with POD are symptom-related only&#46; Thus&#44; prevention and early recognition are essential&#59; it is vital to identify patients at risk to modify and control all possible modifiable risk factors&#46;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">11</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">POD is a complex and heterogeneous disorder with multiple risk factors&#46;<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2&#44;12</span></a> Comorbidities and perioperative conditions appear to be involved in its genesis&#44;<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">13</span></a> and elderly patients are at greatest risk&#46;<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2&#44;14</span></a> Higher rates of POD are also seen in patients with impaired mobility&#44;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a> comorbidities &#40;American Society of Anesthesiologists &#91;ASA&#93; &#8805;3&#41;&#44;<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2&#44;5&#44;10&#44;14&#44;15</span></a> and lower cognitive function or reduction in sensory function&#46;<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">4&#44;16&#44;17</span></a> The incidence of POD may be higher in patients taking benzodiazepines preoperatively&#44;<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">15</span></a> and preoperative pain may increase the risk of POD&#46;<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">18</span></a> Other possible risk factors have been reported&#44; among them a history of alcohol abuse and chronic narcotic use&#46;<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">4&#44;16</span></a> Recently&#44; Radtke et al&#46;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a> reported that preoperative fluid fasting exceeding six hours was an independent risk factor for POD&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Perioperative conditions can also have a pronounced impact on POD&#44; and major surgery is a known risk factor<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">19</span></a> including cardiac surgery&#44;<a class="elsevierStyleCrossRefs" href="#bib0105"><span class="elsevierStyleSup">20&#44;21</span></a> non-cardiac thoracic procedures&#44;<a class="elsevierStyleCrossRefs" href="#bib0070"><span class="elsevierStyleSup">14&#44;22</span></a> and intra-abdominal surgery&#44;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a> but emergency procedures also raise the risk&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a> Pain&#44; blood loss&#44; hemodynamic changes&#44; and exposure to medications are potential risk factors&#46;<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">12&#44;23</span></a> Hematocrit &#60;30&#37; has also been reported as a risk factor for POD&#46;<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">22</span></a> However&#44; there appears to be no difference in risk level between general or local and regional anesthesia&#46;<a class="elsevierStyleCrossRefs" href="#bib0090"><span class="elsevierStyleSup">18&#44;24</span></a> Duration of mechanical ventilation has also been identified as an independent predictor of POD&#46;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">21</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">Postoperative factors are also important&#46; One of the key factors is pain control&#44; because acute pain is associated with POD&#46;<a class="elsevierStyleCrossRefs" href="#bib0025"><span class="elsevierStyleSup">5&#44;9&#44;13&#44;18&#44;25&#44;26</span></a> Early development of POD in the recovery room predicts later POD occurrence in the ward&#46;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">The risk of POD increases with each additional risk factor&#46;<a class="elsevierStyleCrossRefs" href="#bib0050"><span class="elsevierStyleSup">10&#44;14</span></a> As populations age&#44; the number of older surgical patients is set to rise&#44; and POD is likely to remain a common condition&#46;<a class="elsevierStyleCrossRefs" href="#bib0050"><span class="elsevierStyleSup">10&#44;15&#44;18&#44;27</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">The aim of this study was to evaluate the incidence of POD in a post-anesthesia care unit &#40;PACU&#41; and to identify risk factors for the development of POD&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Methods</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Patient selection</span><p id="par0040" class="elsevierStylePara elsevierViewall">The institutional review board and the Ethics Committee of Hospital de S&#227;o Jo&#227;o approved this study and informed consent was obtained preoperatively from all study participants&#46; This prospective study was carried out in the multidisciplinary PACU at Hospital S&#227;o Jo&#227;o&#44; a 1100-bed community teaching hospital in Porto&#44; Portugal&#46; All patients admitted to the PACU over a five-day period &#40;start date September 6&#44; 2010&#41; were evaluated&#46; The inclusion criteria were adult Portuguese-speaking patients undergoing major elective non-cardiac and non-neurological surgery who required anesthesia for which they were expected to remain in the hospital postoperatively for more than 48 hours&#46; We excluded patients who did not provide or were incapable of providing informed consent&#44; and those with a history of central nervous system disease&#44; Parkinson&#39;s disease&#44; neurological or cardiac surgery&#44; delirium&#44; or use of antipsychotic medication&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Patient assessment</span><p id="par0045" class="elsevierStylePara elsevierViewall">The following variables were recorded on admission to the PACU&#58; age&#44; gender&#44; temperature&#44; body mass index&#44; fasting time before surgery&#44; and anesthesia-related data &#40;specifically duration and type of anesthesia&#44; and fluids and blood products used&#41;&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">We calculated the patients&#8217; Revised Cardiac Risk Index &#40;RCRI&#41; scores as described by Lee et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">28</span></a> assigning 1 point for each of the following risk factors&#58; high-risk surgery&#44; ischemic heart disease&#44; cerebrovascular disease&#44; diabetes requiring insulin therapy&#44; and renal failure&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">In accordance with Lee et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">28</span></a> patients were considered to have a history of ischemic heart disease if they had a history of myocardial infarction&#44; had current positive exercise test or ischemic chest pain&#44; used nitrate therapy&#44; or had an ECG with pathological Q waves&#46; A history of congestive heart failure included patients with a history of heart failure&#44; pulmonary edema&#44; or paroxysmal nocturnal dyspnea&#46; Congestive heart failure was also considered present if physical examination revealed bilateral rales or S3 gallop&#44; or if a chest radiograph revealed pulmonary vascular redistribution&#46; Cerebrovascular disease was defined as a history of transient ischemic attack or stroke&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">PACU data&#44; hospital LOS&#44; and in-hospital mortality were also recorded for all patients&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Evaluation of delirium</span><p id="par0065" class="elsevierStylePara elsevierViewall">Each patient included in the study was evaluated for delirium using the Intensive Care Delirium Screening Checklist &#40;ICDSC&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">29</span></a> According to the ICDSC&#44; patients are defined as having developed delirium if they have a test score of 4 or more points&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">Trained research assistants assessed patients in the recovery room after patients were formally declared &#8216;ready for discharge&#8217; by the anesthesiologist in charge of the recovery room&#46; The research team did not interfere with the typical recovery room protocol&#44; and recovery room physicians and nurses were blinded to all study results&#46; Regular recovery room staff did not diagnose delirium for any of the patients in this study&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Statistical analysis</span><p id="par0075" class="elsevierStylePara elsevierViewall">Descriptive analyses of variables were used to summarize data&#44; and the Mann&#8211;Whitney U test was used to compare continuous variables&#59; the chi-square or Fisher&#39;s exact test was used to compare proportions between the two subject groups &#40;POD vs&#46; non-POD&#41;&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">Univariate analysis was performed to evaluate the determinants of POD&#59; these comprised simple binary logistic regression with odds ratios &#40;OR&#41; and 95&#37; confidence intervals &#40;95&#37; CI&#41; and were carried out for the following independent variables&#58; age&#44; gender&#44; body mass index&#44; ASA physical status &#40;ASA-PS&#41;&#44; comorbidities and RCRI score&#44; type and duration of anesthesia&#44; intraoperative fluid administration&#44; and body temperature at PACU admission&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">To reduce the risk of type II error&#44; the significance level for multiple comparisons was controlled by applying the Bonferroni correction for multiple comparisons &#40;test-wise significance level divided by the number of tests performed&#41;&#46; Variables were deemed significant if p&#8804;0&#46;0025&#46; Data were analyzed using SPSS for Windows version 19&#46;0 &#40;SPSS&#44; Chicago&#44; IL&#44; USA&#41;&#46;</p></span></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Results</span><p id="par0090" class="elsevierStylePara elsevierViewall">We screened 105 patients who were admitted to the PACU during the study period&#46; Four patients were excluded because of history of central nervous system disease&#59; two were excluded because of delirium and antipsychotic medication&#59; one because he did not speak Portuguese&#59; and one because he had undergone neurosurgery&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">Thus&#44; 97 patients were included in the study&#46; The baseline characteristics of all patients are listed in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#46; Patients&#8217; median age was 56 years &#40;range&#44; 18&#8211;82 years&#41;&#44; with 71&#37; of subjects aged less than 65 years&#46; The gender proportions were similar &#40;45&#37; men and 55&#37; women&#41;&#46; Forty-five percent of patients underwent general surgery&#44; 14&#37; had orthopedic surgery&#44; 12&#37; urological surgery&#44; and 11&#37; vascular surgery&#59; the remaining patients underwent plastic and reconstructive surgery&#44; or gynecological procedures&#46; Of these&#44; 37&#37; were classified as high-risk surgery&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0100" class="elsevierStylePara elsevierViewall">Overall&#44; six of the 97 patients &#40;6&#46;2&#37;&#41; developed delirium during their PACU stay&#46; <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a> shows the measured variables comparing patients who developed POD with those who did not&#46; Patients who developed delirium were older &#40;median 71 years vs&#46; 55 years&#44; p&#61;0&#46;008&#41;&#44; had higher ASA-PS scores &#40;83&#37; vs&#46; 22&#37; with ASA III&#47;IV&#44; p&#61;0&#46;004&#41; and longer duration of anesthesia &#40;median 225 min vs&#46; 120 min&#44; p&#61;0&#46;012&#41;&#44; were more likely to have a history of congestive heart failure &#40;50&#37; vs&#46; 3&#37;&#44; p&#61;0&#46;003&#41;&#44; had higher RCRI scores &#40;33&#37; vs&#46; 6&#37; with RCRI &#8805;2&#44; p&#61;0&#46;039&#41;&#44; and had a higher use of crystalloids &#40;median volume&#44; 3000 ml vs&#46; 1000 ml&#44; p&#60;0&#46;001&#41;&#44; colloids&#44; and erythrocytes&#46; There were no significant differences in the type of anesthesia used &#40;local and regional vs&#46; general&#41; or in preoperative fasting time &#40;median 14&#46;5 hours vs&#46; 14&#46;0 hours&#44; p&#61;0&#46;730&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0105" class="elsevierStylePara elsevierViewall">Patients who developed POD had longer PACU LOS &#40;median duration&#44; 540 min vs&#46; 95 min&#44; p&#61;0&#46;002&#41; and hospital LOS &#40;median duration&#44; 22 days vs&#46; 3 days&#44; p&#61;0&#46;003&#41;&#59; they also had higher in-hospital mortality &#40;33&#37; vs&#46; 1&#37;&#44; p&#61;0&#46;009&#41;&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">Simple binary logistic regressions were used to examine the covariate effects of each factor on POD development &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#41;&#59; this was done using a significance level of p&#8804;0&#46;0025&#44; and our analysis showed that congestive heart disease was an independent risk factor for POD &#40;OR 29&#46;3&#44; 95&#37; CI&#58; 4&#46;1&#8211;210&#46;6&#59; p&#60;0&#46;001&#41;&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Discussion</span><p id="par0115" class="elsevierStylePara elsevierViewall">To the best of our knowledge&#44; this is the first study to show that congestive heart failure is an independent risk factor for POD&#46; The main finding of our study is that patients who develop POD more often have congestive heart failure and that this condition may be a risk factor for POD&#46; Hutt et al&#46;<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">30</span></a> reported a higher prevalence of delirium in patients with heart failure &#40;35&#46;3&#37; of 156 patients in a nursing home&#41;&#59; that study also found an association with a 3-fold increase in 60-day mortality&#46; Furthermore&#44; a study by Uthamalingam et al&#46;<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">31</span></a> investigating a congestive heart disease population also demonstrated that delirium was independently associated with increased 30- and 90-day readmission and short-term mortality after adjusting for potential confounders&#59; these authors did not&#44; however&#44; demonstrate that congestive heart disease was a risk factor for delirium&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">In the study by Uthamalingam et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">31</span></a> delirium was associated with increased heart rate&#44; increased serum B-type natriuretic peptide levels&#44; and increased rales in the lung base&#44; all of which are associated with activation of the sympathetic nervous and renin&#8211;angiotensin systems&#44; and with increased release of cytokines&#46; This presentation observed in delirious patients stemming from increased angiotensin and aldosterone may impair cerebral metabolism and perfusion and thus help explain the pathophysiology of delirium in patients with congestive heart failure&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">POD is thought to be the result of an interaction between multiple risk factors&#46;<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2&#44;10&#44;12</span></a> Some authors have reported an incidence as high as 60&#37;&#46;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a> However&#44; although we used the ICDSC&#44; a highly sensitive delirium screening tool&#44; we still only determined a POD incidence of 6&#46;2&#37;&#59; this is slightly lower than found by other authors&#46;<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">4&#44;6&#44;7&#44;10&#44;14&#44;16&#44;22</span></a> The lower incidence in our study may be explained by the use of the ICDSC&#44; which some claim is less sensitive than other screening tools&#46;<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">32</span></a> Although the ICDSC is less sensitive than other methods for delirium screening&#44; we used it because of its user-friendly checklist which is easy to administer in environments with relatively high patient flow&#59; the ICDSC also has high sensitivity and reliability and can be completed rapidly&#46;<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">33</span></a></p><p id="par0130" class="elsevierStylePara elsevierViewall">Another possible cause of the low POD incidence in our study is the demographic characteristics of our study population&#44; with a higher proportion of younger patients and better preoperative status &#40;patients with lower ASA-PS and lower RCRI&#41;&#46; Surgical factors may also have contributed to this lower incidence because all of our patients underwent scheduled surgery and only 37&#37; of the procedures were classified as high risk&#46; Additionally&#44; we excluded all patients undergoing cardiac and neurological surgery from this study&#44; and these procedures are frequently associated with higher POD incidence&#46;<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2&#44;20&#8211;22</span></a></p><p id="par0135" class="elsevierStylePara elsevierViewall">This study compared patients who developed POD with those who did not&#46; As in previous studies&#44; we found that delirious patients were older than non-delirious patients&#46; In addition&#44; patients with congestive heart disease had a higher risk of developing POD&#44; and our study showed that congestive heart disease was independently associated with POD &#40;OR 29&#46;3&#41;&#46; These patients have lower cardiac reserve&#59; this could have led to a higher risk of intraoperative hemodynamic complications and may have contributed to POD development&#46; The majority &#40;83&#37;&#41; of patients who developed POD in our study had an ASA-PS of III&#47;IV&#44; in contrast with only 22&#37; of the non-delirious patients&#46; Thus it appears that worse ASA status may lead to a higher risk of developing POD&#46;</p><p id="par0140" class="elsevierStylePara elsevierViewall">Although we did not distinguish between fluid and solid fasting in our study&#44; we found no significant difference in the risk of POD development and fasting time between the POD and non-POD groups&#59; this differs from the results of Radtke et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a> who concluded that the duration of preoperative fluid fasting was an independent risk factor for POD&#46;</p><p id="par0145" class="elsevierStylePara elsevierViewall">On the other hand&#44; the results of the present study agreed with those of earlier studies in that we failed to find any significant differences in POD development according to the type of anesthesia used &#40;local and regional vs&#46; general&#41;&#46;<a class="elsevierStyleCrossRefs" href="#bib0090"><span class="elsevierStyleSup">18&#44;24</span></a> However&#44; patients who developed POD in our study had a longer duration of anesthesia&#44; which may be explained by the need for longer anesthesia in cases of prolonged surgery&#46; This in turn can be considered a possible indicator of increased operative complexity and of a higher risk of neurological complications&#46;<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">20</span></a></p><p id="par0150" class="elsevierStylePara elsevierViewall">Dehydration has been labeled a risk factor for POD&#46;<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">34</span></a> In this study&#44; delirious patients received greater volumes of crystalloids&#44; colloids&#44; and erythrocytes than non-delirious patients&#46; However&#44; there may have been an observation bias in the present study&#44; because the worse the general condition of a patient&#44; the higher the volumes needed to stabilize that patient&#46;</p><p id="par0155" class="elsevierStylePara elsevierViewall">As reported by other authors&#44; our findings demonstrated that patients who developed delirium had longer stay in both the PACU and the hospital&#44; and also had higher in-hospital mortality&#46;<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">4&#44;8&#44;9</span></a> This indicates that POD leads to more post-surgical complications and worse outcomes&#46;</p><p id="par0160" class="elsevierStylePara elsevierViewall">This study has several limitations&#46; First&#44; the number of patients included in our analysis was low&#59; the sample may be too small to draw statistically significant conclusions&#46; This small sample size may also be linked to another important limitation&#44; in that only a small number of patients with a prior history of congestive heart disease were included&#46; This is even more important given that congestive heart disease was considered an independent risk factor for delirium&#46; It should also be taken into account that the patients studied were not critical care patients&#46; However&#44; despite our relatively small sample size&#44; the percentage of patients with postoperative delirium was similar to the percentages seen in other studies involving patients undergoing major surgery&#46;<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">29</span></a></p><p id="par0165" class="elsevierStylePara elsevierViewall">Another limitation of our study is that the patients were screened for delirium only in the PACU and many of these patients stayed in this unit for a short time only&#46; As a result&#44; we may have missed delirium which developed at a later stage&#46; Some authors have stated that most cases of POD arise on the second day after surgery&#46;<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">4&#44;35</span></a></p><p id="par0170" class="elsevierStylePara elsevierViewall">POD can be prevented in some patients&#44; and prevention programs have been applied with some success&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">19</span></a> It is important for hospital teams to be aware of the need for screening and prevention of POD&#46; This study adds to the growing body of evidence demonstrating that POD is an important post-surgical complication and one that can result in worse outcomes for surgical patients&#46; We also found that congestive heart disease was an independent risk factor for POD&#46; In addition&#44; POD appears to be more common in older patients and in patients with worse ASA-PS and worse RCRI scores&#46; Longer anesthesia times&#44; major surgery&#44; and the presence of comorbidities may all increase the risk of POD&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Ethical disclosures</span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Protection of human and animal subjects</span><p id="par0175" class="elsevierStylePara elsevierViewall">The authors declare that no experiments were performed on humans or animals for this study&#46;</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Confidentiality of data</span><p id="par0180" class="elsevierStylePara elsevierViewall">The authors declare that they have followed the protocols of their work center on the publication of patient data and that all the patients included in the study received sufficient information and gave their written informed consent to participate in the study&#46;</p></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Right to privacy and informed consent</span><p id="par0185" class="elsevierStylePara elsevierViewall">The authors have obtained the written informed consent of the patients or subjects mentioned in the article&#46; The corresponding author is in possession of this document&#46;</p></span></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Conflicts of interest</span><p id="par0190" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare&#46;</p></span></span>"
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          "titulo" => "References"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2012-05-08"
    "fechaAceptado" => "2012-12-07"
    "PalabrasClave" => array:2 [
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec280611"
          "palabras" => array:3 [
            0 => "Postoperative delirium"
            1 => "Congestive heart failure"
            2 => "Postoperative complications"
          ]
        ]
      ]
      "pt" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palavras-chave"
          "identificador" => "xpalclavsec280612"
          "palabras" => array:3 [
            0 => "<span class="elsevierStyleItalic">Delirium</span> p&#243;s-operat&#243;rio"
            1 => "Insufici&#234;ncia card&#237;aca congestiva"
            2 => "Complica&#231;&#245;es p&#243;s-operat&#243;rias"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "en" => array:2 [
        "titulo" => "Abstract"
        "resumen" => "<span class="elsevierStyleSectionTitle" id="sect0010">Background</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Postoperative delirium &#40;POD&#41; is a frequent post-surgical complication that is associated with increased mortality and poor patient outcomes&#46; POD is a complex disorder with multiple risk factors such as pre-existing patient comorbidities and perioperative complications&#46; The aim of this study was to evaluate the incidence of POD and to identify risk factors for the development of POD in a post-anesthesia care unit &#40;PACU&#41;&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0015">Methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">We enrolled 97 adult patients admitted to a PACU over a five-day period &#40;start date September 6&#44; 2010&#41;&#46; Patient demographics and intraoperative and postoperative data were collected&#46; Patients were followed for the development of delirium using the Intensive Care Delirium Screening Checklist&#46; Descriptive analyses of variables were used to summarize data&#44; and the Mann&#8211;Whitney U test was used to compare continuous variables&#59; the chi-square or Fisher&#39;s exact test was used for comparisons&#46; Univariate analysis was performed using simple binary logistic regression with odds ratios &#40;OR&#41; and 95&#37; confidence intervals &#40;95&#37; CI&#41;&#46; The significance level for multiple comparisons was controlled by applying the Bonferroni correction for multiple comparisons and variables were deemed significant if p&#8804;0&#46;0025&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Six percent of patients developed POD&#46; These patients were older and more likely to have higher American Society of Anesthesiologists &#40;ASA&#41; physical status &#40;83 vs&#46; 22&#37; with ASA III&#47;IV&#44; p&#61;0&#46;004&#41; as well as a higher frequency of congestive heart failure &#40;50 vs&#46; 3&#37;&#44; p&#61;0&#46;003&#41; and a higher Revised Cardiac Risk Index &#40;RCRI&#41; score &#40;33 vs&#46; 6&#37; with RCRI &#8805;2&#44; p&#61;0&#46;039&#41;&#46; The duration of anesthesia for patients with POD was also longer and they received a greater volume of crystalloids&#44; colloids&#44; and erythrocytes during surgery&#46; Congestive heart disease was an independent risk factor for POD &#40;OR 29&#46;3&#44; 95&#37; CI 4&#46;1&#8211;210&#46;6&#59; p&#60;0&#46;001&#41;&#46; In addition&#44; patients who developed POD had higher in-hospital mortality and longer PACU and hospital stays&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Patients who developed POD had longer hospital and PACU stays and higher in-hospital mortality&#46; Congestive heart disease was considered an independent risk factor for POD&#46;</p>"
      ]
      "pt" => array:2 [
        "titulo" => "Resumo"
        "resumen" => "<span class="elsevierStyleSectionTitle" id="sect0035">Introdu&#231;&#227;o</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">O <span class="elsevierStyleItalic">delirium</span> p&#243;s-operat&#243;rio &#40;DPO&#41; &#233; uma complica&#231;&#227;o frequente ap&#243;s a cirurgia&#46; Est&#225; associado a um aumento da mortalidade e a piores resultados&#46; O DPO &#233; um dist&#250;rbio complexo&#44; com m&#250;ltiplos fatores de risco que incluem a exist&#234;ncia de comorbilidades e complica&#231;&#245;es <span class="elsevierStyleItalic">per</span> operat&#243;rias&#46; O objetivo deste estudo foi avaliar a incid&#234;ncia de DPO e identificar fatores de risco para o seu desenvolvimento numa unidade p&#243;s-anest&#233;sica&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0040">M&#233;todos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Foram inclu&#237;dos no estudo 97 doentes adultos&#44; internados na unidade de cuidados p&#243;s-anest&#233;sica &#40;UCPA&#41;&#44; ap&#243;s seis de setembro de 2010&#44; durante um per&#237;odo de cinco dias&#46; Foram registados dados demogr&#225;ficos&#44; dados intraoperat&#243;rios e p&#243;s-operat&#243;rios&#46; Os doentes foram seguidos para o desenvolvimento de <span class="elsevierStyleItalic">delirium</span> usando o <span class="elsevierStyleItalic">Intensive Care Delirium Screening Checklist</span>&#46; Foi efetuada a an&#225;lise descritiva para descrever as diferentes vari&#225;veis e o teste de Mann-Whitney foi utilizado para comparar vari&#225;veis cont&#237;nuas&#59; o teste do qui-quadrado ou o teste exato de Fisher foram usados para compara&#231;&#245;es&#46; A an&#225;lise univariada foi realizada por meio de regress&#227;o log&#237;stica bin&#225;ria simples com <span class="elsevierStyleItalic">odds ratio</span> &#40;OR&#41; e seu intervalo de confian&#231;a de 95&#37; &#40;CI95&#37;&#41;&#46; O n&#237;vel de signific&#226;ncia para as compara&#231;&#245;es m&#250;ltiplas foi controlado aplicando a corre&#231;&#227;o de Bonferroni para compara&#231;&#245;es m&#250;ltiplas e todas as vari&#225;veis foram consideradas significativas se p<span class="elsevierStyleHsp" style=""></span>&#8804;<span class="elsevierStyleHsp" style=""></span>0&#44;0025&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Seis por cento dos doentes desenvolveram DPO&#46; Os doentes que desenvolveram DPO eram mais velhos&#44; tinham maior probabilidade de apresentar estado f&#237;sico da <span class="elsevierStyleItalic">American Society of Anesthesiologists</span> &#40;ASA&#41; III&#47;IV &#40;83 <span class="elsevierStyleItalic">versus</span> 22&#37;&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;004&#41;&#44; tinham insufici&#234;ncia card&#237;aca congestiva em maior frequ&#234;ncia &#40;50 <span class="elsevierStyleItalic">versus</span> 3&#37;&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;003&#41; e um maior <span class="elsevierStyleItalic">score</span> no <span class="elsevierStyleItalic">Revised Cardiac Risk Index</span> &#40;RCRI&#41; &#40;33 <span class="elsevierStyleItalic">versus</span> 6&#37; para RCRI<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>2&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;039&#41;&#46; Os doentes com DPO tiveram uma maior dura&#231;&#227;o da anestesia e receberam um maior volume de cristaloides&#44; coloides e eritr&#243;citos durante a cirurgia&#46; A doen&#231;a card&#237;aca congestiva foi um fator de risco independente para DPO &#40;OR 29&#44;3&#44; IC 95&#37; 4&#44;1-210&#44;6&#44; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#46; Os doentes que desenvolveram DPO tiveram maior mortalidade hospitalar e maior tempo de internamento na UCPA e no hospital&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0050">Conclus&#245;es</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Os doentes que desenvolveram DPO tiveram maior tempo de internamento no hospital e na UCPA e tiveram maiores taxas de mortalidade hospitalar&#46; A exist&#234;ncia de doen&#231;a card&#237;aca congestiva pr&#233;via foi considerado fator de risco independente para a ocorr&#234;ncia de DPO&#46;</p>"
      ]
    ]
    "NotaPie" => array:1 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0015">Please cite this article as&#58; Parente D&#44; Lu&#237;s C&#44; Veiga D&#44; Silva H&#44; Abelha F&#46; Insufici&#234;ncia card&#237;aca congestiva como determinante de <span class="elsevierStyleItalic">delirium</span> p&#243;s-operat&#243;rio 2012&#46; http&#58;&#47;&#47;dx&#46;doi&#46;org&#47;&#46;</p>"
      ]
    ]
    "multimedia" => array:3 [
      0 => array:7 [
        "identificador" => "tbl0005"
        "etiqueta" => "Table 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">ASA&#58; American Society of Anesthesiologists&#59; CI&#58; confidence interval&#59; COPD&#58; chronic obstructive pulmonary disease&#59; IQR&#58; interquartile range&#59; PACU&#58; post-anesthesia care unit&#59; RCRI&#58; Revised Cardiac Risk Index&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>&#8805;65 years&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>&#60;65 years&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">44 &#40;45&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Female&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">53 &#40;55&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>III&#47;IV&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">59 &#40;61&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">3 &#40;3&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">36 &#40;37&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">6 &#40;6&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">6 &#40;6&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#46;569<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">3 &#40;50&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Female&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">3 &#40;50&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">0&#46;004<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>I&#47;II&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>III&#47;IV&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">0&#46;505<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Duration of anesthesia &#40;min&#41;&#44; median &#40;IQR&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">225 &#40;143&#8211;480&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">0&#46;012<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Type of anesthesia&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>General&#47;combined general and local and regional&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Local and regional&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Temperature at PACU admission&#44; median &#40;IQR&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">35&#46;0 &#40;34&#46;5&#8211;35&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#46;559<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Hypertension&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">COPD&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">High-risk surgery&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Ischemic heart disease&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Congestive heart disease&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Cerebrovascular disease&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Renal failure&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Total RCRI&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Crystalloids&#44; median &#40;IQR&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1000 &#40;1000&#8211;2000&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">3000 &#40;2300&#8211;4125&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#60;0&#46;001<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Colloids&#44; median &#40;IQR&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0 &#40;0&#8211;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0 &#40;0&#8211;125&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;049<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Erythrocytes&#44; median &#40;IQR&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0 &#40;0&#8211;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0 &#40;0&#8211;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#46;001<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Platelets&#44; median &#40;IQR&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0 &#40;0&#8211;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0 &#40;0&#8211;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Fasting time &#40;hours&#41;&#44; median &#40;IQR&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">14&#46;0 &#40;10&#46;1&#8211;16&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">14&#46;5 &#40;12&#46;8&#8211;15&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;730<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">PACU length of stay &#40;hours&#41;&#44; median &#40;IQR&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">95 &#40;69&#8211;141&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">540&#40;331&#8211;540&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;002<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Hospital length of stay &#40;days&#41;&#44; median &#40;IQR&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">3 &#40;2&#8211;8&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">22 &#40;12&#8211;125&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;003<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">In-hospital mortality&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">1 &#40;1&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;33&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;009<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" style="border-bottom: 2px solid black">Variable&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" style="border-bottom: 2px solid black">Delirium&#47;non-delirium &#40;n&#61;91&#41;&#47;&#40;n&#61;6&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" style="border-bottom: 2px solid black">p&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1&#46;11 &#40;1&#46;01&#8211;1&#46;21&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;028&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " colspan="4" align="left" valign="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Gender&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;814&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Male&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#40;50&#41;&#47;41&#40;45&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;22 &#40;0&#46;23&#8211;6&#46;64&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Female&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#40;50&#41;&#47;50 &#40;55&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">ASA physical status&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;011&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>I&#47;II&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;17&#41;&#47;71 &#40;78&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>III&#47;IV&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5 &#40;83&#41;&#47;20 &#40;22&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">17&#46;75 &#40;1&#46;96&#8211;160&#46;77&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Body mass index in kg&#47;m</span><span class="elsevierStyleSup"><span class="elsevierStyleItalic">2</span></span><span class="elsevierStyleItalic">&#44; median &#40;IQR&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">26 &#40;25&#8211;30&#41;&#47;26 &#40;23&#8211;30&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1&#46;02 &#40;0&#46;90&#8211;1&#46;15&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#46;786&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Duration of anesthesia &#40;min&#41;&#44; median &#40;IQR&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">225 &#40;143&#8211;480&#41;&#47;120 &#40;70&#8211;180&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1&#46;00 &#40;1&#46;00&#8211;1&#46;01&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#46;050&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Type of anesthesia&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#46;761&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>General&#47;combined general and local and regional&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">5 &#40;83&#41;&#47;71 &#40;78&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1&#46;41 &#40;0&#46;16&#8211;12&#46;76&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Local and regional&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">1&#40;17&#41;&#47;20 &#40;22&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Temperature at PACU admission&#44; median &#40;IQR&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">34&#46;7 &#40;34&#46;1&#8211;35&#46;9&#41;&#47;35&#46;0 &#40;34&#46;5&#8211;35&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#46;82 &#40;0&#46;29&#8211;2&#46;32&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#46;703&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Hypertension&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">5 &#40;83&#41;&#47;54 &#40;59&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#46;270&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">COPD&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1 &#40;17&#41;&#47;2 &#40;2&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#46;095&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">High-risk surgery&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">4 &#40;67&#41;&#47;32 &#40;35&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">3&#46;69 &#40;0&#46;64&#8211;21&#46;24&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Ischemic heart disease&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">2 &#40;33&#41;&#47;7&#40;8&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">6&#46;00 &#40;0&#46;93&#8211;38&#46;71&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#46;060&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Congestive heart disease&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">3 &#40;50&#41;&#47;3 &#40;3&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">29&#46;33 &#40;4&#46;09&#8211;210&#46;57&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#46;001&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Cerebrovascular disease&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1 &#40;17&#41;&#47;4 &#40;4&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">4&#46;35 &#40;0&#46;41&#8211;46&#46;51&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#46;224&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Renal failure&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Insulin therapy for diabetes&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1 &#40;17&#41;&#47;8 &#40;9&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#46;528&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Total RCRI&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>&#8804;2&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">5 &#40;83&#41;&#47;87 &#40;96&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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Article information

ISSN: 21742049
Original language: English

DOI:10.1016/j.repce.2012.12.004

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Year/Month	Html	Pdf	Total

2024 November	9	5	14
2024 October	42	25	67
2024 September	55	25	80
2024 August	53	33	86
2024 July	36	28	64
2024 June	39	25	64
2024 May	63	23	86
2024 April	24	27	51
2024 March	25	17	42
2024 February	24	19	43
2024 January	27	27	54
2023 December	24	25	49
2023 November	29	26	55
2023 October	24	19	43
2023 September	28	19	47
2023 August	26	17	43
2023 July	22	7	29
2023 June	22	21	43
2023 May	27	29	56
2023 April	12	1	13
2023 March	25	28	53
2023 February	31	30	61
2023 January	21	12	33
2022 December	31	19	50
2022 November	58	20	78
2022 October	22	14	36
2022 September	24	32	56
2022 August	28	27	55
2022 July	24	22	46
2022 June	20	20	40
2022 May	20	25	45
2022 April	21	20	41
2022 March	18	27	45
2022 February	19	17	36
2022 January	20	16	36
2021 December	15	22	37
2021 November	34	41	75
2021 October	28	35	63
2021 September	22	22	44
2021 August	30	24	54
2021 July	18	27	45
2021 June	16	13	29
2021 May	25	29	54
2021 April	33	15	48
2021 March	57	20	77
2021 February	50	10	60
2021 January	24	18	42
2020 December	30	8	38
2020 November	16	14	30
2020 October	15	20	35
2020 September	49	7	56
2020 August	29	5	34
2020 July	34	8	42
2020 June	37	1	38
2020 May	42	4	46
2020 April	29	17	46
2020 March	35	8	43
2020 February	46	13	59
2020 January	24	6	30
2019 December	25	7	32
2019 November	17	4	21
2019 October	28	5	33
2019 September	29	9	38
2019 August	29	1	30
2019 July	31	24	55
2019 June	11	17	28
2019 May	36	8	44
2019 April	18	17	35
2019 March	25	9	34
2019 February	31	12	43
2019 January	10	8	18
2018 December	52	16	68
2018 November	57	11	68
2018 October	157	23	180
2018 September	63	10	73
2018 August	37	3	40
2018 July	46	10	56
2018 June	46	6	52
2018 May	55	8	63
2018 April	99	3	102
2018 March	71	6	77
2018 February	135	2	137
2018 January	47	8	55
2017 December	90	4	94
2017 November	56	5	61
2017 October	27	7	34
2017 September	33	5	38
2017 August	35	10	45
2017 July	25	7	32
2017 June	49	7	56
2017 May	32	13	45
2017 April	23	23	46
2017 March	29	18	47
2017 February	21	4	25
2017 January	23	3	26
2016 December	25	5	30
2016 November	22	6	28
2016 October	29	2	31
2016 September	14	6	20
2016 August	6	4	10
2016 July	5	2	7
2016 June	6	1	7
2016 May	7	3	10
2016 April	16	1	17
2016 March	43	6	49
2016 February	44	14	58
2016 January	30	4	34
2015 December	60	9	69
2015 November	26	2	28
2015 October	28	7	35
2015 September	25	9	34
2015 August	31	8	39
2015 July	21	7	28
2015 June	17	1	18
2015 May	50	3	53
2015 April	27	6	33
2015 March	14	2	16
2015 February	11	3	14
2015 January	27	4	31
2014 December	43	9	52
2014 November	19	3	22
2014 October	32	6	38
2014 September	27	4	31
2014 August	29	7	36
2014 July	29	7	36
2014 June	14	11	25
2014 May	30	9	39
2014 April	15	2	17
2014 March	46	12	58
2014 February	47	5	52
2014 January	54	17	71
2013 December	28	8	36

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