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blood flow stasis&#44; and hypercoagulability have been described as the three main components in the pathogenesis of venous thrombosis&#44; advances in research have also identified many other transient and persistent risk factors &#8211; demographic &#40;e&#46;g&#46; advanced age&#41;&#44; biological &#40;e&#46;g&#46; increased prothrombin and fibrinogen levels&#41;&#44; behavioral &#40;e&#46;g&#46; smoking&#41;&#44; environmental &#40;e&#46;g&#46; long-distance travel&#41;&#44; and health condition-related &#40;e&#46;g&#46; surgical and comorbid conditions&#44; such as hypertension&#44; diabetes or high cholesterol levels&#41; &#8211; that interact simultaneously or sequentially in the development of VTE&#46;<a class="elsevierStyleCrossRefs" href="#bib0205"><span class="elsevierStyleSup">8&#8211;10</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">VTE is of special concern in hospitalized patients&#46;<a class="elsevierStyleCrossRefs" href="#bib0220"><span class="elsevierStyleSup">11&#8211;13</span></a> According to the current American College of Chest Physicians &#40;ACCP&#41;<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">14</span></a> and European Society of Cardiology<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">15</span></a> guidelines&#44; it requires acute treatment with low molecular weight heparin &#40;LMWH&#41; or novel oral anticoagulants &#40;NOACs&#41; followed by at least three months of therapy with oral anticoagulants such as vitamin K antagonists or NOACs&#46; This is a fairly effective treatment strategy for preventing VTE recurrence&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Assessment of VTE risk is essential to accurately identify patients who might benefit from VTE prophylaxis and to develop prevention strategies for optimal care&#46; Although effective VTE prophylaxis can halve the risk of VTE&#44;<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">16</span></a> it is still largely underused in medical and surgical patients&#46;<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">17</span></a> In a population-based study&#44;<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">18</span></a> of all cases with venous thromboembolism&#44; 24&#37; had been previously admitted to a surgical ward and 22&#37; to a medical ward&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">Several clinical studies have shown the need to put into practice effective hospital strategies based on systematic and individualized assessment of VTE&#44; and also to optimize the institution of proper prophylaxis in the context of in-hospital and outpatient management&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">Information on VTE risk and prophylaxis practices in Portugal is scarce&#46; Hence&#44; the primary aim of this study was to assess the incidence of VTE risk in the hospital care setting in Portugal using a thromboembolic score based on a risk assessment model &#40;RAM&#41;&#44; adapted from Caprini et al&#46;<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">19</span></a> and Khorana et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">20</span></a> whenever applicable &#40;hereafter the ARTE-RAM score&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0035" class="elsevierStylePara elsevierViewall">Secondary objectives were to characterize the profile of patients at risk for VTE&#44; to determine the proportion of at-risk patients who receive effective prophylaxis &#40;during hospitalization and after discharge&#41;&#44; and to determine the incidence of thromboembolic and bleeding events &#40;during hospitalization and after discharge&#41;&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Methods</span><p id="par0040" class="elsevierStylePara elsevierViewall">The detailed methodology of the ARTE &#40;<span class="elsevierStyleItalic">Avalia&#231;&#227;o de Risco de Tromboembolismo Venoso</span> &#8211; Assessment of Venous Thromboembolism Risk&#41; study has been previously published&#46;<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">21</span></a> Briefly&#44; ARTE was a non-interventional&#44; multicenter&#44; prospective study performed from December 2008 to June 2012 at 14 Portuguese hospitals &#40;listed in the Acknowledgements section&#41;&#46; Inclusion criteria were patients aged &#8805;18 years hospitalized in one of the eligible medical departments &#40;internal medicine&#44; oncology&#44; surgical or orthopedic&#41;&#44; who signed informed consent to participate&#46; The study excluded patients admitted with a diagnosis of VTE&#44; or who were receiving chronic antithrombotic therapy&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">Patients were enrolled sequentially in each participating center until the desired sample size of 4000 patients was achieved&#44; and treated at the physician&#39;s discretion according to local clinical practice&#46; Data were collected from hospital charts and the relevant information was entered onto standardized case report forms&#46; Patient demographics&#44; admission discharge diagnoses&#44; risk factors for VTE &#40;as defined in the ACCP guidelines<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">22</span></a>&#41;&#44; risk factors for bleeding&#44; duration of hospitalization&#44; type of VTE prophylaxis and concomitant medication were obtained directly from patients at the time of enrollment and of hospital discharge&#46; At the time of enrollment&#44; the ARTE-RAM thromboembolic score was also calculated for each patient&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">In order to assess the occurrence of thromboembolic and bleeding events&#44; as well as cases of death or hospital readmission&#44; patients were further contacted by telephone at six months after discharge&#46;</p><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Statistical analysis</span><p id="par0055" class="elsevierStylePara elsevierViewall">An estimated 1000 patients were included per analysis subgroup to assess the true occurrence of VTE risk at a 95&#37; confidence interval with a margin of error of 3&#37;&#46; Quantitative data were expressed as medians or means &#40;and standard deviation&#41; when appropriate&#44; while categorical data were expressed as number and percentage of the population&#46; Exploratory analysis was performed using chi-square testing for categorical variables and two-sided t tests for continuous variables&#46; A p-value of less than 0&#46;05 was considered statistically significant&#46;</p></span></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Results</span><p id="par0060" class="elsevierStylePara elsevierViewall">The number of patients included and the study flow diagram are depicted in <a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0065" class="elsevierStylePara elsevierViewall">A total of 4090 patients were enrolled &#40;54&#37; female&#41;&#44; mean age 57 years&#44; mean weight 71 kg&#44; mean height 164 cm&#44; mean body mass index 26&#46;2 kg&#47;m<span class="elsevierStyleSup">2</span>&#44; and 17&#37; obese&#46; Patients&#8217; demographic and clinical characteristics are shown in <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0070" class="elsevierStylePara elsevierViewall">The proportions of patients included in each of the four medical areas considered were 38&#46;4&#37; &#40;n&#61;1570&#41; in oncology&#44; 24&#46;6&#37; &#40;n&#61;1008&#41; in general surgery&#44; 18&#46;7&#37; &#40;n&#61;764&#41; in internal medicine and 18&#46;3&#37; &#40;n&#61;748&#41; in orthopedics&#46; Of the total population&#44; 592 patients &#40;14&#46;5&#37;&#41; had a family history of thromboembolism&#46; The mean length of hospital stay was 8&#46;3&#177;18&#46;1 days &#40;median 5&#41;&#44; and the major reasons for hospitalization were cancer &#40;15&#46;0&#37;&#41;&#44; gastrointestinal&#47;hepatobiliary disease &#40;8&#46;5&#37;&#41; and acute non-infectious respiratory disease &#40;6&#46;1&#37;&#41;&#46; Six-month follow-up was obtained in 2923 &#40;71&#46;5&#37;&#41; patients&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">The incidence of the ARTE-RAM scores obtained at admission in the overall population is shown in <a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0080" class="elsevierStylePara elsevierViewall">According to the predefined classes of thromboembolic risk&#44; 192 patients &#40;4&#46;7&#37;&#41; were considered to have low risk for VTE &#40;ARTE-RAM score of 0 or 1&#41;&#44; 1090 &#40;26&#46;7&#37;&#41; intermediate risk &#40;ARTE-RAM score of 2&#44; 3 or 4&#41; and 2808 &#40;68&#46;6&#37;&#41; had an ARTE-RAM score &#8805;5&#44; and were considered at high risk for VTE&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">Considering the different medical areas individually&#44; the distribution of the risk classes was as shown in <a class="elsevierStyleCrossRef" href="#tbl0020">Table 4</a>&#46; A high risk of VTE &#40;ARTE-RAM score &#8805;5&#41; was more prevalent among oncology patients &#40;88&#46;2&#37;&#41;&#44; followed by orthopedic patients &#40;72&#46;5&#37;&#41;&#44; surgical patients &#40;54&#46;6&#37;&#41; and internal medicine patients &#40;43&#46;2&#37;&#41;&#46;</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia><p id="par0090" class="elsevierStylePara elsevierViewall">Overall&#44; 2747 patients &#40;67&#46;2&#37;&#41; received VTE prophylaxis during hospitalization&#44; and 592 &#40;20&#46;3&#37;&#41; of those with follow-up received VTE prophylaxis after discharge&#46; During hospitalization&#44; VTE prophylaxis was most frequently prescribed for orthopedic and oncology patients &#40;76&#46;5&#37; and 72&#46;0&#37;&#44; respectively&#41;&#44; and LMWH was the most commonly used type of prophylaxis &#40;88&#46;3&#37; of the 2747 treated inpatients&#41;&#44; for a mean of 7&#46;8&#177;10&#46;6 days &#40;median 6&#41;&#46; In 12&#46;3&#37; &#40;n&#61;505&#41; of the patients&#44; LMWH was maintained after discharge from hospital&#46; Regarding the outpatient setting&#44; among the 2923 patients with six-month follow-up&#44; VTE prophylaxis was also most frequently recorded in orthopedic and oncology patients &#40;36&#46;2&#37; and 14&#46;3&#37;&#44; respectively&#41;&#44; and LMWH was also the most commonly prescribed type of prophylaxis &#40;85&#46;3&#37; of the 592 treated outpatients&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0025">Table 5</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0025"></elsevierMultimedia><p id="par0095" class="elsevierStylePara elsevierViewall">In the study population&#44; 59 patients &#40;1&#46;4&#37;&#41; had contraindications for pharmacological prophylaxis&#44; 26 &#40;44&#46;1&#37;&#41; of whom were hospitalized in internal medicine departments&#46; Even though contraindication for anticoagulation was identified&#44; 22 patients received prophylaxis during hospitalization&#44; and three during follow-up&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">The overall incidence of thromboembolic events was 1&#46;5&#37;&#44; corresponding to 60 patients&#44; 22 &#40;0&#46;58&#37;&#41; during hospital stay and 36 &#40;0&#46;93&#37;&#41; during the six-month follow-up period&#46; The most common types of VTE during hospitalization were deep vein thrombosis &#40;n&#61;10&#41;&#44; ischemic stroke &#40;n&#61;6&#41; and pulmonary embolism &#40;n&#61;5&#41;&#44; and deep vein thrombosis &#40;n&#61;13&#41; and ischemic stroke &#40;n&#61;13&#41; during follow-up&#46; Overall&#44; the majority of VTE occurred in oncology and internal medicine patients &#40;n&#61;29 and n&#61;21&#44; respectively&#41;&#46; Analysis of the occurrence of VTE during hospitalization and follow-up periods separately reveals a significantly greater number of VTE episodes in internal medicine patients during hospitalization &#40;n&#61;13&#44; p&#60;0&#46;001&#41; and also more in oncology patients during follow-up &#40;n&#61;21&#41;&#44; although this was not statistically significant &#40;p&#61;0&#46;055&#41;&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">A total of 327 patients &#40;8&#37;&#41; had bleeding events&#44; in 216 of whom the event occurred during hospitalization&#44; 106 during follow-up&#44; and five during both periods&#46; Major bleeding events were observed in 159 &#40;3&#46;9&#37;&#41; of hospitalized patients&#44; and in 68 &#40;2&#46;3&#37;&#41; of outpatients&#46; The most frequent major bleeding events during hospitalization were &#8805;2 g&#47;dl hemoglobin decrease &#40;n&#61;142&#41;&#44; blood transfusion &#40;n&#61;98&#41;&#44; intestinal and gastric bleeding &#40;n&#61;17 and n&#61;12&#44; respectively&#41; and intestinal bleeding &#40;n&#61;63&#41;&#44; &#8805;2 g&#47;dl hemoglobin decrease &#40;n&#61;7&#41; and blood transfusion &#40;n&#61;6&#41; during follow-up&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">Mortality from any cause over the six-month study period was 3&#46;4&#37;&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Discussion</span><p id="par0115" class="elsevierStylePara elsevierViewall">The validation of a RAM modified from the Caprini and Khorana scores in a heterogeneous hospitalized population that includes medical and cancer patients may be useful in clinical practice&#46; Given the complexity of a significant number of medical and cancer patients&#44; an ideal model must accurately identify a threshold for the risk of VTE and predict the correct risk level in heterogeneous patients at admission&#44; irrespective of their initial or final diagnosis&#46;<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">23</span></a> One attempt to develop such a risk score in patients with active cancer in chemotherapy was the Protecht score&#46;<a class="elsevierStyleCrossRef" href="#bib0285"><span class="elsevierStyleSup">24</span></a> This score requires a P-selectin assay&#44; which may limit its practical use&#44;<a class="elsevierStyleCrossRef" href="#bib0290"><span class="elsevierStyleSup">25</span></a> and is only included here for reasons of comparison&#46; The ARTE-RAM score presented in this study was based on both well-established and novel risk factors&#44; aiming for a consensual version of a tool that can be widely used in daily clinical practice&#44; responding to a perceived need in the medical community&#46;<a class="elsevierStyleCrossRef" href="#bib0295"><span class="elsevierStyleSup">26</span></a></p><p id="par0120" class="elsevierStylePara elsevierViewall">The ARTE study&#44; including populations admitted to general surgery and medicine departments&#44; was designed to assess a new risk scoring method and to demonstrate the value of individual risk assessment for a broad range of patients&#46; The study was conducted in a cohort of patients hospitalized in four departments &#40;internal medicine&#44; oncology&#44; surgical or orthopedic&#41; of 14 hospitals in Portugal&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">Overall&#44; the study demonstrated a high prevalence of high risk for VTE &#40;68&#37; of all patients&#41;&#44; which is considerably higher than the overall risk for VTE &#40;52&#46;7&#37;&#41; found in the Portuguese patients included in the ENDORSE study&#46;<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">27</span></a> This difference may be due to the especially high prevalence of VTE risk among oncology and orthopedic patients found in our study&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">The 67&#46;2&#37; of all in-hospital patients who received some kind of thromboprophylaxis in the ARTE study is an improvement over the 58&#46;5&#37; treated patients found in the Portuguese ENDORSE subgroup&#44; which may reflect an increase in awareness on this subject&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">Despite the variety of prophylaxis measures&#44; 45 of the 2747 treated patients &#40;1&#46;6&#37;&#41; suffered VTE&#46; In a paper by Zakai et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0305"><span class="elsevierStyleSup">28</span></a> the incidence of VTE was 7&#46;6 per 1000 admissions&#46; If ischemic stroke is excluded&#44; we found an incidence of 3&#46;9 VTE events per 1000 admissions&#46; This difference could be explained by a higher percentage of prophylaxis in our study &#40;67&#46;2&#37; vs&#46; 52&#37; in Zakai et al&#41;&#46;</p><p id="par0140" class="elsevierStylePara elsevierViewall">The ARTE study corroborates other reports<a class="elsevierStyleCrossRef" href="#bib0310"><span class="elsevierStyleSup">29</span></a> that alert the medical community to the need for extended VTE prophylaxis beyond hospital discharge&#46; In fact&#44; the majority of VTE events were recorded in the six-month follow-up period &#40;0&#46;93&#37; of all patients&#41;&#46;</p><p id="par0145" class="elsevierStylePara elsevierViewall">Major bleeding events were mainly observed during hospital stay&#44; when close medical vigilance enables immediate intervention to minimize its consequences&#46; Of inpatients receiving anticoagulant prophylaxis&#44; only 3&#46;89&#37; had a major bleeding complication&#46; This underlines the need for accurate risk estimation before the introduction of pharmacological VTE prophylaxis&#44; in order to offer an appropriate strategy for each patient and especially to avoid underuse of anticoagulants based on wrongly perceived clinical assumptions of risk for bleeding complications&#46;</p><p id="par0150" class="elsevierStylePara elsevierViewall">Several studies&#44; including a Cochrane review&#44; have evaluated the importance of interventions designed to increase the implementation of thromboprophylaxis in hospitalized adult medical and surgical patients&#46; The Cochrane review&#44; published in 2013&#44;<a class="elsevierStyleCrossRef" href="#bib0315"><span class="elsevierStyleSup">30</span></a> analyzed 55 studies&#44; including randomized controlled trials and observational studies&#44; that implemented a variety of system-wide strategies aimed at improving thromboprophylaxis rates in many settings and patient populations&#46; The authors found statistically significant improvements in prescription of prophylaxis therapies associated with education&#44; alerts and multifaceted interventions&#46; Multifaceted interventions with an alert component seems to be the most effective&#46; Another review analyzed ambulatory cancer patients receiving chemotherapy<a class="elsevierStyleCrossRef" href="#bib0320"><span class="elsevierStyleSup">31</span></a> and confirmed the importance of primary thromboprophylaxis in reducing the incidence of symptomatic VTE&#46;</p><p id="par0155" class="elsevierStylePara elsevierViewall">Worldwide&#44; the search for cost-effective strategies for prevention of VTE has been a fundamental concern in recent years&#46; There is&#44; however&#44; no agreement as to the best approach on this issue&#46; On one hand there is solid evidence showing the effectiveness of computerized decision support for the implementation of thromboprophylaxis&#46; On the other hand&#44; there have been doubts about its cost-effectiveness&#46;</p><p id="par0160" class="elsevierStylePara elsevierViewall">A study published in 2011<a class="elsevierStyleCrossRef" href="#bib0325"><span class="elsevierStyleSup">32</span></a> assessed a four-year period in a Spanish hospital and demonstrated that the implementation of e-alerts led to a net cost saving of &#8364;6&#46;50 per hospitalized patient and concludes that if all hospitalized patients in Spain were considered&#44; the total yearly savings would approach &#8364;30 million&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Limitations</span><p id="par0165" class="elsevierStylePara elsevierViewall">This study has several limitations&#46; Firstly&#44; although we made an initial assessment of risk factors at time of admission&#44; identified by qualified physicians&#44; there may have been intersite variability in data collection&#46; Secondly&#44; for the purpose of classifying patients in disease categories&#44; we used the admission diagnosis as the main diagnosis&#44; accepting that&#44; in some cases&#44; this diagnosis could be wrong or the clinical course of the disease episode could modify the relative effect of VTE risk factors &#40;for example&#44; a patient could be admitted for an acute condition attributed to cancer but undergo surgical intervention during hospital stay&#41;&#46; Thirdly&#44; clinical diagnosis of DVT and PE is known to be unreliable and clinical examination alone underestimates the true incidence of VTE&#44;<a class="elsevierStyleCrossRef" href="#bib0330"><span class="elsevierStyleSup">33</span></a> particularly in an outpatient setting&#44; which may have contributed to underestimation of asymptomatic VTE events and hence of the true incidence of VTE&#46; Finally&#44; a large number of patients were lost to follow-up&#44; hampering analysis of thromboprophylaxis and clinical outcomes after hospital discharge&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Conclusions</span><p id="par0170" class="elsevierStylePara elsevierViewall">The ARTE study demonstrated that a large proportion of hospitalized patients are at high risk of VTE&#46; Thromboprophylaxis was administered to a significant number of these patients but its use may be less desirable in the outpatient setting&#46; Validation of the ARTE-RAM score in future studies may support the ARTE study&#39;s findings and lead to its use when combined with appropriate information technology&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Disclosures</span><p id="par0175" class="elsevierStylePara elsevierViewall">The ARTE study was sponsored by Sanofi and promoted by ForPoint - Instituto de Forma&#231;&#227;o e Inova&#231;&#227;o na Sa&#250;de&#46; Editorial assistance was provided by KeyPoint - Consultoria Cient&#237;fica&#46;</p></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Funding sources</span><p id="par0205" class="elsevierStylePara elsevierViewall">The ARTE study was granted an unconditional financial grant by Sanofi Portugal&#46;</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Conflicts of interest</span><p id="par0190" class="elsevierStylePara elsevierViewall">D&#46; Ferreira&#44; J&#46; A&#46; De Sousa&#44; P&#46; Felicissimo&#44; and A&#46; Fran&#231;a formed the scientific committee of the ARTE study and have received honoraria from Forpoint &#8211; Institute for Training and Innovation in Health&#46;</p><p id="par0195" class="elsevierStylePara elsevierViewall">The authors declare that they all contributed to the concept and design of the study and to the interpretation of data&#44; as well as to the writing&#44; revising and final approval of the version to be published&#46;</p></span></span>"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Introduction</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Venous thromboembolism &#40;VTE&#41; is a relatively common complication during hospital stay and determination of VTE risk is critical to choosing the best prophylactic strategy for each patient&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Objectives</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">In the present study we studied the risk profile for VTE in hospitalized patients in a group of hospitals in Portugal&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Methods</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Based on an open cohort of 4248 patients hospitalized in surgical&#44; internal medicine&#44; orthopedic or oncology departments&#44; we determined thromboembolic risk at admission by applying a new score&#44; modified from the Caprini and Khorana scores&#46; Thrombotic&#44; embolic and bleeding events and death were assessed during hospital stay and at three and six months after discharge&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Results</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">The median duration of hospital stay was five days and thromboembolic prophylaxis was implemented in 67&#46;2&#37; &#40;n&#61;2747&#41; of the patients&#46; A low molecular weight heparin was used as prophylaxis in the majority of cases &#40;88&#46;3&#37;&#41;&#46; Most patients were classified as high &#40;68&#37;&#41; or intermediate risk &#40;27&#37;&#41;&#46; The overall incidence of thromboembolic events was 1&#46;5&#37;&#46; Major bleeding events were recorded in 3&#46;89&#37; of patients and all-cause mortality was 3&#46;4&#37;&#46;</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Conclusions</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">In this study&#44; we propose a modified VTE risk score that effectively risk-stratifies a mixed inpatient population during hospital stay&#46; The use of this score may result in improvement of thromboprophylaxis practices in hospitals&#46;</p></span>"
        "secciones" => array:5 [
          0 => array:2 [
            "identificador" => "abst0005"
            "titulo" => "Introduction"
          ]
          1 => array:2 [
            "identificador" => "abst0010"
            "titulo" => "Objectives"
          ]
          2 => array:2 [
            "identificador" => "abst0015"
            "titulo" => "Methods"
          ]
          3 => array:2 [
            "identificador" => "abst0020"
            "titulo" => "Results"
          ]
          4 => array:2 [
            "identificador" => "abst0025"
            "titulo" => "Conclusions"
          ]
        ]
      ]
      "pt" => array:3 [
        "titulo" => "Resumo"
        "resumen" => "<span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Introdu&#231;&#227;o</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">O tromboembolismo venoso &#40;TEV&#41; &#233; uma complica&#231;&#227;o relativamente frequente&#44; complica o internamento hospitalar&#44; e a determina&#231;&#227;o do risco da ocorr&#234;ncia de TEV &#233; essencial&#44; de molde a permitir a escolha da melhor estrat&#233;gia de profilaxia para cada doente&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Objetivo</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Estudar o perfil de risco para TEV em doentes hospitalizados&#44; num grupo de hospitais de Portugal&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">M&#233;todos</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Neste estudo&#44; com a inclus&#227;o duma coorte aberta de 4248 doentes internados nos departamentos de cirurgia&#44; medicina interna&#44; ortopedia ou oncologia&#44; foi determinado na admiss&#227;o o risco tromboemb&#243;lico de cada doente&#44; atrav&#233;s dum novo <span class="elsevierStyleItalic">score</span>&#44; modificado dos <span class="elsevierStyleItalic">scores</span> de Caprini e de Khorana&#46; Os eventos tromb&#243;ticos&#44; emb&#243;licos e hemorr&#225;gicos e morte foram registados durante o internamento e aos tr&#234;s e seis meses ap&#243;s a alta&#46;</p></span> <span id="abst0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Resultados</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">A mediana do tempo de internamento foi de cinco dias e foi administrada terap&#234;utica de profilaxia tromboemb&#243;lica em 67&#44;2&#37; &#40;n&#61;2747&#41; dos doentes&#44; foi usada uma heparina de baixo peso molecular em 59&#44;3&#37; dos casos&#46; A maior parte dos doentes foi classificada com um risco elevado &#40;68&#37;&#41; ou interm&#233;dio &#40;27&#37;&#41;&#46; A incid&#234;ncia global de eventos tromboemb&#243;licos foi de 1&#44;5&#37;&#46; Foram registados eventos hemorr&#225;gicos maiores em 3&#44;89&#37; dos doentes e a mortalidade por todas as causas foi de 3&#44;4&#37;&#46;</p></span> <span id="abst0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Conclus&#245;es</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Neste estudo&#44; os autores prop&#245;em um novo <span class="elsevierStyleItalic">score</span> para avalia&#231;&#227;o do risco de TEV que estratificou de modo efetivo uma popula&#231;&#227;o mista de doentes durante o internamento hospitalar&#46; O uso desse <span class="elsevierStyleItalic">score</span> poder&#225; resultar numa melhoria da pr&#225;tica da tromboprofilaxia nos nossos hospitais&#46;</p></span>"
        "secciones" => array:5 [
          0 => array:2 [
            "identificador" => "abst0030"
            "titulo" => "Introdu&#231;&#227;o"
          ]
          1 => array:2 [
            "identificador" => "abst0035"
            "titulo" => "Objetivo"
          ]
          2 => array:2 [
            "identificador" => "abst0040"
            "titulo" => "M&#233;todos"
          ]
          3 => array:2 [
            "identificador" => "abst0045"
            "titulo" => "Resultados"
          ]
          4 => array:2 [
            "identificador" => "abst0050"
            "titulo" => "Conclus&#245;es"
          ]
        ]
      ]
    ]
    "multimedia" => array:6 [
      0 => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 1903
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            "Tamanyo" => 189513
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        "descripcion" => array:1 [
          "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Study flow diagram&#46; <span class="elsevierStyleSup">a</span>Of the total 4248 patients originally included&#44; 158 were excluded&#44; of whom 63 &#40;39&#46;9&#37;&#41; did not fulfill eligibility criteria&#44; 44 &#40;27&#46;9&#37;&#41; had seriously incomplete records&#44; 42 &#40;26&#46;6&#37;&#41; had no available weight data&#44; and nine &#40;5&#46;7&#37;&#41; had no available hospital discharge and&#47;or follow-up data&#46;</p>"
        ]
      ]
      1 => array:8 [
        "identificador" => "tbl0005"
        "etiqueta" => "Table 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at1"
            "detalle" => "Table "
            "rol" => "short"
          ]
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        "tabla" => array:2 [
          "leyenda" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">BMI&#58; body mass index&#59; CHF&#58; congestive heart failure&#59; COPD&#58; chronic obstructive pulmonary disease&#59; DVT&#58; deep vein thrombosis&#59; HRT&#58; hormone replacement therapy&#59; RhEPO&#58; recombinant human erythropoietin&#46;</p>"
          "tablatextoimagen" => array:1 [
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                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Risk factor&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Points&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Age 40-60 years&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Obesity &#40;BMI &#62;30 kg&#47;m<span class="elsevierStyleSup">2</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Major surgery &#40;&#60;1 month&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Varicose veins&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Smoking&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">CHF &#40;present or &#60;1 month&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Sepsis or severe infection &#40;&#60;1 month&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Acute pulmonary disease&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">COPD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Inflammatory bowel disease&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Oral contraception or HRT&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Pregnancy or postpartum &#40;&#60;1 month&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">History of unexplained stillborn infant&#44; miscarriage&#44; premature birth with toxemia or growth-restricted infant&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Minor surgery&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Lung tumor&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Lymphoma&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Gynecologic cancer&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Genitourinary or prostate cancer&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Platelet count before chemotherapy &#8804;350<span class="elsevierStyleHsp" style=""></span>000&#47;&#956;l&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Hemoglobin &#60;10 g&#47;dl or RhEPO use&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Leukocyte count before chemotherapy &#62;11<span class="elsevierStyleHsp" style=""></span>000&#47;mm<span class="elsevierStyleSup">3</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Medical patient currently at bed rest&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Age 61-74 years&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">BMI &#62;35 kg&#47;m<span class="elsevierStyleSup">2</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Cancer &#40;active or previous&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Patient confined to bed &#40;&#62;72 h&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Immobilization&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Central venous access&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Major surgery &#40;&#62;45 min&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Laparoscopic surgery&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Arthroscopic surgery&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Gastric tumor&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Pancreatic tumor&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Age &#62;74 years&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">History of DVT&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Thrombophilia &#40;per type&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Family history of DVT&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Stroke &#40;&#60;1 month&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Major lower limb arthroplasty&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Pelvic&#44; hip or leg fracture &#40;&#60;1 month&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Acute spinal cord injury &#40;paralysis&#41; &#40;&#60;1 month&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Multiple trauma &#40;&#60;1 month&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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          "en" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Risk factors and corresponding point count for calculation of the ARTE-RAM thromboembolic risk score &#40;adapted from Caprini et al&#46;<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">19</span></a> and Khorana et al&#46;<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">20</span></a>&#41;&#46;</p>"
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          "leyenda" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">BMI&#58; body mass index&#59; CHF&#58; congestive heart failure&#59; COPD&#58; chronic obstructive pulmonary disease&#59; DVT&#58; deep vein thrombosis&#59; HRT&#58; hormone replacement therapy&#59; RhEPO&#58; recombinant human erythropoietin&#46;</p>"
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleItalic">Demographic</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Female&#44; &#37; &#40;n&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">54 &#40;2209&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Age in years&#44; mean &#40;SD&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">57 &#40;17&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Weight in kg&#44; mean &#40;SD&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">71 &#40;15&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>BMI in kg&#47;m<span class="elsevierStyleSup">2</span>&#44; mean &#40;SD&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">26&#46;2 &#40;4&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Body mass index &#62;30 kg&#47;m<span class="elsevierStyleSup">2</span>&#44; &#37; &#40;n&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">17 &#40;695&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleItalic">General aspects</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Family history of DVT&#44; &#37; &#40;n&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">14&#46;5 &#40;592&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Patient confined to bed &#40;&#62;72 h&#41;&#44; &#37; &#40;n&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">16&#46;6 &#40;690&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Immobilization&#44; &#37; &#40;n&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8&#46;9 &#40;364&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Central venous access&#44; &#37; &#40;n&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7&#46;7 &#40;314&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleItalic">Previous history</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Stroke &#40;&#60;1 month&#41;&#44; &#37; &#40;n&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;9 &#40;36&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Deep vein thrombosis history&#44; &#37; &#40;n&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&#46;5 &#40;144&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Cancer &#40;active or previous&#41;&#44; &#37; &#40;n&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">34&#46;6 &#40;1&#44;416&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Major surgery &#40;&#60;1 month&#41;&#44; &#37; &#40;n&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&#46;8 &#40;156&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Varicose veins&#44; &#37; &#40;n&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">30&#46;5 &#40;1&#44;248&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Smoking habits&#44; &#37; &#40;n&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">19&#46;7 &#40;806&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Thrombophilia &#40;per type&#41;&#44; &#37; &#40;n&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;3 &#40;10&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleItalic">Clinical history</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>CHF &#40;present or &#60;1 month&#41;&#44; &#37; &#40;n&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&#46;1 &#40;248&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Sepsis or severe infection &#40;&#60;1 month&#41;&#44; &#37; &#40;n&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&#46;7 &#40;152&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Acute pulmonary disease&#44; &#37; &#40;n&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&#46;5 &#40;266&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>COPD&#44; &#37; &#40;n&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&#46;1 &#40;168&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Medical patient currently at bed rest&#44; &#37; &#40;n&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7&#46;6 &#40;311&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Inflammatory bowel disease&#44; &#37; &#40;n&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;2 &#40;48&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleItalic">Gynecological&#47;obstetric history</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Oral contraception or hormone replacement therapy&#44; &#37; &#40;n&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">15&#46;7 &#40;343&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Pregnancy or postpartum &#40;&#60;1 month&#41;&#44; &#37; &#40;n&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;1 &#40;25&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>History of unexplained stillborn infant&#44; miscarriage&#44; premature birth with toxemia or growth-restricted infant&#44; &#37; &#40;n&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&#46;6 &#40;100&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleItalic">Surgical patients</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Major surgery &#40;&#62;45 min&#41;&#44; &#37; &#40;n&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">47&#46;3 &#40;1&#44;935&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Laparoscopic surgery&#44; &#37; &#40;n&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8&#46;2 &#40;336&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Arthroscopic surgery&#44; &#37; &#40;n&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&#46;9 &#40;161&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Minor elective surgery&#44; &#37; &#40;n&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9&#46;9 &#40;403&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleItalic">Orthopedic patients</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Major lower limb arthroplasty&#44; &#37; &#40;n&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7&#46;2 &#40;294&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Pelvic&#44; hip or leg fracture &#40;&#60;1 month&#41;&#44; &#37; &#40;n&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&#46;3 &#40;134&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Acute spinal cord injury &#40;paralysis&#41; &#40;&#60;1 month&#41;&#44; &#37; &#40;n&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;4 &#40;18&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Multiple trauma &#40;&#60;1 month&#41;&#44; &#37; &#40;n&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;5 &#40;20&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleItalic">Cancer patients under chemotherapy</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Gastric tumor&#44; &#37; &#40;n&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9&#46;0 &#40;130&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Pancreatic tumor&#44; &#37; &#40;n&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;4 &#40;20&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Lung tumor&#44; &#37; &#40;n&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&#46;9 &#40;57&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Lymphoma&#44; &#37; &#40;n&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;4 &#40;20&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Gynecologic cancer&#44; &#37; &#40;n&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">16&#46;2 &#40;129&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Genitourinary or prostate cancer&#44; &#37; &#40;n&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">10&#46;2 &#40;148&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Platelet count before chemotherapy &#8804;350<span class="elsevierStyleHsp" style=""></span>000&#47;&#956;l&#44; &#37; &#40;n&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&#46;9 &#40;71&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Hemoglobin &#60;10 g&#47;dl or RhEPO use&#44; &#37; &#40;n&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&#46;0 &#40;87&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Leukocyte count before chemotherapy &#62;11<span class="elsevierStyleHsp" style=""></span>000&#47;mm<span class="elsevierStyleSup">3</span>&#44; &#37; &#40;n&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&#46;7 &#40;54&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">ARTE-RAM score&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Incidence<br>n &#40;&#37;&#59; 95&#37; CI&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">48 &#40;1&#46;2&#59; 0&#46;9-1&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">144 &#40;3&#46;5&#59; 3&#46;0-4&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">263 &#40;6&#46;4&#59; 5&#46;7-7&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">395 &#40;9&#46;7&#59; 8&#46;8-10&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">432 &#40;10&#46;6&#59; 9&#46;6-11&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">&#8805;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2808 &#40;68&#46;6&#59; 67&#46;2-70&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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          "en" => "<p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">Observed ARTE-RAM scores in the overall population&#46;</p>"
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                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td-with-role" title="table-head ; entry_with_role_rowhead " align="left" valign="top" scope="col">Risk classes &#40;ARTE-RAM score&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Internal medicine&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Oncology&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Orthopedic&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">13 &#40;0&#46;8&#41; &#40;0&#46;4-1&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">23 &#40;3&#46;1&#41; &#40;1&#46;9-4&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">182 &#40;24&#46;3&#41; &#40;21&#46;2-27&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">417 &#40;41&#46;4&#41; &#40;38&#46;4-44&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1385 &#40;88&#46;2&#41; &#40;86&#46;6-89&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">543 &#40;72&#46;5&#41; &#40;69&#46;3-75&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">550 &#40;54&#46;6&#41; &#40;51&#46;5-57&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">&#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">&#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Treated patients&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">592&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">20&#46;3&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;1&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">59&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">505&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">32&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;1&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">20&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">34&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;2&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">622&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">15&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">41&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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        "descripcion" => array:1 [
          "en" => "<p id="spar0100" class="elsevierStyleSimplePara elsevierViewall">Thromboembolic prophylaxis&#46;</p>"
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    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0015"
          "bibliografiaReferencia" => array:33 [
            0 => array:3 [
              "identificador" => "bib0170"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Incidence of venous thromboembolism&#58; a community-based study in Western France&#46; EPI-GETBP Study Group&#46; Groupe d&#8217;Etude de la Thrombose de Bretagne Occidentale"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "E&#46; Oger"
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                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Thromb Haemost"
                        "fecha" => "2000"
                        "volumen" => "83"
                        "paginaInicial" => "657"
                        "paginaFinal" => "660"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10823257"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
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            1 => array:3 [
              "identificador" => "bib0175"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The Surgeon General&#39;s call to action to prevent deep vein thrombosis and pulmonary embolism"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "US OOTSG"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Libro" => array:3 [
                        "fecha" => "2008"
                        "editorial" => "U&#46;S&#46; Public Health Service&#44; Office of the Surgeon General"
                        "editorialLocalizacion" => "Rockville&#44; MD"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0180"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Venous thromboembolism prophylaxis in acutely ill hospitalized medical patients&#58; findings from the International Medical Prevention Registry on Venous Thromboembolism"
                      "autores" => array:1 [
                        0 => array:2 [
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        "texto" => "<p id="par0200" class="elsevierStylePara elsevierViewall">The authors acknowledge the principal investigators who participated in the study&#58; Dr&#46; Aida Paulino &#40;Hospital Amato Lusitano&#41;&#59; Dr&#46; Belarmino Clemente &#40;Hospital Santa Cruz&#41;&#59; Dr&#46; Daniel Ferreira &#40;Hospital da Luz&#41;&#59; Dr&#46; Dialina Brilhante &#40;Instituto Portugu&#234;s de Oncologia de Lisboa &#8211; Francisco Gentil&#41;&#59; Dr&#46; Diogo Silva Gomes &#40;Hospital de Faro&#41;&#59; Dr&#46; Jo&#227;o Pacheco Pereira &#40;Hospital Egas Moniz&#41;&#59; Dr&#46; Joaquim Abreu de Sousa &#40;Instituto Portugu&#234;s de Oncologia do Porto &#8211; Francisco Gentil&#41;&#59; Dr&#46; Joaquim Lebre &#40;Centro Hospitalar Vila Nova de Gaia&#47;Espinho&#41;&#59; Dr&#46; Jorge Rold&#227;o Vieira &#40;Hospital Garcia de Orta&#41;&#59; Dr&#46; L&#250;cia Borges &#40;Hospital Infante D&#46; Pedro&#41;&#59; Dr&#46; Lu&#237;s Branco Amaral &#40;Hospital Curry Cabral&#41;&#59; Dr&#46; Paulo Felic&#237;ssimo &#40;Hospital Prof&#46; Doutor Fernando Fonseca&#41;&#59; Dr&#46; Pedro Carvalho &#40;Hospital S&#227;o Francisco Xavier&#41;&#59; Dr&#46; Rubina Silva &#40;Hospital Pedro Hispano&#41;&#46;</p>"
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