Incidencia de delírium en una población de adultos mayores de 65 años, hospitalizados en un centro de referencia del nororiente colombiano

El delírium es un síndrome neuropsiquiátrico que se presenta de forma frecuente en el adulto mayor hospitalizado. Tiene factores de riesgo que sustentan la teoría multifactorial como desencadenante durante la estancia hospitalaria. Se considera que el desarrollo de delírium y eventos adversos (caída...

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Autores:
Cadena Sanabria, Miguel Oswaldo
González Aparicio, Álvaro Alexis
Serrano Gómez, Sergio Eduardo
Carrillo Parada, Manuela Fernanda
Ballesteros Tapias, Jennifer Katherine
Martínez Vega, Bárbara Lizeth
Granados Oliveros, Lina María
Santana Porras, Julián David
Carrillo Márquez, Melissa K.
Roa Luna, Stefanie
Garavito Santos, Zully Nayibe
Tipo de recurso:
http://purl.org/coar/resource_type/c_f744
Fecha de publicación:
2017
Institución:
Universidad Autónoma de Bucaramanga - UNAB
Repositorio:
Repositorio UNAB
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spa
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oai:repository.unab.edu.co:20.500.12749/16980
Acceso en línea:
http://hdl.handle.net/20.500.12749/16980
Palabra clave:
Delirium
Elderly
Incidence
Hospital stay
Event adverse
Health sciences
Research proposal
Hotbeds of research
UNAB
Event memories
Ciencias de la salud
Propuesta de investigación
Semilleros de investigación
UNAB
Memorias de evento
Delirium
Adulto mayor
Incidencia
Estancia hospitalaria
Evento adverso
Rights
License
http://creativecommons.org/licenses/by-nc-nd/2.5/co/
id UNAB2_352f8d6dc69e37457735394b13c938f5
oai_identifier_str oai:repository.unab.edu.co:20.500.12749/16980
network_acronym_str UNAB2
network_name_str Repositorio UNAB
repository_id_str
dc.title.spa.fl_str_mv Incidencia de delírium en una población de adultos mayores de 65 años, hospitalizados en un centro de referencia del nororiente colombiano
dc.title.translated.spa.fl_str_mv Incidence of delirium in a population of adults over 65 years of age, hospitalized in a reference center in northeastern Colombia
title Incidencia de delírium en una población de adultos mayores de 65 años, hospitalizados en un centro de referencia del nororiente colombiano
spellingShingle Incidencia de delírium en una población de adultos mayores de 65 años, hospitalizados en un centro de referencia del nororiente colombiano
Delirium
Elderly
Incidence
Hospital stay
Event adverse
Health sciences
Research proposal
Hotbeds of research
UNAB
Event memories
Ciencias de la salud
Propuesta de investigación
Semilleros de investigación
UNAB
Memorias de evento
Delirium
Adulto mayor
Incidencia
Estancia hospitalaria
Evento adverso
title_short Incidencia de delírium en una población de adultos mayores de 65 años, hospitalizados en un centro de referencia del nororiente colombiano
title_full Incidencia de delírium en una población de adultos mayores de 65 años, hospitalizados en un centro de referencia del nororiente colombiano
title_fullStr Incidencia de delírium en una población de adultos mayores de 65 años, hospitalizados en un centro de referencia del nororiente colombiano
title_full_unstemmed Incidencia de delírium en una población de adultos mayores de 65 años, hospitalizados en un centro de referencia del nororiente colombiano
title_sort Incidencia de delírium en una población de adultos mayores de 65 años, hospitalizados en un centro de referencia del nororiente colombiano
dc.creator.fl_str_mv Cadena Sanabria, Miguel Oswaldo
González Aparicio, Álvaro Alexis
Serrano Gómez, Sergio Eduardo
Carrillo Parada, Manuela Fernanda
Ballesteros Tapias, Jennifer Katherine
Martínez Vega, Bárbara Lizeth
Granados Oliveros, Lina María
Santana Porras, Julián David
Carrillo Márquez, Melissa K.
Roa Luna, Stefanie
Garavito Santos, Zully Nayibe
dc.contributor.author.none.fl_str_mv Cadena Sanabria, Miguel Oswaldo
González Aparicio, Álvaro Alexis
Serrano Gómez, Sergio Eduardo
Carrillo Parada, Manuela Fernanda
Ballesteros Tapias, Jennifer Katherine
Martínez Vega, Bárbara Lizeth
Granados Oliveros, Lina María
Santana Porras, Julián David
Carrillo Márquez, Melissa K.
Roa Luna, Stefanie
Garavito Santos, Zully Nayibe
dc.contributor.cvlac.spa.fl_str_mv Cadena Sanabria, Miguel Oswaldo [0001339250]
González Aparicio, Álvaro Alexis [0001374105]
Serrano Gómez, Sergio Eduardo [0001521095]
Carrillo Parada, Manuela Fernanda [0001816569]
Ballesteros Tapias, Jennifer Katherine [0001816568]
Martínez Vega, Bárbara Lizeth [0001816725]
Granados Oliveros, Lina María [0000002762]
Garavito Santos, Zully Nayibe [0001634309]
Santana Porras, Julián David [0000162996]
dc.contributor.googlescholar.spa.fl_str_mv Cadena Sanabria, Miguel Oswaldo [jQUx5WcAAAAJ]
Ballesteros Tapias, Jennifer Katherine [2fR_LQsAAAAJ]
Santana Porras, Julián David [cz6Eef0AAAAJ]
dc.contributor.orcid.spa.fl_str_mv Cadena Sanabria, Miguel Oswaldo [0000-0001-9807-3029]
González Aparicio, Álvaro Alexis [0000-0001-7749-4342]
Serrano Gómez, Sergio Eduardo [0000-0001-6418-7116]
Ballesteros Tapias, Jennifer Katherine [0000-0001-9229-8091]
Granados Oliveros, Lina María [0000-0002-0770-388X]
dc.contributor.scopus.spa.fl_str_mv Cadena Sanabria, Miguel Oswaldo [56437735000]
Serrano Gómez, Sergio Eduardo [57197758865]
Granados Oliveros, Lina María [57215412422]
dc.contributor.researchgroup.spa.fl_str_mv Grupo de Investigación en Ciencias y Educación en Salud
Grupo de Investigaciones Clínicas
dc.subject.keywords.spa.fl_str_mv Delirium
Elderly
Incidence
Hospital stay
Event adverse
Health sciences
Research proposal
Hotbeds of research
UNAB
Event memories
topic Delirium
Elderly
Incidence
Hospital stay
Event adverse
Health sciences
Research proposal
Hotbeds of research
UNAB
Event memories
Ciencias de la salud
Propuesta de investigación
Semilleros de investigación
UNAB
Memorias de evento
Delirium
Adulto mayor
Incidencia
Estancia hospitalaria
Evento adverso
dc.subject.lemb.spa.fl_str_mv Ciencias de la salud
Propuesta de investigación
Semilleros de investigación
UNAB
Memorias de evento
dc.subject.proposal.spa.fl_str_mv Delirium
Adulto mayor
Incidencia
Estancia hospitalaria
Evento adverso
description El delírium es un síndrome neuropsiquiátrico que se presenta de forma frecuente en el adulto mayor hospitalizado. Tiene factores de riesgo que sustentan la teoría multifactorial como desencadenante durante la estancia hospitalaria. Se considera que el desarrollo de delírium y eventos adversos (caídas, ulceras por presión y desalojo de dispositivos) van en paralelo, asociándose con mayor riesgo de mortalidad, deterioro cognitivo y declinación funcional. En Santander, no hay publicados estudios que describan su incidencia y factores epidemiológicos asociados
publishDate 2017
dc.date.issued.none.fl_str_mv 2017-11
dc.date.accessioned.none.fl_str_mv 2022-07-18T21:23:56Z
dc.date.available.none.fl_str_mv 2022-07-18T21:23:56Z
dc.type.eng.fl_str_mv Conference
dc.type.driver.spa.fl_str_mv info:eu-repo/semantics/conferenceProceedings
dc.type.local.spa.fl_str_mv Memoria de eventos
dc.type.coar.none.fl_str_mv http://purl.org/coar/resource_type/c_f744
dc.type.hasversion.spa.fl_str_mv info:eu-repo/semantics/acceptedVersion
dc.type.redcol.none.fl_str_mv http://purl.org/redcol/resource_type/EC_AC
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dc.identifier.issn.spa.fl_str_mv ISSN 2344-7079
dc.identifier.uri.none.fl_str_mv http://hdl.handle.net/20.500.12749/16980
dc.identifier.instname.spa.fl_str_mv instname:Universidad Autónoma de Bucaramanga - UNAB
dc.identifier.reponame.spa.fl_str_mv reponame:Repositorio Institucional UNAB
dc.identifier.repourl.spa.fl_str_mv repourl:https://repository.unab.edu.co
identifier_str_mv ISSN 2344-7079
instname:Universidad Autónoma de Bucaramanga - UNAB
reponame:Repositorio Institucional UNAB
repourl:https://repository.unab.edu.co
url http://hdl.handle.net/20.500.12749/16980
dc.language.iso.spa.fl_str_mv spa
language spa
dc.relation.ispartofseries.spa.fl_str_mv Generación Creativa : Encuentro de Semilleros de Investigación UNAB
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dc.relation.references.spa.fl_str_mv Saxena S, Lawley D. Delirium in the elderly: a clinical review. Postgrad Med J 2009;85:405-413.
Marcantonio ER. Confusion about confusion: What is delirium, and what should you do about it? Geriatric medicine course, Harvard Medical School: Boston-MA, 1996; 155-64.
American Psychiatric Association, Diagnostic and Statistical Manual, 5th Ed, APA Press, Washington, DC 2013.
Phy MP, Vanness DJ, Melton LJ 3rd, Long KH, Schleck CD, Larson DR, et al. Effects of a hospital model on elderly patients with hip fracture. Arch Inter Med. 2005; 165(7):796-801.
Inouye SK. Delirium in Older Persons. N Engl J Med 2006;354:1157-65
Von Elm E, Altman DG, Egger M, Pocock SJ, Gotzsche PC, Vandenbroucke JP. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Lancet 2007;370:1453-57.
Inouye SK. The Dilemma of Delirium: Clinical and Research Controversies Regarding Diagnosis and Evaluation of Delirium in Hospitalized Elderly Medical Patients. The American Journal of Medicine 1994;97(3):278-88
Massie MJ, Holland J, Glass E. Delirium in the terminally ill cancer patients. A prospective study. Cancer 1996; 78:1131-7.
Wilber ST, Ondrejka JE. Altered Mental Status and Delirium. Emerg Med Clin N Am 2016; 34:649-65.
Inouye SK, Westendorp RGJ, Saczynski JS. Delirium in elderly people. The lancet 2014; 383 (9920):911-22.
Calderon M, Castuera AI, Díez P, Fernandez M. Medicine 2015;11(89):5303-13.
Veiga F, Cruz A. Etiología y fisiopatología del delirium. Rev Esp Geriatr Gerontol. 2008;43(3):4-12.
National Institute for Health and Care Excellence. Delirium: prevention, diagnosis and management, Clinical guideline 2010.
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González M, De Pablo J, Fuente F, Valdes M, Peri JM, Nomdedeu M, Matrai S. Instrument for Detection of delirium in General Hospitals: Adaptation of the confusion Assessment Method. Psychosomatics. 2004; 45:426-31.
O‘Keeffe ST, Lavan JN. Clinical significance of the delirium subtipes in older people. Age Ageing 1999;26:115-19.
Stagno D, Gibson C, Breibart W. The Delirium subtypes: a review of prevalence, phenomenology, pathophysiology and treatment response. Palliative and Supportive Care 2004;2:171-9.
Brennan T, Leape L, et al. Incidence of adverse events and negligence in hospitalizad patients. Qual Saf Health Care 2004;13:145–152.
González M, Uslar W, et al. Coste hospitalario asociado al delírium en pacientes mayores. Rev Esp Geriatr Gerontol. 2012;47(1):23–26.
Convertino V. Cardiovascular consequences of bed rest: effect on maximal oxygen uptake. Med Sci Sports Exerc. 1997(2):191-6
Yu S, et al. Sarcopenia in older people. Int J Evid Based Health. 2014(4):227-43
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Brown C, Friedkin R, Inouye S. Prevalence and Outcomes of Low Mobility in Hospitalized Older Patients. JAGS. 204;52:1263-1270.
Kortebeil P, Symons T, et al. Functional impact of 10 days of bed rest in Healthy older adults. J Gerontol A Biol Sci Med Sci. 2008;63(10):1076-81.
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Bail K, Goss J, Draper B, Berry H, Karmer R, Gibson D. The cost of hospital-acquired complications for older people with and without dementia; a retrospective cohort study. BMC Health Services Research (2015) 15:91
Tropea J, LoGiudice D, Liew D, Gorelik A, Brand C.. Poorer outcomes and greater healthcare costs for hospitalised older people with dementia and delirium: a retrospective cohort study. Int J Geriatr Psychiatry 2016.
Tahir TA, Mahajan D. Delirium. Psychiatric Aspects of General Medicine. 2016;44(12):724-8.
Fong TG, Tulebaev SR, Inouye SK. Delirium in the elderly adults: diagnosis, prevention and treatment. Nat Rev Neurol. 2009;5(4):210-20.
Florez PP, Velásquez JD. Frecuencia y factores de riesgo de delirium en población geriátrica en la unidad de cuidado intensivos (UCI) de la Clínica Reina Sofia en Bogotá. Rev Medica Sanitas 2009;12(3):66-73.
Hospital Elder Life Program (HELP) for Prevention of Delirium. Disponible en www.hospitalelderlifeprogram.org
Ahmed S,Leurent B, Sampson EL. Risk factors for incident delirium among older people in acute hospital medical units: a systematic review and meta-analysis. Age and Ageing 2014; 43:326-333.
Restrepo D, Cardeño C, Páramo L, Ospina S, Calle j. Delirium: incidencia y características clínicas y epidemiológicas en un hospital universitario. Rev Colomb Psiquiat, vol. 38;3:2009.
Aslaner MA, Boz M, Celik A, Ahmedali A, Eroglu S, Aksu NM, Eroglu SE. Etiologies and Delirium Rates of Ederly ED Patients with Acutely Altered Mental Status: A Multicenter Prospective Study. Am J Emerg Med. 2016; manuscript
Bellelli G, Morandi A, Di Santo S, Mazzone A, Cherubini A, Mossello E, Bo M, Bianchetti A, Rozzini R, Zanetti E, Musicco M, Ferrari A, Ferrara N, Trabucchi M. Delirium Day: Anationwide point prevalence study of delirium in older hospitalized patients using an easy standardize diagnostic tool. BMC Medicine 2016. 14:106
Petersen PB, Jorgensen CC, Kehlet H. Delirium after fasttrak hip an knee arthroplasty – a cohort study of 6331 elderly patients. The Acta Anaesthesiologica Scandinavica Foundation. 2017;61:767-772.
Isfandiaty R, Harimurti K, Setiati S, Roosheroe A. Incidence and Predictors for Delirium in Hospitalized Patients: a Retrospective Cohort Study. The Indonesian Journal of Internal Medicine 2012; Vol 44;4:290-297.
Liao Y, Flaherty JH, Yue J, Wang Y, Deng C, Chen L. The incidence of delirium after cardiac surgery in the elderly: protocol for a systematic review and meta-analysis. BMJ 2017;7:e014726
Carrasco M, Accatino-Scagliotti L, Calderon J, Villarroel L, Marin PP, González M. Impacto del delírium en pacientes de edad avanzada hospitalizados: un estudio prospectivo de cohortes. Rev Med Chile 2012;140:847-52.
Witlox J, Eurelings LS, deJonghe JF, Kalisvaart KJ, Eikelenboom P, Van Gool WA. Delirium in the elderly patients and the Risk of postdischarge mortality, institutionalitation, and dementia: a meta-analysis. JAMA 2010;304(4):443-51.
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Sannella, M. J. 1994. Constraint Satisfaction and Debugging for Interactive User Interfaces. Doctoral Thesis. UMI Order Number: UMI Order No. GAX95-09398., University of Washington.
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Yu, Y. T. and Lau, M. F. 2006. A comparison of MC/DC, MUMCUT and several other coverage criteria for logical decisions. J. Syst. Softw. 79, 5 (May. 2006), 577-590. DOI= http://dx.doi.org/10.1016/j.jss.2005.05.030.
Spector, A. Z. 1989. Achieving application requirements. In Distributed Systems, S. Mullender, Ed. ACM Press Frontier Series. ACM, New York, NY, 19-33. DOI= http://doi.acm.org/10.1145/90417.90738.
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dc.coverage.spatial.spa.fl_str_mv Bucaramanga (Santander, Colombia)
dc.coverage.temporal.spa.fl_str_mv 2017
dc.publisher.grantor.spa.fl_str_mv Universidad Autónoma de Bucaramanga UNAB
dc.publisher.faculty.none.fl_str_mv Facultad Ciencias de la Salud
dc.publisher.program.none.fl_str_mv Pregrado Medicina
dc.publisher.deparment.spa.fl_str_mv Sistema de Investigación SIUNAB
dc.source.spa.fl_str_mv Generación Creativa. Generación Creativa : Encuentro de Semilleros de Investigación UNAB ; Volumen 06, Número 06 (Noviembre 2017) ; páginas 39-45
institution Universidad Autónoma de Bucaramanga - UNAB
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spelling Cadena Sanabria, Miguel Oswaldo37621265-7d57-4f31-aecf-1ceff550e3f9González Aparicio, Álvaro Alexisc48c18a6-e77f-4144-a90f-a2ea0b96aea4Serrano Gómez, Sergio Eduardo39fd82cc-6a26-48df-8091-73e9d7a0a86bCarrillo Parada, Manuela Fernanda602ae125-83aa-409a-9ec7-ac66594e9343Ballesteros Tapias, Jennifer Katherine33c932a2-6af8-4046-a216-a250e8d04daaMartínez Vega, Bárbara Lizeth8d11b301-68f8-472e-a443-372e37ae2952Granados Oliveros, Lina María684c45e7-fdf9-4dba-93e3-6d834a15f6b3Santana Porras, Julián David8f5be37d-4f67-4026-ab36-30c893e9b2a0Carrillo Márquez, Melissa K.3f515c91-38fd-4a1b-899a-2f3ee8297b6bRoa Luna, Stefaniece6c9a66-57e1-42e4-abb1-1629c0594c7cGaravito Santos, Zully Nayibee0eda4e3-982a-4738-becf-f65822ecf45cCadena Sanabria, Miguel Oswaldo [0001339250]González Aparicio, Álvaro Alexis [0001374105]Serrano Gómez, Sergio Eduardo [0001521095]Carrillo Parada, Manuela Fernanda [0001816569]Ballesteros Tapias, Jennifer Katherine [0001816568]Martínez Vega, Bárbara Lizeth [0001816725]Granados Oliveros, Lina María [0000002762]Garavito Santos, Zully Nayibe [0001634309]Santana Porras, Julián David [0000162996]Cadena Sanabria, Miguel Oswaldo [jQUx5WcAAAAJ]Ballesteros Tapias, Jennifer Katherine [2fR_LQsAAAAJ]Santana Porras, Julián David [cz6Eef0AAAAJ]Cadena Sanabria, Miguel Oswaldo [0000-0001-9807-3029]González Aparicio, Álvaro Alexis [0000-0001-7749-4342]Serrano Gómez, Sergio Eduardo [0000-0001-6418-7116]Ballesteros Tapias, Jennifer Katherine [0000-0001-9229-8091]Granados Oliveros, Lina María [0000-0002-0770-388X]Cadena Sanabria, Miguel Oswaldo [56437735000]Serrano Gómez, Sergio Eduardo [57197758865]Granados Oliveros, Lina María [57215412422]Grupo de Investigación en Ciencias y Educación en SaludGrupo de Investigaciones ClínicasBucaramanga (Santander, Colombia)20172022-07-18T21:23:56Z2022-07-18T21:23:56Z2017-11ISSN 2344-7079http://hdl.handle.net/20.500.12749/16980instname:Universidad Autónoma de Bucaramanga - UNABreponame:Repositorio Institucional UNABrepourl:https://repository.unab.edu.coEl delírium es un síndrome neuropsiquiátrico que se presenta de forma frecuente en el adulto mayor hospitalizado. Tiene factores de riesgo que sustentan la teoría multifactorial como desencadenante durante la estancia hospitalaria. Se considera que el desarrollo de delírium y eventos adversos (caídas, ulceras por presión y desalojo de dispositivos) van en paralelo, asociándose con mayor riesgo de mortalidad, deterioro cognitivo y declinación funcional. En Santander, no hay publicados estudios que describan su incidencia y factores epidemiológicos asociadosDelirium is a neuropsychiatric syndrome that occurs frequently in hospitalized older adults. It has risk factors that support the multifactorial theory as a trigger during hospital stay. It is considered that the development of delirium and adverse events (falls, pressure ulcers, and device dislodgement) go hand in hand, being associated with an increased risk of mortality, cognitive impairment, and functional decline. In Santander, there are no published studies that describe its incidence and associated epidemiological factorsapplication/pdfspaGeneración Creativa : Encuentro de Semilleros de Investigación UNABhttp://hdl.handle.net/20.500.12749/14239Saxena S, Lawley D. Delirium in the elderly: a clinical review. Postgrad Med J 2009;85:405-413.Marcantonio ER. Confusion about confusion: What is delirium, and what should you do about it? Geriatric medicine course, Harvard Medical School: Boston-MA, 1996; 155-64.American Psychiatric Association, Diagnostic and Statistical Manual, 5th Ed, APA Press, Washington, DC 2013.Phy MP, Vanness DJ, Melton LJ 3rd, Long KH, Schleck CD, Larson DR, et al. Effects of a hospital model on elderly patients with hip fracture. Arch Inter Med. 2005; 165(7):796-801.Inouye SK. Delirium in Older Persons. N Engl J Med 2006;354:1157-65Von Elm E, Altman DG, Egger M, Pocock SJ, Gotzsche PC, Vandenbroucke JP. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Lancet 2007;370:1453-57.Inouye SK. The Dilemma of Delirium: Clinical and Research Controversies Regarding Diagnosis and Evaluation of Delirium in Hospitalized Elderly Medical Patients. The American Journal of Medicine 1994;97(3):278-88Massie MJ, Holland J, Glass E. Delirium in the terminally ill cancer patients. A prospective study. Cancer 1996; 78:1131-7.Wilber ST, Ondrejka JE. Altered Mental Status and Delirium. Emerg Med Clin N Am 2016; 34:649-65.Inouye SK, Westendorp RGJ, Saczynski JS. Delirium in elderly people. The lancet 2014; 383 (9920):911-22.Calderon M, Castuera AI, Díez P, Fernandez M. Medicine 2015;11(89):5303-13.Veiga F, Cruz A. Etiología y fisiopatología del delirium. Rev Esp Geriatr Gerontol. 2008;43(3):4-12.National Institute for Health and Care Excellence. 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Generación Creativa : Encuentro de Semilleros de Investigación UNAB ; Volumen 06, Número 06 (Noviembre 2017) ; páginas 39-45Incidencia de delírium en una población de adultos mayores de 65 años, hospitalizados en un centro de referencia del nororiente colombianoIncidence of delirium in a population of adults over 65 years of age, hospitalized in a reference center in northeastern ColombiaConferenceinfo:eu-repo/semantics/conferenceProceedingsMemoria de eventoshttp://purl.org/coar/resource_type/c_f744info:eu-repo/semantics/acceptedVersionhttp://purl.org/redcol/resource_type/EC_ACUniversidad Autónoma de Bucaramanga UNABFacultad Ciencias de la SaludPregrado MedicinaSistema de Investigación SIUNABDeliriumElderlyIncidenceHospital stayEvent adverseHealth sciencesResearch proposalHotbeds of researchUNABEvent memoriesCiencias de la saludPropuesta de investigaciónSemilleros de investigaciónUNABMemorias de eventoDeliriumAdulto mayorIncidenciaEstancia hospitalariaEvento adversoORIGINALGeneración_creativa_2017-39-45.pdfGeneración_creativa_2017-39-45.pdfArtículoapplication/pdf479171https://repository.unab.edu.co/bitstream/20.500.12749/16980/1/Generaci%c3%b3n_creativa_2017-39-45.pdfe73d3b69f8c0732629952725f0819b43MD51open accessLICENSElicense.txtlicense.txttext/plain; charset=utf-8829https://repository.unab.edu.co/bitstream/20.500.12749/16980/2/license.txt3755c0cfdb77e29f2b9125d7a45dd316MD52open accessTHUMBNAILGeneración_creativa_2017-39-45.pdf.jpgGeneración_creativa_2017-39-45.pdf.jpgIM Thumbnailimage/jpeg9925https://repository.unab.edu.co/bitstream/20.500.12749/16980/3/Generaci%c3%b3n_creativa_2017-39-45.pdf.jpg8b0df1eb5801531d231e21f914bc8aa4MD53open access20.500.12749/16980oai:repository.unab.edu.co:20.500.12749/169802024-01-18 17:53:43.755open accessRepositorio Institucional | Universidad Autónoma de Bucaramanga - UNABrepositorio@unab.edu.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