'2/25725$&,&2',$*1267,&2',)(5(1&,$/

-26(5$021$*8,/$55(*8(52(3(66(59,&,23529,1&,$/'(0$/$*$

'2/25725$&,&2',$*1267,&2',)(5(1&,$/'(),1,&,21GRORU WRUiFLFR FXDOTXLHUPROHVWLDR VHQVDFLyQDQyPDODORFDOL]DGDHQHOWyUD[SRUHQFLPDGHOGLDIUDJPD/DVVHQVDFLRQHV GRORURVDV HQ OD SDUHG WRUiFLFD DVt FRPR ORV LPSXOVRVQHUYLRVRV GH ODVYtVFHUDV WRUiFLFDV FRQIOX\HQ DQLYHO GH ODV DVWDV SRVWHULRUHV GH OD PHGXOD SRU HOOR GRORUHV WRUiFLFRV GH RULJHQ GLVWLQWR WLHQHQ XQD PLVPDORFDOL]DFLyQ /D SUR\HFFLyQ PHGXODU GH GLFKR HVWLPXOR HV PX\ DPSOLD GHVGH & D ' OR TXH MXVWLILFD TXH ODHVWUXFWXUDV WRUiFLFDV SXHGDQ SUHVHQWDU DGHPiV GRORU UHIHULGR D PDQGtEXOD KRPEURV EUD]RV HVSDOGD \DEGRPHQUHSUHVHQWDQGR XQ GH ODV XUJHQFLDV PHGLFDV 3XHGH GHEHUVH D P~OWLSOHV FDXVDV SHUR HQ XUJHQFLDV ODDFWXDFLyQPHGLFDGHEHLURULHQWDGDDGHVFDUWDU\WUDWDUODVFDXVDVGHGRORUWRUiFLFRSRWHQFLDOPHQWHPRUWDOHVHQEUHYH SOD]R ,1)$572 '( 0,2&$5',2 $1*,1$ ,1(67$%/( 3(5,&$5',7,6 7$321$0,(172&$5',$&2$1(85,60$',6(&$17('($257$0(',$67,1,7,652785$(62)$*,&$(0%2/,$(,1)$57238/021$51(802725$;$7(16,21(7,2/2*,$/D&DUGLRSDWtD ,VTXpPLFD UHSUHVHQWDDOUHGHGRUGHOGH ODV FDXVDVGHGRORU WRUiFLFR6HJ~Q VXRULJHQHOGRORUWRUiFLFRVHFODVLILFDHQ 25,*(1&$5',$&2$ ,648(0,&$ +7$ VLVWHPLFD +7$ SXOPRQDU HVSDVPR \ HPEROLD FRURQDULD DUWHULRHVFOHURVLV HVWHQRVLVDRUWLFDPLRFDUGLRSDWLDKLSHUWURILFDDQHPLDVHYHUDKLSHUWLURLGLVPR%12,648(0,&2 SHULFDUGLWLVPLRFDUGLWLVSURODSVRPLWUDOURWXUDGHFXHUGDWHQGLQRVD\PLRFDUGLRSDWLD&$257,&2 DQHXULVPDGLVHFDQWHDQHXULVPDVLILOtWLFR

25,*(1(1275$6(6758&785$6725$&,&$6$38/021 QHXPRQtDHPEROLDHLQIDUWRSXOPRQDUFDUFLQRPDSXOPRQDUWUDTXHLWLVEURQTXLWLV%3/(85$ SOHXULWLVQHXPRWRUD[KHPRWRUD[HPSLHPDPHVRWHOLRPD&0(',$67,12PHGLDVWLQLWLVDJXGDHQILVHPDPHGLDVWLQLFRWXPRUHV'(62)$*2 DFKDODVLDXOFXVHVSDVPRHVRIDJLFRGLYHUWLFXORUHJOXMRWXPRUSHUIRUDFLyQ) 18(52*(12 FRPSUHVLyQ UDGLFXODU KHUSHV ]RVWHU FRVWLOOD FHUYLFDO VLQGURPH KRPEUR PDQR OHVLyQ GHSOH[REUDTXLDOHVSRQGLOLWLVQHXULWLVLQWHUFRVWDO

086&8/2(648(/(7,&2 PLRVLWLV HVSDVPRPXVFXODU ILEURVLWLV HVTXLQFH VtQGURPH GH 7LHW]H EXUVLWLVVXEDFURPLDOWUDXPDWLVPRFRVWDOHVWHUQDORYHUWHEUDOWXPRUFRVWDOHVWHUQDORYHUWHEUDORVWHRSRURVLVRVWHRPDODFLDKLSHUFLIRVLVPLHORPDHVSRQGLORDUWURVLV */$1'8/$5 PDVWRGLQLDPDVWLWLVIOHELWLVGHYHQDVWRUiFLFDVWXPRUPDPDULR25,*(1 ,1)5$',$)5$*0$7,&2 SHULWRQLWLV FROHFLVWLWLV XOFHUD SpSWLFD FROHOLWLDVLV SDQFUHDWLWLVSHUIRUDFLyQJDVWURLQWHVWLQDOWXPRU 25,*(136,&2*(12 GHSUHVLyQDQVLHGDGVLPXODFLyQVHFXQGDULRDKLSHUYHQWLODFLyQ

7$%/$,&$86$6327(1&,$/0(17(0257$/(6'('2/25725$&,&2 $1*25,1(67$%/( 1(802725$;$7(16,21 ,1)$572$*8'2'(0,2&$5',2 3(5)25$&,21(62)$*,&$ 7520%2(0%2/,60238/021$50(',$67,1,7,6 ',6(&&,21'($257$ 7$321$0,(172&$5',$&2

',$*1267,&2(Q PHGLRV H[WUDKRVSLWDODULRV 89, 029,/ VH EDVDQ HQ OD DQDPQHVLV OD H[SORUDFLyQ ItVLFD FRQVWDQWHVYLWDOHV(.*(QXQSULPHUPRPHQWRDXQTXHQRVHOOHJXHDXQGLDJQyVWLFRGHILQLWLYRVHGHEHQH[FOXLUDTXHOODVFDXVDVTXHVXSRQJDQXQULHVJRYLWDODFRUWRSOD]RH[SXHVWDVHQOD7$%/$,&XDOTXLHUGRORUWRUiFLFRSXHGHVHUHQFXDGUDGRGHQWURGHFXDOHVTXLHUDGHORVSDWURQHVVLJXLHQWHV 3$7521 ,648(0,&2 HO GRORU WtSLFR GH OD DQJLQD GH SHFKR HV RSUHVLYR TXHPDQWH UHWURHVWHUQDOFRQVWULFWLYRTXHLUUDGLDDEUD]RL]TXLHUGRFXHOORPDQGtEXODHSLJDVWULRKRPEURHVSDOGDTXHGXUDPHQRVGHPLQXWRVTXHSXHGHLUDFRPSDxDGRGHVtQWRPDVDVRFLDGRVFRUWHMRYHJHWDWLYRGLVQHD WRVSDOSLWDFLRQHVTXH VHUHODFLRQDFRQHOHMHUFLFLRODFRPLGDODVHPRFLRQHVHOIUtR\HPSHRUDFRQHOWDEDFRPHMRUDQGRHQPHQRVGHPLQXWRVFRQHOUHSRVRODQLWURJOLFHULQDVXEOLQJXDORDPERV/DQLWURJOLFHULQDVXEOLQJXDOWLHQHHIHFWRVPX\UiSLGRVPHQRVGHPLQXWRVSRUORTXHFXDQGRHOGRORUWDUGDHQFHGHUPDVGHPLQXWRVGHEHGHDWULEXLUVHDOHIHFWR SODFHER GHO IiUPDFR 8Q GRORU GHELGR D HVSDVPR HVRIDJLFR R D FyOLFR ELOLDU SXHGH DOLYLDUVH FRQ 17*VXEOLQJXDO(QHO,$0 ODGXUDFLyQVXHOHVHUVXSHULRUDPLQXWRVODLQWHQVLGDGPD\RU\QRORDOLYLDQHOUHSRVRQLOD17*(OPDVDMHGHOVHQRFDURWLGHR\ODPDQLREUDGH9DOVDOYDSXHGHQDOLYLDUHOGRORUGHODDQJLQD(QFDPELRODSUHVLyQHMHUFLGDDQLYHOGHOSUHFRUGLRQRPRGLILFDSDUDQDGDHOGRORU

(/ '2/25 $1*,21262 38('( (;&/8,56( +$%,78$/0(17( (1 /$6 6,*8,(17(6&,5&8167$1&,$6

6LVHSXHGHORFDOL]DUDSXQWDGHGHGRFRQXQVRORGHGR

6LGXUDPHQRVGHVHJXQGRVRPDVGHPLQXWRV

6LHOGRORUHVHQIRUPDGHSLQFKD]RVYLROHQWRVRFRPRSDOSLWDFLRQHV

6LODLQWHQVLGDGGHOGRORUHVILUPHPHQWHDJXGD

6LDSDUHFHH[FOXVLYDPHQWHHVWDQGRHQUHSRVR H[FHSWR HQODDQJLQDGH3ULQ]PHWDO YDVRHVSDVPRHQODTXHVXUHSHWLFLyQFtFOLFDHQXQPRPHQWRGHWHUPLQDGRGHOGRORUHVFDUDFWHUtVWLFRODDQJLQDTXHSUHFHGHDO,$0

25,(17$&,21',$*1267,&$'(/$$1*,1$$+$//$=*26),6,&26D3UHVHQFLDGHFXDUWRWRQRE$XPHQWRGHODnn SUHVLyQDUWHULDOnnGHODIUHFXHQFLDGHSXOVR RDPERVF 6RSORGHUHJXUJLWDFLyQPLWUDO SRUGLVIXQFLRQSDSLODUG$UHDSDOSDEOHGHGLVFLQHVLDRDEREDPLHQWRFHUFDGHODSXQWDFDUGLDFDH 'HVGREODPLHQWRSDUDGyMLFRGHOVHJXQGRUXLGR FDUGLDFRI $OLYLRGHOGRORUPHGLDQWHPDVDMHGHVHQRFDURWLGHRSUXHEDGH/HYLQH \PDQLREUDGH9DOVDOYD%862'(1,752*/,&(5,1$ /DDGPLQLVWUDFLyQVXEOLQJXDOGH17*DOLYLDHOGRORUDQJLRQRVRHQ PHQRVGHPLQXWRVVLHPSUHTXHODGRVLVVHDVXILFLHQWHFDSD]GHLQGXFLUGRORURHQURMHFLPLHQWRRGHSURGXFLUVHQVDFLyQGHTXHPRUGHEDMRGHODOHQJXD6LHOGRORUGLVPLQX\HDORVPLQXWRVRPDVHVXQDSUXHEDHQFRQWUDPDVTXHHQIDYRUGHODDQJLQD&&$0%,26(/(&752&$5',2*5$),&26D1LQJ~QFDPELRHQHO(.*HVSDWRJQRPRQLFRGHODDQJLQDGHKHFKRHQSDFLHQWHVFRQDQJLQDHO(.*HQUHSRVRVXHOHVHUQRUPDOE 'XUDQWH ODV FULVLV DQJLRQRVDV OD GHSUHVLyQ GHO VHJPHQWR 67 HV HO KDOOD]JR PDV IUHFXHQWHSRU OHVLyQ RLVTXHPLD VXEHQGRFDUGLFD6LKD\ HVSDVPRDUWHULDO FRURQDULR SXHGHKDEHU HOHYDFLyQGHO VHJPHQWR67 \ HQRFDVLRQHVDXPHQWRGHODDPSOLWXGGHODRQGD5 7DPELpQSXHGHQDSUHFLDUVHGHSUHVLyQGH67\FDPELRHQODRQGD725,(17$&,21',$*1267,&$(1(/,$0$ &$5$&7(5,67,&$6'(/'2/25 (O GRORU HQ HO ,$0 HV FXDOLWDWLYDPHQWH VLPLODU D OD DQJLQD GHUHSRVR\SRUORJHQHUDOLPSRVLEOHGLVWLQJXLUOREDViQGRVHVRORHQODKLVWRULDFOtQLFD(QHOLQIDUWRWUDQVPXUDOHVPDVLQWHQVR\SURORQJDGRGHVGHPHGLDDYDULDVKRUDVTXHHOGHODDQJLQD\YDDFRPSDxDGRFRQIUHFXHQFLDGHQDXVHDVYyPLWRV\GLDIRUHVLV1R VLHPSUHHOGRORU HVWHSUHVHQWH WDOHVHOFDVRGH ORVDQFLDQRV\ ORVGLDEpWLFRVH LQFOXVRHOGRORUSXHGHVHUVXVWLWXLGRSHMSRUGLVQHD(VWRVVtQWRPDVVHOODPDQHTXLYDOHQWHVDQJLRQRVRV%'$726),6,&26D(OSDFLHQWHVXHOHSUHVHQWDUIULDOGDGVXGRUDFLyQSDOLGH]FLDQRVLV\VHQVDFLyQGHHQIHUPHGDGJUDYHE3UHVHQFLDGHFXDUWRUXLGRVRSORVLVWROLFRPLWUDOGHVGREODPLHQWRGHOVHJXQGRWRQR DXPHQWRGHnn WHQVLyQDUWHULDO RIUHFXHQFLDGHnn SXOVR

F 6KRFNFDUGLRJHQLFRG6tQWRPDV GH GLVIXQFLRQ YHQWULFXODU L]TXLHUGD PDQWHQLGD GLVQHD RUWRSQHD \ PDQLIHVWDFLRQHV GHKLSHUDFWLYLGDGGHOVLVWHPDQHUYLRVRDXWyQRPRGLDIRUHVLVEUDGLFDUGLDWDTXLFDUGLD&&$0%,26(/(&752&$5',2*5$),&26 (QQXHVWURPHGLR89,029,/HOGLDJQyVWLFRGHO,$0VHEDVDHQORVFDPELRVHOHFWURFDUGLRJUDILFRV\HQODVFDUDFWHUtVWLFDVFOtQLFDVD (O (.* SXHGH VHU QRUPDO R PRVWUDU DQRUPDOLGDGHV LQHVSHFLILFDV QR GHVFDUWDQGRQHFHVDULDPHQWHHO,$0E3UHVHQFLDGHRQGD446R5DQRUPDOHVMXQWRFRQDOWHUDFLRQHVGHOVHJPHQWR67\XRQGD7

3$7521'(/7520%2(0%2/,60238/021$5/DV FDUDFWHUtVWLFDV GHO GRORU GHO 7(3PDVLYR WDO YH] VHDQ LGpQWLFDV D ODV GHO GRORU LVTXHPLFR VLQ LUUDGLDFLyQFXDQGRHO7(3HVGHPHQRVFXDQWtDHOGRORUHVGHWLSRSOHXULWLFRHLQFOXVRPHFiQLFRSHURODDVRFLDFLyQGHVLJQRVFRPR GLVQHD WDTXLSQHD \ FLDQRVLV LQWHQVD DFRPSDxDGRV GH DQVLHGDG SURIXQGD \ DJLWDFLyQ DVt FRPRDQWHFHGHQWHV GHSRVWRSHUDWRULRSXHUSHULR LQPRYLOL]DFLyQSURORQJDGD LQVXILFLHQFLDFDUGLDFDFRQJHVWLYDFRQHGHPDVSHULIpULFRV\WURPERIOHELWLVYHQRVD SURIXQGDMXQWRFRQGHVGREODPLHQWRGHOVHJXQGRUXLGRKLSHUWHQVLyQSXOPRQDUGHEHQKDFHUQRVSHQVDUHQHO7(3

(O(.*SXHGHSUHVHQWDU'HVYLDFLyQGHOHMHHOpFWULFRKDFLDODGHUHFKD'HIHFWRGHFRQGXFFLyQYHQWULFXODUGHUHFKD$OWHUDFLRQHVLQHVSHFLILFDVGHODRQGD7LQYHUVLyQ\GHO67VRQPX\VXJHUHQWHVGHFRUSXOPRQDOH DJXGR647FRQLQYHUVLyQGHODV7 HQSUHFRUGLDOHVGHUHFKDV647FRQKHPLEORTXHRGHUHFKR6y57 RLQYHUVLyQGHODRQGD7 HQ ',,, \HQODVGHULYDFLRQHVSUHFRUGLDOHVGHUHFKDV

3$7521 '( /$ ',6(&&,21 $257,&$ (O GRORU GHO DQHXULVPD VXHOH VHU GH FRPLHQ]R EUXVFR DGLIHUHQFLD GHO TXH VH SURGXFH HQ OD LVTXHPLD PLRFDUGLFD TXH YD DXPHQWDQGR SURJUHVLYDPHQWH VX LQWHQVLGDG (OSDFLHQWHORGHVFULEHFRPRHOGRORUPDVLQWHQVRTXHKD\DVXIULGRQXQFDVHUiQQHFHVDULDVJUDQGHV\UHSHWLGDVGRVLVGHQDUFyWLFRVSDUDDOLYLDUHOGRORUDFRPSDxDGRGHVHQVDFLyQGHGHVJDUUR/DGXUDFLyQSXHGHVHUGHKRUDVSXHGHLUUDGLDUVHDPSOLDPHQWHDFXHOORHVSDOGDIODQFRVRSLHUQDVVHJ~QODORFDOL]DFLyQ6DOYR HQ ORV FDVRV GH VtQGURPHGH0DUIDQ R QHFURVLV TXLVWLFD GH ODPHGLD ODPD\RUtD GH ORV SDFLHQWHV WLHQHQDQWHFHGHQWHVGHKLSHUWHQVLyQDUWHULDO VLVWHPLFDGHODUJDGXUDFLyQ+$//$=*26&/,1,&26 /DGLVHFFLyQGHODDRUWDSXHGHSURGXFLUGHKLVFHQFLD\RFOXVLyQGHODVDUWHULDVSULQFLSDOHVGDQGROXJDUDORVKDOOD]JRVFDUDFWHUtVWLFRV/DRFOXVLyQFDURWLGHDRYHUWHEUDO SXHGHSURGXFLUVLQFRSHKHPLSOHMtDFRPDRFHJXHUD/DRFOXVLyQGHODVDUWHULDVGHORVPLHPEURV SXHGHSURGXFLUSpUGLGDGHOSXOVRDUWHULDOHLQVXILFLHQFLDYDVFXODU/DRFOXVLyQGHODDUWHULDUHQDO SXHGHFDXVDUKLSHUWHQVLyQ\ROLJXULD/DRFOXVLyQGHODDUWHULDPHVHQWHULFD SXHGHSURGXFLULQIDUWRLQWHVWLQDOFRQGRORUH,OLR/DRFOXVLyQGHODDUWHULDFRURQDULD SXHGHSURGXFLU,$0'HKHFKRHODQHXULVPD GLVHFDQWHSXHGHGLDJQRVWLFDUVHHUUyQHDPHQWHFRPR,$0/DGLVHFFLyQFHUFDGHODEDVHGHODDRUWD SXHGHFDXVDUUHJXUJLWDFLyQDRUWLFDDJXGD\ODURWXUDHQHOLQWHULRUGHOVDFRSHULFDUGLFRSXHGHSURGXFLUWDSRQDPLHQWRFDUGLDFRRPXHUWH/D URWXUD H[WHUQD GHO DQHXULVPD SXHGH VHU KDFLD PHGLDVWLQR SHULWRQHR RUHWURSHULWRQHR

6XHOHKDEHUFDPELRVHQHOSXOVR\DVLPHWUtDVWHQVLRQDOHV HQPLHPEUR

3$75213(5,&$5',&2 (OGDWRPDVLPSRUWDQWHSDUDGLDJQRVWLFDUHORULJHQSHULFDUGLFRGHOGRORUHVVXDJUDYDFLyQFRQORVFDPELRVGHSRVWXUDGXUDQWHODLQVSLUDFLyQSURIXQGD\DYHFHVFRQODGHJOXFLyQUHPLWLHQGRDYHFHVDOVHQWDUVHRLQFOLQDUVHKDFLDDGHODQWHQDGDGHHVWRRFXUUHHQHO,$0/DORFDOL]DFLyQPDVIUHFXHQWHGHOGRORUHVODUHJLyQSUHFRUGLDOHLUUDGLDDKRPEURUHJLyQHVFDSXODU\FXHOOR3XHGHKDEHUWUHVWLSRVGHGRORUHQODVSHULFDU GLWLVDJXGDVx (OGRORUSOHXULWLFR FRQVWLWX\HHOWLSRPDVIUHFXHQWHx 3XHGHVHUILMRGHFRPLHQ]RV~ELWRUHWURHVWHUQDOHLQWHQVRVLPXODQGR,$0x 'RORUORFDOL]DGRHQODSXQWDFDUGLDFD \HVVLQFUyQLFRFRQHOODWLGRFDUGLDFR25,(17$&,21',$*1267,&$$$17(&('(17(6 HQODVGRVVHPDQDVSUHYLDVDSDUHFHILHEUHHLQIHFFLyQUHVSLUDWRULD%&$5$&7(5,67,&$6'(/'2/25&+$//$=*26&/,1,&26D5RFH SHULFDUGLFR SRU IULFFLyQ ORFDOL]DGR HQ UHJLyQ SUHFRUGLDO VXHOH VHU PX\ WUDQVLWRULRDXQTXHSXHGHSHUVLVWLUVHPDQDV$XPHQWDGHLQWHQVLGDGnnFRQODLQVSLUDFLyQSURIXQGD \SXHGHDXVFXOWDUVHVRORHQDOJXQDVSRVLFLRQHVSHMFRQHOSDFLHQWHVHQWDGRLQFOLQDGRKDFLDDGHODQWHE3HULFDUGLWLVFRQGHUUDPH ORVVLJQRVItVLFRVGHSHQGHQGHODFDQWLGDGGHOLTXLGR\GH ODUDSLGH]GHDFXPXODFLyQOOHJDQGRDOWDSRQDPLHQWRFDUGLDFRVLHVWHHVPX\LQWHQVR/RVVLJQRVKDOODGRVLQFOX\HQ$SDJDPLHQWRGHWRQRVFDUGLDFRV\DXPHQWRGHOD]RQDGHPDWLGH]6LJQRVGHWDSRQDPLHQWRFDUGLDFRGHVFHQVRGHppSUHVLyQVLVWROLFD WDTXLFDUGLDSXOVRSDUDGyMLFRUHGXFFLyQGHODSUHVLyQGHSXOVRHLQJXUMLWDFLyQ\XJXODUHQODLQVSLUDFLyQ

' &$0%,26 (/(&752&$5',2*5$),&26 eVWRV VRQ VHFXHQFLDOHV HQ YDULDV GHULYDFLRQHV HQ ORVVHJPHQWRV67\ RQGDV71RH[LVWHQ DQRUPDOLGDGHVGHO456 3XHGHQDSDUHFHUSRWHQFLDOHVGHEDMRYROWDMH \DOWHUQDQFLDVHOpFWULFDVWDPELpQSXHGHQDSDUHFHUDOWHUDFLRQHVGHO35

(',$*1267,&2',)(5(1&,$/(175(3(5,&$5',7,6(,$0

/DSUHVHQFLDGHXQFRPSRQHQWHSOHXULWLFRHQHOGRORU YDDIDYRUGHODSHULFDUGLWLV/DVRQGDV4SDWROyJLFDVVRORDSDUHFHQHQHO,$0/DVDOWHUDFLRQHVGHO67VRQPDVGLIXVDV HQODVSHULFDUGLWLVFXDQGRVHHOHYDQORVVHJPHQWRV67SXHGHQVHUFyQFDYRVKDFLDDUULED HQODVSHULFDUGLWLVPLHQWUDVTXHORVFDPELRVFRQYH[RVYDQPDVHQIDYRUGHO,$0(Q ODV SHULFDUGLWLV FDVL QXQFD VH HQFXHQWUDQ FDPELRV UHFtSURFRV GHO 67 HQ ODV GHULYDFLRQHV GH ORVPLHPEURVPLHQWUDVHQHO,$0HVIUHFXHQWH(QODVSHULFDUGLWLVODVRQGDV7QRDFRVWXPEUDQLQYHUWLUVHKDVWDTXHHO67HVLVRHOHFWULFR SHURHQHO,$0ODVRQGDV7VHLQYLHUWHQPLHQWUDVHOVHJPHQWR67HVWDWRGDYtDHOHYDGR 3$75213/(85,7,&2 (OGRORUSOHXULWLFRVXHOHVHUGHWLSRSXQ]DQWHFRQ ORFDOL]DFLyQFRVWDOTXHSXHGHLUUDGLDUDFXHOORDXPHQWDFRQORVnnPRYLPLHQWRVUHVSLUDWRULRV\FRQODWRV\GXUDPDV TXHHOGRORULVTXHPLFRVHDVRFLD D QHXPRWRUD[ SDWRORJtD SOHXUDOSOHXULWLV QHRSODVLDV QHXPRQtDV WUDTXHREURQTXLWLV 7(3 \ SURFHVRVPHGLDVWLQLFRVPHGLDVWLQLWLVQHXPRPHGLDVWLQRWXPRUHV(QIXQFLyQGHODFDXVDVXE\DFHQWHSRGHPRVHQFRQWUDURWURVVtQWRPDVDFRPSDxDQWHVQHXPRQtDILHEUH 3$7521(62)$*,&2$(VRIDJLWLVSRUUHIOXMRHOGRORUFRQRVLQKHUQLDGHKLDWRSXHGHVLPXODUHOGRORUDQJLRQRVR/DORFDOL]DFLyQGHODPROHVWLDHVUHWURHVWHUQDO\SXHGHLUUDGLDUVHDEUD]RL]TXLHUGR\DOPD[LODULQIHULRU6HSXHGHGHVHQFDGHQDUSRUH[FHVRHQODLQJHVWDRDOFRKROSRUWRPDUDOLPHQWRVPX\FRQGLPHQWDGRV RFRQODSRVLFLyQHQGHF~ELWR (OGRORUHVGHDSDULFLyQQRFWXUQD0HMRUDFRQDQWLiFLGRV\HQSRVLFLyQHUHFWD6HUHSURGXFHFRQIDFLOLGDGFRQODLQJHVWDGHLQIXVLRQHViFLGDV%(VSDVPR HVRIDJLFR HO GRORU SXHGH VHU OHYH R LQWHQVR EUHYH R GXUDGHUR FRQ VHQVDFLyQ GH SUHVLyQ RFRPSUHVLyQ ORFDOL]DGR UHWURHVWHUQDOPHQWH H LUUDGLDPDQGtEXOD FXHOOR HVSDOGD R EUD]R 6XHOH SUHVHQWDUVHFRQ ODFRPLGD\DFRPSDxDGRGHGLVIDJLDWDQWRSDUDOtTXLGRVFRPRSDUDVyOLGRVPHMRUDQGRFRQODQLWURJOLFHULQDSRUORTXHSXHGHVHUFRQIXQGLGRFRQODDQJLQD&5RWXUDDJXGDGHOHVyIDJRSURGXFHGRORUUHWURHVWHUQDOLQWHQVRVHFXQGDULRDPHGLDVWLQLWLVTXtPLFD/DURWXUDHVSRQWDQHD WLHQH OXJDUGHVSXpV GH XQ DWDTXHSURORQJDGRGH YyPLWRV R QDXVHDV LQWHQVDV R FRPRFRPSOLFDFLyQLDWURJHQLFDHQODHVRIDJRVFRSLD

3$7521 267(2086&8/$5 (O GRORU WLHQH FDUDFWHUtVWLFDV PHFiQLFDV HV GH WLSR SXQ]DQWH \ GH ODUJDGXUDFLyQFRQLQWHUPLWHQFLD$XPHQWDFRQ ORVPRYLPLHQWRVGHODFDMDWRUiFLFDHOFDQVDQFLRODSRVWXUDLQFRUUHFWDODWRV\SXHGHGXUDUGHVGHKRUDVDGtDV0HMRUD FRQHOUHSRVRDQDOJHVLD\FDORUORFDO/D UHSURGXFFLyQ GHO GRORU D OD SDOSDFLyQ GH OD ]RQD DIHFWD HV FODYH HQ HO GLDJQyVWLFR /D DSDULFLyQ GHVtQWRPDVDVRFLDGRVFRPRSDUHVWHVLDVHQEUD]RVSDUHVLDIULDOGDGGHELOLGDGRSHUGLGDGHIXHU]DHQEUD]RV SXHGHQDSDUHFHUHQ ORVVtQGURPHVGHFRPSUHVLyQGHOSOH[REUDTXLDO(QRWURVFDVRV ODGLVWULEXFLyQPHWDPHULFDGHOGRORUMXQWRFRQODSUHVHQFLDGHYHVtFXODV WUHVRFXDWURGtDVGHVSXpVGHORVVtQWRPDV\ODHGDGDYDQ]DGDSXHGHVHUODFODYHGLDJQRVWLFDHQHOKHUSHV]RVWHU

3$752136,&2*(12 /DPROHVWLDWRUiFLFDTXHSURSRUFLRQDODDQJLQDSXHGHUHPHGDUODGHORVHVWDGRVGHDQVLHGDG(VWDPROHVWLDSXHGHSUHVHQWDUVHGHYDULDVIRUPDV$&RPRGRORUDJXGRLQWHUPLWHQWHRHQSXxDODGD%&RPRGRORUSUHFRUGLDOSUHH[LVWHQWH VLQUHODFLyQFRQHOHVIXHU]R&&RPRVHQVDFLyQGHRSUHVLyQ HQHOWyUD[7tSLFDPHQWHQRH[LVWHUHODFLyQHQWUHHOGRORU\HOHMHUFLFLR/DGXUDFLyQGHOGRORUHVYDULDEOHGHVGHPLQXWRV

DGtDV \VHDVRFLDD UHVSLUDFLyQVXVSLURVD \DVtQWRPDVGHELGRVDKLSHUYHQWLODFLyQ8QD YH] HQFXDGUDGR FXDOTXLHU GRORU WRUiFLFR HQ ORV SDWURQHV DQWHULRUHV D WUDYpV GH OD KLVWRULD FOtQLFD ODH[SORUDFLyQ ItVLFD HO(.* \ OD WRPDGH FRQVWDQWHV YLWDOHV VH GHEH LQWHQWDU HIHFWXDUXQGLDJQyVWLFR HWLRORJLFRSUHHOLPLQDUFRQREMHWRGHWRPDUGHFLVLRQHVSULRULWDULDV3DUDORFXDOVHWRPDUDHQFRQVLGHUDFLyQTXH (OGRORUSXQWLIRUPH TXHVHH[DFHUEDFRQXQGHWHUPLQDGRPRYLPLHQWRRSRVWXUD\TXHUHSURGXFHDODSDOSDFLyQVXHOHWHQHUVXRULJHQHQODSDUHGWRUiFLFDVRPiWLFR 'HVFDUWDGR HO RULJHQ VRPiWLFR HO GRORU GH ORFDOL]DFLyQ FHQWUDO REOLJD D GHVFDUWDU HQ SULPHU OXJDUFXDOTXLHUD GH ODV FDXVDV HWLTXHWDGDV FRPR SRWHQFLDOPHQWH JUDYHV /D DOWHUDFLyQ GH ORV VLJQRV YLWDOHV ODSUHVHQFLDGHFRUWHMRYHJHWDWLYR\ODDOWHUDFLyQGHOQLYHOGHFRQFLHQFLDKDUiQVRVSHFKDUPDVDXQHVWDVHWLRORJLDV/DH[LVWHQFLD GH IDFWRUHV GH ULHVJR YDVFXODU GH DQWHFHGHQWHV SUHYLRV GH FDUGLRSDWLD LVTXHPLFD R GH FXDOTXLHU RWUDSDWRORJtDYDVFXODUKDUiFRQVLGHUDUODFDUGLRSDWLDLVTXHPLFDHQSULPHUOXJDU 'HVFDUWDQGR HO RULJHQ VRPiWLFR HO GRORU GH ORFDOL]DFLyQ ODWHUDO KDUi VRVSHFKDU XQ RULJHQ SVLFRJHQR RSOHXURSXOPRQDU HQHOFDVRGHGRORUGHWLSRSOHXULWLFRHOFXDOWDPELpQSXHGHVHUFDXVDGRSRUQHXPRWRUD[RSRUHPEROLVPRSXOPRQDU(QWRGRVORVSDFLHQWHVHQTXHVHVRVSHFKDXQDSDWRORJtDSRWHQFLDOPHQWHJUDYHHQHOPHGLRH[WUDKRVSLWDODULRVHHIHFWXDUD 0RQLWRUL]DFLyQFRQWLQXDGDGHO(.* &DQDOL]DFLyQGHXQDYtDYHQRVD $GPLQLVWUDFLyQGHR[tJHQR$QDOJHVLDFRQRSLiFHRVVLHVQHFHVDULRSXOVLRPHWULD9LJLODQFLDLQWHQVLYDKDVWDHIHFWXDUHOGLDJQRVWLFR\WUDWDPLHQWRDGHFXDGRV. Criterios de Derivacin Hospitalaria.

Todos los pacientes con dolor torcico agudo secundario a patologa potencialmente grave.

Pacientes con dolor torcico agudo secundario a patologa no vital, pero subsidiaria de estudio hospitalario segn medio y disponibilidad.

Ausencia de diagnstico a pesar de la valoracin y que necesite pruebas complementarias hospitalarias.