G A Sutton1, R Ertzman-Ginsburg, A Steinman, J Milgram. 1. Koret School of Veterinary Medicine, Hebrew University of Jerusalem, Faculty of Agricultural, Food and Environmental Quality Sciences, POB 12, Rehovot 76100, Israel.
Abstract
REASONS FOR PERFORMING STUDY: Initial assessment of the mortality rates and prognostic indicators in horses with colic presented to a referral hospital in Israel. OBJECTIVES: To determine mortality rates and to identify potential prognostic indicators in horses undergoing treatment for colic. METHODS: The medical records of 208 colic cases were reviewed and mortality rates calculated including 95% confidence intervals. Mortality rates in surgical cases were calculated separately for strangulating and nonstrangulating lesions as well as for lesions of the large and small intestines. Potential prognostic indicators were identified and evaluated by Student's t test or chi2 test, where appropriate. Those found to be significant (P < 0.05) were evaluated in 2 logistic regression models; one including all horses with colic and one for surgical cases only. RESULTS: The overall mortality rate was 51/208 (25%); 5/72 (7%) in medically treated cases, 46/136 (34%) in surgical cases, 30/50 (60%) in strangulating lesions and 15/85 (18%) in nonstrangulating lesions, 17/27 (63%) in cases involving small intestinal lesions and 28/108 (26%) in cases with large intestinal lesions. Clinical parameters found to be significantly associated with death by univariate analysis were medical/surgical treatment, location of lesion, severity of lesion, mucous membrane colour (MM), capillary refill time (CRT) and heart rate. Using a multivariate logistic regression model, including all cases, medical/surgical treatment, CRT and MM were found to be prognostic indicators and when using the surgical cases alone, only CRT and lesion severity remained related to mortality. CONCLUSIONS: Mortality rates were similar or better than those previously reported in most cases, however, studies from the USA and the UK published better success rates for small intestinal surgeries. Cultural attitudes toward euthanasia may be associated with mortality rates. POTENTIAL RELEVANCE: These results assist clinicians in providing an immediate prognosis based on clinical findings at presentation and contribute to an international database that may aid future research in improving treatment of colic.
REASONS FOR PERFORMING STUDY: Initial assessment of the mortality rates and prognostic indicators in horses with colic presented to a referral hospital in Israel. OBJECTIVES: To determine mortality rates and to identify potential prognostic indicators in horses undergoing treatment for colic. METHODS: The medical records of 208 colic cases were reviewed and mortality rates calculated including 95% confidence intervals. Mortality rates in surgical cases were calculated separately for strangulating and nonstrangulating lesions as well as for lesions of the large and small intestines. Potential prognostic indicators were identified and evaluated by Student's t test or chi2 test, where appropriate. Those found to be significant (P < 0.05) were evaluated in 2 logistic regression models; one including all horses with colic and one for surgical cases only. RESULTS: The overall mortality rate was 51/208 (25%); 5/72 (7%) in medically treated cases, 46/136 (34%) in surgical cases, 30/50 (60%) in strangulating lesions and 15/85 (18%) in nonstrangulating lesions, 17/27 (63%) in cases involving small intestinal lesions and 28/108 (26%) in cases with large intestinal lesions. Clinical parameters found to be significantly associated with death by univariate analysis were medical/surgical treatment, location of lesion, severity of lesion, mucous membrane colour (MM), capillary refill time (CRT) and heart rate. Using a multivariate logistic regression model, including all cases, medical/surgical treatment, CRT and MM were found to be prognostic indicators and when using the surgical cases alone, only CRT and lesion severity remained related to mortality. CONCLUSIONS: Mortality rates were similar or better than those previously reported in most cases, however, studies from the USA and the UK published better success rates for small intestinal surgeries. Cultural attitudes toward euthanasia may be associated with mortality rates. POTENTIAL RELEVANCE: These results assist clinicians in providing an immediate prognosis based on clinical findings at presentation and contribute to an international database that may aid future research in improving treatment of colic.
Authors: Mogens T Christophersen; Nana Dupont; Kristina S Berg-Sørensen; Christel Konnerup; Tina H Pihl; Pia H Andersen Journal: Acta Vet Scand Date: 2014-04-08 Impact factor: 1.695