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Topic:Survival Rate

The survival rate in horses refers to the proportion of horses that continue to live following a specific event, condition, or treatment. This metric is often used in veterinary studies to assess the outcomes of various medical interventions, diseases, or surgical procedures. Survival rates can provide valuable insights into the effectiveness of treatments, the progression of diseases, and the overall health management of equine populations. Factors influencing survival rates may include the horse's age, breed, underlying health conditions, and the timeliness and appropriateness of medical care. This page aggregates peer-reviewed research studies and scholarly articles that explore the determinants, methodologies, and implications of survival rates in equine health management.
Clinical findings, diagnoses, and outcomes of horses presented for colic to a referral hospital in Atlantic Canada (2000-2015).
The Canadian veterinary journal = La revue veterinaire canadienne    March 14, 2020   Volume 61, Issue 3 281-288 
Kaufman JM, Nekouei O, Doyle AJ, Biermann NM.Medical records of equine patients presented for signs of abdominal pain to the Atlantic Veterinary College Teaching Hospital between 2000 and 2015 were reviewed. A total of 575 patients were enrolled, and the most common clinical findings, diagnoses, and outcomes are described. Potential predictors of survival to discharge were assessed. The most common diagnosis was large colon impaction (18.4%), followed by large colon volvulus (6.2%). Overall survival to discharge was 69%. The survival rates for horses were 82.9% for those with no diagnosis, 74.6% for those with large intestine lesions, an...
Prognostic value of measuring heart rate variability at the time of hospital admission in horses with colic.
American journal of veterinary research    January 28, 2020   Volume 81, Issue 2 147-152 doi: 10.2460/ajvr.81.2.147
Vitale V, Viu J, Armengou L, Ríos J, Jose-Cunilleras E.To evaluate the prognostic value of measuring heart rate variability (HRV) in horses with colic at the time of admission to a referral hospital. Methods: 51 horses > 1 year of age with colic (41 that survived [survivors] and 10 that died or were euthanized [nonsurvivors]). Methods: HRV was recorded within 1 hour after admission by use of heart rate sensors with horses restrained in stocks. A 5-minute recording period was analyzed to obtain HRV measurements (eg, SD of R-R intervals [SDRR], root mean square of successive differences between R-R intervals [RMSSD], and geometric SDs determined ...
Outcome of horses with enterocolitis receiving oncotic fluid support with either plasma or hetastarch.
The Canadian veterinary journal = La revue veterinaire canadienne    November 7, 2019   Volume 60, Issue 11 1207-1212 
Kopper JJ, Kogan CJ, Cook VL, Schott HC.The objective of this study was to determine whether there was an association between type of colloid administered and survival of horses with enterocolitis (N = 92). A retrospective review of medical records of horses with enterocolitis treated with plasma or hetastarch (HES) between January 1, 2005 and December 31, 2011 was performed. Data collected included signalment, outcome, physical and clinicopathologic findings, and volume and type of colloid administered. Sixty-nine horses (75%) were treated with plasma and 23 horses (25%) were treated with HES. After accounting for confounding varia...
Factors Associated With Survival and Return to Function Following Synovial Infections in Horses.
Frontiers in veterinary science    October 22, 2019   Volume 6 367 doi: 10.3389/fvets.2019.00367
Crosby DE, Labens R, Hughes KJ, Nielsen S, Hilbert BJ.Synovial infections (SI) are common in horses of all ages and can be associated with high rates of morbidity and mortality. Identifying factors influencing survival and return to function may be useful for management of affected individuals and determination of prognosis. The objectives of this study were to identify factors associated with survival and return to function of horses and foals with SI presented to an equine hospital. This study is a retrospective case series. Data were collected from medical records of all horses with SI that were presented to a single equine hospital between Ap...
A multi-centre cohort study investigating the outcome of synovial contamination or sepsis of the calcaneal bursae in horses treated by endoscopic lavage and debridement.
Equine veterinary journal    October 16, 2019   Volume 52, Issue 3 404-410 doi: 10.1111/evj.13180
Isgren CM, Salem SE, Singer ER, Wylie CE, Lipreri G, Graham RJTY, Bladon B, Boswell JC, Fiske-Jackson AR, Mair TS, Rubio-Martínez LM.Previous studies investigating factors associated with survival following endoscopic treatment of contamination/sepsis of the calcaneal bursa are limited. Objective: To investigate the factors associated with survival in horses with contamination/sepsis of the calcaneal bursae treated endoscopically and to describe the bacterial isolates involved in the synovial infections. Methods: Retrospective analysis of clinical records. Methods: Medical records from 128 horses with contamination/sepsis of the calcaneal bursae treated by endoscopic lavage at seven equine hospitals were reviewed. A follow-...
Clinical, hematologic, hemostatic, and serum biochemical findings related to survival in Arabian horses with colic.
Veterinary clinical pathology    September 17, 2019   Volume 48, Issue 3 441-448 doi: 10.1111/vcp.12779
Nikvand AA, Jalali SM, Ghadrdan Mashhadi A, Razi Jalali M, Hassanpour Amirabadi S.The efficacy of clinical examinations, and hematologic, hemostatic, and serum biochemical assessments to determine appropriate early medical or surgical therapy in Arabian horses with colic have not been well-described. Objective: We aimed to evaluate clinical and hematologic findings, coagulation-fibrinolytic parameters, and organ dysfunction markers in association with survival in horses with colic. Methods: Seventeen Arabian horses with colic and ten healthy horses were enrolled. After clinical examinations, including heart rates (HRs), capillary refill times (CRTs), abdominal sounds, recta...
Cortisol and adrenocorticotropic hormone concentrations in horses with systemic inflammatory response syndrome.
Journal of veterinary internal medicine    September 12, 2019   Volume 33, Issue 5 2257-2266 doi: 10.1111/jvim.15620
Stewart AJ, Hackett E, Bertin FR, Towns TJ.Plasma adrenocorticotropic hormone (ACTH) and serum cortisol concentrations increase with illness-associated stress. Dynamics of plasma ACTH and serum cortisol concentrations in adult horses with systemic illness are undocumented. Objective: To determine whether ACTH and cortisol concentrations and the ACTH/cortisol ratio vary with survival, the presence of systemic inflammatory response syndrome (SIRS), or ischemic gastrointestinal lesions at admission, or throughout hospitalization. Methods: One hundred fifty-one adult horses. Methods: Prospective study measuring serum cortisol and plasma AC...
Evaluation of the foal survival score in a Danish-Swedish population of neonatal foals upon hospital admission.
Journal of veterinary internal medicine    April 19, 2019   Volume 33, Issue 3 1507-1513 doi: 10.1111/jvim.15487
Bohlin A, Saegerman C, Hoeberg E, Sånge A, Nostell K, Durie I, Husted L, Öhman A, van Galen G.It is highly desirable to assess the probability of survival in sick neonatal foals upon admission. The foal survival score (FSS) is a published scoring system used to estimate the probability of survival in hospitalized neonatal foals <4 days old. Objective: To evaluate the ability of the FSS to predict survival in older foals from a geographically different area compared to the original study. Methods: Five-hundred ninety hospitalized neonatal foals ≤14 days of age. Methods: Retrospective Danish-Swedish multicenter study that included details of signalment, history, clinical examinatio...
Clinical findings associated with development of postoperative reflux and short-term survival after small intestinal surgery in geriatric and mature nongeriatric horses.
Veterinary surgery : VS    April 19, 2019   Volume 48, Issue 5 795-802 doi: 10.1111/vsu.13217
Boorman S, Stefanovski D, Southwood LL.To determine risk factors, especially age, associated with postoperative reflux (POR; >2 L of reflux present upon intubation), high-volume POR (≥20 L in 24 hours), and short-term outcome after small intestinal (SI) surgery. Methods: Retrospective case-control study. Methods: Horses aged ≥16 years (geriatric; range, 16-30; n = 44) and <16 years (mature; range, 2-15; n = 39) with an SI surgical lesion that survived general anesthesia and did not have a second exploratory celiotomy during the same visit. Methods: Medical records (2009-2015) were reviewed; perioperative var...
Complications and survival in horses with surgically confirmed right dorsal displacement of the large colon.
The Canadian veterinary journal = La revue veterinaire canadienne    April 18, 2019   Volume 60, Issue 4 381-385 
Whyard JM, Brounts SH.This study compared post-operative complications and survival in horses with right dorsal displacement of the large colon (RDD) and horses with other non-strangulating large colon (NSLC) lesions. Data were obtained from medical records of horses undergoing exploratory laparotomy from 2000 to 2016 and from owner questionnaire. Of 137 horses that fitted the inclusion criteria, 67 (49%) had RDD and 70 (51%) had NSLC lesions. Twenty-eight horses with RDD (42%) and 27 horses with NSLC (39%) experienced ≥ 1 complication after surgery. The RDD group showed more severe complications than the NSLC gr...
Retrospective evaluation of clinical outcome after chemotherapy for lymphoma in 15 equids (1991-2017).
Journal of veterinary internal medicine    January 12, 2019   Volume 33, Issue 2 953-960 doi: 10.1111/jvim.15411
Luethy D, Frimberger AE, Bedenice D, Byrne BS, Groover ES, Gardner RB, Lewis T, MacDonald VS, Proctor-Brown L, Tomlinson JE, Rassnick KM, Johnson AL.Prognosis associated with lymphoma in horses is poorly characterized, and treatment is often palliative. Long-term outcome after chemotherapy for horses with lymphoma is not well documented. Objective: To report long-term outcome of horses with lymphoma treated with chemotherapy. Methods: Fifteen equids. Methods: Retrospective case series. Medical record search and call for cases on the ACVIM listserv for horses treated with chemotherapy for lymphoma. Results: Fifteen cases with adequate data were identified. Complete remission was achieved in 5 horses (33.3%), partial response was achieved in...
Factors associated with survival, laminitis and insulin dysregulation in horses diagnosed with equine pituitary pars intermedia dysfunction.
Equine veterinary journal    December 3, 2018   Volume 51, Issue 4 440-445 doi: 10.1111/evj.13041
Horn R, Bamford NJ, Afonso T, Sutherland M, Buckerfield J, Tan RHH, Secombe CJ, Stewart AJ, Bertin FR.Pituitary pars intermedia dysfunction (PPID) is a commonly described endocrine disorder in higher latitudes of the Northern hemisphere but the description of the disease at lower latitudes and in the Southern hemisphere is limited. Objective: Document the clinical features of PPID at different Australian latitudes and climates, and investigate factors associated with survival, laminitis and insulin dysregulation (ID). Methods: Retrospective study of 274 equids from eight institutions across Australia. Methods: A diagnosis of PPID was based on endogenous ACTH, overnight dexamethasone suppressio...
Initial antimicrobial treatment of foals with sepsis: Do our choices make a difference?
Veterinary journal (London, England : 1997)    November 27, 2018   Volume 243 74-76 doi: 10.1016/j.tvjl.2018.11.012
Theelen MJP, Wilson WD, Byrne BA, Edman JM, Kass PH, Magdesian KG.The study objectives were to provide cumulative antimicrobial susceptibility data at the patient level and to evaluate the effect of initial antimicrobial treatment on survival in foals with sepsis. Foals below 30days of age with a diagnosis of sepsis, confirmed by isolation of bacteria from normally sterile sites on the day of hospital admission, were included. Susceptibility testing was performed using the broth microdilution procedure. In total, 213 foals and 306 bacterial isolates were included. The likelihood of survival for foals from which all bacteria were susceptible to the initial an...
Surgical management of postcastration spermatic cord stump infection in horses: A retrospective study of 23 cases.
Veterinary surgery : VS    September 28, 2018   Volume 47, Issue 8 1016-1020 doi: 10.1111/vsu.12954
Claffey EF, Brust K, Hackett RP, Fubini S.To report the surgical management and the short- and long-term follow-up of postcastration spermatic cord infection in horses. Methods: Retrospective case series. Methods: Twenty-three client-owned horses. Methods: Medical records (2001-2017) of horses that had been surgically treated for spermatic cord stump infection after castration were reviewed. Time from castration to presentation, diagnostic procedures, surgical complications, bacterial culture and ancillary testing, and survival to discharge were collected. Long-term follow-up was obtained by owner survey when possible. Descriptive sta...
Competition lifespan survival analysis in the Norwegian-Swedish Coldblooded Trotter racehorse.
Equine veterinary journal    August 2, 2018   Volume 51, Issue 2 206-211 doi: 10.1111/evj.12989
Velie BD, Jäderkvist Fegraeus K, Ihler CF, Lindgren G, Strand E.Studies of large racing populations have established clear differences in the career profile of stallions, mares and geldings. Multiple studies have also demonstrated positive effects on racing careers for horses that commence racing at a younger age. However, the applicability of these studies to small, native racing populations is unknown and warrants investigation. Objective: To provide summary statistics for performance outcomes for the Norwegian-Swedish Coldblooded Trotter and to document and provide evidence on the current differences in racing careers across age at first start groups, s...
Infectivity and virulence of Trypanosoma evansi and Trypanosoma equiperdum Venezuelan strains from three different host species.
Veterinary parasitology, regional studies and reports    July 9, 2018   Volume 13 205-211 doi: 10.1016/j.vprsr.2018.07.004
Perrone T, Sánchez E, Hidalgo L, Mijares A, Balzano-Nogueira L, Gonzatti MI, Aso PM.The infectivity and virulence of seven Trypanosoma evansi and Trypanosoma equiperdum Venezuelan strains isolated from horses, donkeys and capybaras were compared in a mouse model up to 41 days, for parasitemia, animal weight, survival rates, packed cell volume, haemoglobin and erythrocyte count. Two T. equiperdum strains and three of the T. evansi strains resulted in 100% mice mortality, while the two T. evansi donkey strains exhibited lower infectivity and mortality. T. equiperdum strains had shorter pre-patent periods (4 days) than the T. evansi strains (4-12 days). In terms of pathoge...
Cortisol, progesterone, 17αOHprogesterone, and pregnenolone in foals born from mare’s hormone-treated for experimentally induced ascending placentitis.
Theriogenology    June 30, 2018   Volume 123 139-144 doi: 10.1016/j.theriogenology.2018.06.024
Müller V, Curcio BR, Toribio RE, Feijó LS, Borba LA, Canisso IF, Nogueira CEW.This study aimed to evaluate steroid hormones in foals born from mares treated for ascending placentitis with different combinations of trimethoprim-sulfamethoxazole (TMS), flunixin meglumine (FM), long-acting altrenogest (ALT) and estradiol cypionate (ECP) for ten consecutive days, starting two days after experimental induction of placentitis with Streptococcus zooepidemicus. Fourty-six pregnant mares and respective foals were assigned as healthy group (Control, n = 8) or treated groups as follows: TMS+FM (n = 8), TMS+FM+ALT (n = 8), TMS+FM+ALT+ECP (n = 6), TMS+FM+ECP (n = 6) and no...
Insulin dysregulation in horses with systemic inflammatory response syndrome.
Journal of veterinary internal medicine    May 10, 2018   Volume 32, Issue 4 1420-1427 doi: 10.1111/jvim.15138
Bertin FR, Ruffin-Taylor D, Stewart AJ.Systemic inflammation is a cause of insulin dysregulation in many species, but the insulin and glucose dynamics in adult horses diagnosed with systemic inflammatory response syndrome (SIRS) are poorly documented. Objective: In SIRS in horses, insulin and glucose dynamics will be altered and associated with survival. Methods: Adult horses diagnosed with SIRS admitted to a referral hospital. Methods: Prospective study enrolling horses diagnosed with SIRS in which serum insulin and glucose concentrations were measured. Horses were grouped by outcome (survival, hyperinsulinemia, and hyperglycemia)...
Effects of hyaluronate-carboxymethylcellulose membranes on the clinical outcome of horses undergoing emergency exploratory celiotomy.
Veterinary surgery : VS    February 20, 2018   Volume 47, Issue 3 385-391 doi: 10.1111/vsu.12777
Troy JR, Holcombe SJ, Fogle CA, Epstein KL, Woodie JB.To determine the influence of hyaluronate-carboxymethylcellulose (HA-CMC) membranes applied to intestinal anastomoses or enterotomies on postoperative complications after emergency exploratory celiotomy. Methods: Multicenter retrospective case-controlled series. Methods: Adult horses (59 in the HA-CMC group and 91 controls). Methods: Medical records from 4 referral hospitals were searched for horses ≥1 year of age, treated between 2008 and 2014 with emergency exploratory celiotomy, and surviving at least 24 hours postoperatively. Horses receiving repeat celiotomy during the same hospitalizat...
Technique-associated outcomes in horses following large colon resection.
Veterinary surgery : VS    October 7, 2017   Volume 46, Issue 8 1061-1067 doi: 10.1111/vsu.12725
Pezzanite LM, Hackett ES.To compare survival and complications in horses undergoing large colon resection with either sutured end-to-end or stapled functional end-to-end anastomoses. Methods: Retrospective cohort study. Methods: Twenty-six client-owned horses with gastrointestinal disease. Methods: Retrospective data were retrieved from the medical records of 26 horses undergoing colectomy, including 14 horses with sutured end-to-end and 12 horses with stapled functional end-to-end anastomoses, between 2003 and 2016. Records were evaluated for signalment, medical and surgical treatments, and survival to hospital disch...
Elapid snake envenomation in horses: 52 cases (2006-2016).
Equine veterinary journal    September 6, 2017   Volume 50, Issue 2 196-201 doi: 10.1111/evj.12735
Bamford NJ, Sprinkle SB, Cudmore LA, Cullimore AM, van Eps AW, Verdegaal EJMM, Tennent-Brown BS.Snake envenomation is a cause of morbidity and mortality in domestic animals worldwide. The clinical features of crotalid snake (pit viper) envenomation are widely reported and well described in horses but elapid snake envenomation is poorly characterised. Objective: To describe the presentation, clinical and laboratory findings, treatment and outcome of horses with a diagnosis of elapid snake envenomation in Australia. Methods: Retrospective case series. Methods: Medical records of horses with a diagnosis of elapid snake envenomation (2006-2016) at several university and private veterinary pr...
Outcomes after medical and surgical interventions in horses with temporohyoid osteoarthropathy.
Equine veterinary journal    July 3, 2017   Volume 49, Issue 6 770-775 doi: 10.1111/evj.12701
Espinosa P, Nieto JE, Estell KE, Kass PH, Aleman M.Temporohyoid osteoarthropathy (THO) is a cause of neurological disease in horses that is characterised by facial and vestibulocochlear nerve deficits. Studies reporting and comparing survival following medical or surgical treatment of THO are lacking. Objective: To compare survival and prognosis in horses with THO treated medically or surgically, and to report surgical complications. Methods: Retrospective study. Methods: The medical records of horses diagnosed with THO were retrieved, and data on signalment, clinical signs and duration, corneal ulceration and bilateral occurrence were recorde...
Influence of Salmonella status on the long-term outcome of horses after colic surgery.
Veterinary surgery : VS    April 29, 2017   Volume 46, Issue 6 780-788 doi: 10.1111/vsu.12660
Southwood LL, Lindborg S, Myers M, Aceto HW.To compare long-term outcome of Salmonella-positive versus Salmonella-negative horses discharged from hospital after colic surgery. Methods: Retrospective case-control. Methods: Horses discharged from the hospital after colic surgery. For each horse with positive culture for Salmonella enterica (SAL-POS, n = 59), at least 2 horses testing negative for S. enterica (SAL-NEG, n = 119) were enrolled. Methods: Owners were interviewed via phone at least 12 months after surgery regarding: (1) complications after discharge from the hospital; (2) duration of survival; and (3) return to prior or...
Factors Associated with Survival in 97 Horses with Septic Pleuropneumonia.
Journal of veterinary internal medicine    March 8, 2017   Volume 31, Issue 3 894-900 doi: 10.1111/jvim.14679
Arroyo MG, Slovis NM, Moore GE, Taylor SD.Septic pleuropneumonia is a common cause of morbidity and mortality in horses, but there is limited data available regarding factors associated with survival. Objective: To identify factors predictive of survival in horses with septic pleuropneumonia. Methods: A total of 97 horses with septic pleuropneumonia at 2 referral institutions. Methods: A retrospective study was performed. A diagnosis of septic pleuropneumonia was based on the presence of sepsis, pleural effusion, and positive bacterial culture from tracheal aspiration (TA) or pleural fluid (PF). Results: Thirty-one percent of horses h...
Fallen stock data: An essential source of information for quantitative knowledge of equine mortality in France.
Equine veterinary journal    February 13, 2017   Volume 49, Issue 5 596-602 doi: 10.1111/evj.12664
Tapprest J, Morignat E, Dornier X, Borey M, Hendrikx P, Ferry B, Calavas D, Sala C.Quantitative information about equine mortality is relatively scarce, yet it could be of great value for epidemiological purposes. In France, data from rendering plants are centralised in the Fallen Stock Data Interchange database (FSDI), managed by the French Ministry of Agriculture, while individual equine data are centralised in the French equine census database, SIRE, managed by the French horse and riding institute (IFCE). Objective: To evaluate whether the combined use of the FSDI and SIRE databases can provide representative and accurate quantitative information on mortality for the Fre...
Duodenojejunal mesenteric rents: Survival and complications after surgical correction in 38 broodmares (2006-2014).
Veterinary surgery : VS    February 1, 2017   Volume 46, Issue 3 367-375 doi: 10.1111/vsu.12611
Lawless SP, Werner LA, Baker WT, Hunt RJ, Cohen ND.To describe short-term and long-term survival of horses with duodenojejunal mesenteric rents, and to examine the association of selected preoperative, intraoperative, and postoperative factors with survival or colic after discharge, in horses with duodenojejunal mesenteric rents. Methods: Retrospective case series. Methods: Horses undergoing surgery for correction of small intestinal lesions secondary to duodenojejunal mesenteric rents (n = 38). Methods: Medical records (2006-2014) of horses admitted to a referral hospital in Kentucky were reviewed. Data for preoperative and intraoperative...
Clinical Implications and Hospital Outcome of Immune-Mediated Myositis in Horses.
Journal of veterinary internal medicine    January 2, 2017   Volume 31, Issue 1 170-175 doi: 10.1111/jvim.14637
Hunyadi L, Sundman EA, Kass PH, Williams DC, Aleman M.Immune-mediated myositis (IMM) is a cause of rhabdomyolysis, stiffness, and muscle atrophy predominantly affecting Quarter horses. Limited information is available with regard to outcome, prognostic indicators, and associations with concurrent diseases. Objective: To report outcomes and associations between outcome and clinical and laboratory parameters, and presence of concurrent illness. Methods: Sixty-eight horses; 52 Quarter horses and related breeds and 16 other breeds. Methods: Retrospective cohort study (1991-2014). Medical records of horses with histological diagnosis of IMM were revie...
Factors associated with survival of horses following relaparotomy.
Equine veterinary journal    October 13, 2016   Volume 49, Issue 4 448-453 doi: 10.1111/evj.12635
Findley JA, Salem S, Burgess R, Archer DC.Relaparotomy may be required to investigate and manage complications that occur following surgical management of colic. Objective: To report factors associated with survival following relaparotomy. Methods: Retrospective cohort study. Methods: Records of horses that had undergone exploratory laparotomy for treatment of colic over a 10-year period (2002-2012) and had undergone relaparotomy <8 weeks following the initial surgery were reviewed. Descriptive data were generated and association with survival time was modelled using Cox proportional hazards models. Results: Relaparotomy was perfor...
Laparoscopic Closure of the Nephrosplenic Space in Horses with Nephrosplenic Colonic Entrapment: Factors Associated with Survival and Colic Recurrence.
Veterinary surgery : VS    September 13, 2016   Volume 45, Issue S1 O60-O69 doi: 10.1111/vsu.12549
Nelson BB, Ruple-Czerniak AA, Hendrickson DA, Hackett ES.1) To identify factors associated with short-term survival and time to death after hospital discharge in horses with nephrosplenic entrapment (NSE). 2) To compare the frequency of recurrent colic episodes in horses with and without laparoscopic closure of the nephrosplenic space. Methods: Historical cohort with a nested case control. Methods: Client-owned horses. Methods: Medical records of horses treated for NSE from January 1, 2002 to June 1, 2014 were reviewed. Data collected included signalment, physical examination parameters, laboratory results, diagnostic findings, and treatments. Facto...
Prevalence, survival analysis and multimorbidity of chronic diseases in the general veterinarian-attended horse population of the UK.
Preventive veterinary medicine    July 26, 2016   Volume 131 137-145 doi: 10.1016/j.prevetmed.2016.07.011
Welsh CE, Duz M, Parkin TDH, Marshall JF.The average age of the global human population is increasing, leading to increased interest in the effects of chronic disease and multimorbidity on health resources and patient welfare. It has been posited that the average age of the general veterinarian-attended horse population of the UK is also increasing, and therefore it could be assumed that chronic diseases and multimorbidity would pose an increasing risk here also. However, evidence for this trend in ageing is very limited, and the current prevalence of many chronic diseases, and of multimorbidity, is unknown. Using text mining of firs...