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Home / Equine Research Bank / Vet Rec / Evaluation of long-term postoperative morbidity and survival...
The Veterinary record2026; doi: 10.1002/vetr.70174

Evaluation of long-term postoperative morbidity and survival after equine colic surgery using a complication severity classification.

Abstract: Most studies on colic surgery outcome focus on short-term survival and complications. Long-term outcomes, particularly post-discharge morbidity, are poorly characterised despite their relevance. No standardised system has previously integrated both short- and long-term postoperative complications with survival outcomes. Therefore, this study aimed to evaluate long-term survival and morbidity in horses after colic surgery using the equine postoperative complication score (EPOCS), and to assess the association between complications and survival. Methods: The medical records of horses undergoing colic surgery between January 2017 and March 2021 were retrospectively reviewed. Long-term follow-up (≥4 years) was obtained via telephone. Complications were scored using the EPOCS. Results: Of the 244 horses undergoing surgery, 203 were discharged, and 176 were successfully followed up. Post-discharge complications occurred in 44.8%, with colic being the most common. Pre-discharge EPOCS was negatively correlated with long-term survival (r = -0.25, 95% confidence interval [CI]: -0.40 to 0.09, p = 0.002). Total EPOCS was also inversely associated with survival (r = -0.19, 95% CI: -0.35 to -0.02, p = 0.02). Post-discharge EPOCS was not associated with survival. Lesion type, intestinal segment and resection did not significantly affect survival. Conclusions: The retrospective design, owner-reported follow-up and single-centre data limit generalisability and underrepresent minor complications. Conclusions: Long-term survival in horses with colic is favourable; however, postoperative complications are common and prognostically relevant. EPOCS provides a structured method for quantifying morbidity and may support future comparisons between surgical techniques and management strategies.
© 2026 The Author(s). Veterinary Record published by John Wiley & Sons Ltd on behalf of British Veterinary Association.
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Publication Date: 2026-01-17 PubMed ID: 41546600DOI: 10.1002/vetr.70174Google Scholar: Lookup
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Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

Overview

  • This study assessed the long-term survival and postoperative complications in horses following colic surgery using a standardized complication scoring system called the Equine Postoperative Complication Score (EPOCS).
  • The research aimed to understand how complications influence survival beyond the immediate postoperative period, addressing a gap in existing literature that largely focuses on short-term outcomes.

Background and Purpose

  • Colic surgery in horses is a common emergency intervention, but most research concentrates on survival and complications during the hospital stay or shortly after surgery.
  • Long-term postoperative morbidity—complications occurring after discharge—is not well documented, despite its importance for horse owners and veterinarians.
  • Prior to this study, no standardized system had been used to integrate both short-term and long-term postoperative complications with survival data.
  • The study introduced the Equine Postoperative Complication Score (EPOCS) as a tool to systematically quantify complications over time.

Methods

  • The researchers conducted a retrospective review of medical records from a single center, including horses that underwent colic surgery between January 2017 and March 2021.
  • Long-term follow-up was obtained by telephone at least 4 years post-surgery to assess survival and record post-discharge complications.
  • Complications were scored using EPOCS, a severity classification system, to evaluate morbidity in a structured way.
  • Statistical analysis was applied to explore correlations between complication scores and survival outcomes.

Key Findings

  • Out of 244 treated horses, 203 survived to discharge and 176 were successfully followed up long term.
  • Post-discharge complications were fairly common, occurring in 44.8% of horses, with recurrent colic episodes being the most frequently reported issue.
  • Higher complication scores recorded before discharge (pre-discharge EPOCS) were significantly associated with reduced long-term survival.
  • When considering the total complication score (including both pre- and post-discharge periods), there remained an inverse relationship with survival.
  • Post-discharge complications alone (post-discharge EPOCS) did not show a significant association with survival, indicating early complications might be more prognostically relevant.
  • Neither the type of intestinal lesion, the specific intestinal segment affected, nor whether resection surgery was performed, had a significant impact on survival rates.

Interpretation and Implications

  • The findings suggest that colic surgery has a generally favorable long-term survival rate for horses.
  • However, postoperative complications remain common and can influence prognosis, especially those occurring before discharge.
  • EPOCS proved to be a useful tool in quantifying complications systematically, enabling better comparisons and possibly guiding clinical decisions or management practices in the future.

Limitations

  • The retrospective design of the study may introduce bias in data collection and completeness.
  • Follow-up data were owner-reported via telephone, which can lead to under-reporting of minor complications and reliance on owner recall accuracy.
  • Data were collected from a single center, which may limit the applicability of the results to other populations or clinical settings.

Conclusions

  • Long-term survival after equine colic surgery is generally good, but postoperative morbidity is frequent and important for prognosis.
  • The use of a standardized score like EPOCS allows for better tracking and understanding of postoperative complications over time.
  • This scoring system could support future research comparing surgical techniques and postoperative management to improve outcomes.

Cite This Article

APA
Gandini M, Giusto G. (2026). Evaluation of long-term postoperative morbidity and survival after equine colic surgery using a complication severity classification. Vet Rec. https://doi.org/10.1002/vetr.70174

Publication

The Veterinary record
ISSN: 2042-7670
NlmUniqueID: 0031164
Country: England
Language: English

Researcher Affiliations

Gandini, Marco
  • Department of Veterinary Sciences, University of Turin, Turin, Italy.
Giusto, Gessica
  • Department of Veterinary Sciences, University of Turin, Turin, Italy.

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