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BMC veterinary research2024; 20(1); 562; doi: 10.1186/s12917-024-04405-0

Factors affecting survival of foals with pneumonia in a referral hospital.

Abstract: Pneumonia is a common condition in ailing neonatal foals, and it remains an important cause of morbidity and mortality in this veterinary patient group. Factors affecting the survival of young foals with pneumonia have not been thoroughly investigated. The aim of this study was to explore the potential prognostic factors associated with survival of these foals. Fifty foals under one month of age with pneumonia were included in this retrospective clinical study. The foals were divided into groups based on survival (survived to discharge or died/euthanised during hospitalisation). Multiple clinical and laboratory variables were investigated as risk factors with univariate logistic regression analyses and subsequently with multivariate analyses. If a variable showed prediction potential in regression analysis, a receiver operating characteristic (ROC) analysis was conducted. Results: In univariate analysis, odds (OR, 95% CI) of non-survival were associated with higher respiratory rate (RR) on the first day after admission to hospital (D1) (1.32, 1.07-1.62, P = 0.009, for each 5-unit increase) and positive bacterial blood culture (12.08, 1.88-77.67, P = 0.009). Odds of non-survival were decreased for Standardbred breed (0.11, 0.01-0.96, P = 0.046) and for foals with longer hospitalisation, with each additional day in hospital further reducing the odds (0.59, 0.40-0.86, P = 0.006). In multivariate analysis, odds of non-survival were associated only with higher RR on D1 (1.36, 1.07-1.71, P = 0.011, for each 5-unit increase). In ROC analysis, optimal cut-off value for RR was ≥ 55/min with sensitivity 75.0% and specificity 76.3%. Based on predictive values, RR < 55/min on D1 favoured survival. Conclusions: Higher RR on D1 is a predictor of non-survival in foals with pneumonia in this study, increasing the odds of death by 36% for each 5-unit increase in RR. Respiratory rate below 55/min on D1 favours survival. These findings could assist in early identification of foals that are at increased risk of mortality, thereby aiding in treatment decisions.
Publication Date: 2024-12-18 PubMed ID: 39695596PubMed Central: 1718193DOI: 10.1186/s12917-024-04405-0Google Scholar: Lookup
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  • Journal Article

Summary

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The research paper explores factors that influence the survival of young foals with pneumonia, with the conclusion that a higher respiratory rate on the first day of hospital admission is a predictor of non-survival.

Study Design and Methodology

  • The researchers conducted a retrospective clinical study involving fifty foals under one month of age suffering from pneumonia.
  • The foals were categorised based on survival – those who survived to discharge and those who died or had to be euthanised during hospitalisation.
  • They studied multiple clinical and laboratory variables as risk factors using univariate logistic regression analyses and multivariate analyses.
  • If a variable displayed predictive potential, a Receiver Operating Characteristic (ROC) analysis was conducted.

Key Findings

  • From the univariate analysis, it was found that non-survival was associated with a higher respiratory rate (RR) on the first day after admission (D1) and a positive bacterial blood culture.
  • The odds of non-survival were decreased for Standardbred breed and foals with longer hospitalisation, with each additional day in the hospital reducing the odds.
  • In the multivariate analysis, the odds of non-survival were linked only with a higher RR on D1.
  • Through ROC analysis, the ideal cut-off value for RR was discovered to be ≥ 55/min with a sensitivity of 75.0% and a specificity of 76.3%.
  • It was concluded that a respiratory rate below 55/min on D1 favoured survival.

Significance of the Study

  • The identification of higher RR on D1 as a predictor of non-survival is significant. It suggests that for every 5-unit increase in RR, the odds of death increase by 36%.
  • These results could potentially be used to identify foals at increased risk of mortality at an early stage. This early identification could assist veterinarians in making treatment decisions and possibly improve survival outcomes in foals suffering from pneumonia.

Cite This Article

APA
Rossi HS, Hyytiäinen HK, Junnila JJT, Rajamäki MM, Mykkänen AK. (2024). Factors affecting survival of foals with pneumonia in a referral hospital. BMC Vet Res, 20(1), 562. https://doi.org/10.1186/s12917-024-04405-0

Publication

ISSN: 1746-6148
NlmUniqueID: 101249759
Country: England
Language: English
Volume: 20
Issue: 1
Pages: 562

Researcher Affiliations

Rossi, Heini Sofia
  • Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Viikintie 49, Helsinki, FI-00014, Finland. heini.rossi@helsinki.fi.
Hyytiäinen, Heli Katariina
  • Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Viikintie 49, Helsinki, FI-00014, Finland.
Junnila, Jouni Juho Tapio
  • EstiMates Oy, Lemminkäisenkatu 14-18, Turku, FI-20520, Finland.
Rajamäki, Minna Marjaana
  • Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Viikintie 49, Helsinki, FI-00014, Finland.
Mykkänen, Anna Kristina
  • Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Viikintie 49, Helsinki, FI-00014, Finland.

MeSH Terms

  • Animals
  • Horses
  • Horse Diseases / mortality
  • Retrospective Studies
  • Male
  • Pneumonia / veterinary
  • Pneumonia / mortality
  • Female
  • Animals, Newborn
  • Risk Factors
  • Hospitals, Animal
  • Prognosis
  • ROC Curve
  • Respiratory Rate

Grant Funding

  • 341581 / Research Council of Finland
  • 341581 / Research Council of Finland
  • 341581 / Research Council of Finland
  • 341581 / Research Council of Finland
  • 341581 / Research Council of Finland

Conflict of Interest Statement

Declarations. Ethics approval and consent to participate: The Viikki Campus Research Ethics Committee of Animal Research at the University of Helsinki approved this retrospective study (Approval date 3 November 2020, Approval number 13/2020). Consent to participate is not applicable to this study. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

References

This article includes 27 references
  1. Beech J. Respiratory problems in foals.. Vet Clin North Am Equine Pract 1985;1(1):131–50.
    doi: 10.1016/S0749-0739(17)30773-3pubmed: 2866829google scholar: lookup
  2. Reuss SM, Cohen ND. Update on bacterial pneumonia in the foal and weanling.. Vet Clin Equine Pract 2015;31(1):121–35.
  3. Wilkins PA, Wong DM, Dunkel B, Sponseller B. Lower respiratory tract disorders.. In: Wong DM, Wilkins PA, editors. Equine neonatal medicine. Hoboken (NJ, USA): John Wiley & Sons, Inc.; 2024. pp. 156–82.
  4. Gayle JM, Cohen ND, Chaffin MK. Factors associated with survival in septicemic foals: 65 cases (1988–1995).. J Vet Intern Med 1998;12(3):140–6.
  5. Steel CM, Hunt AR, Adams PL, Robertson ID, Chicken C, Yovich JV, Stick JA. Factors associated with prognosis for survival and athletic use in foals with septic arthritis: 93 cases (1987–1994).. J Am Vet Med Assoc 1999;215:973–7.
    doi: 10.2460/javma.1999.215.07.973pubmed: 10511863google scholar: lookup
  6. Hoffman AM, Staempfli HR, Willan A. Prognostic variables for survival of neonatal foals under intensive care.. J Vet Intern Med 1992;6:89–95.
  7. Furr M, Tinker MK, Edens L. Prognosis for neonatal foals in an intensive care unit.. J Vet Intern Med 1997;11:183–8.
  8. Bedenice D, Heuwieser W, Solano M, Rand W, Paradis MR. Risk factors and prognostic variables for survival of foals with radiographic evidence of pulmonary disease.. J Vet Intern Med 2003;17:868–75.
  9. Giguère S, Weber EJ, Sanchez LC. Factors associated with outcome and gradual improvement in survival over time in 1065 equine neonates admitted to an intensive care unit.. Equine Vet J 2017;49:45–50.
    doi: 10.1111/evj.12536pubmed: 26538009google scholar: lookup
  10. Bedenice D, Avila B, Paradis MR. Comparative evaluation of clinical findings and prognostic outcome parameters in hospitalized, critically ill neonatal foals and crias.. J Vet Emerg Crit Care 2021;31:619–28.
    doi: 10.1111/vec.13093google scholar: lookup
  11. Stewart JH, Rose RJ, Barko AM. Respiratory studies in foals from birth to seven days old.. Equine Vet J 1984;16:323–28.
  12. Greiner M, Pfeiffer D, Smith RD. Principles and practical application of the receiver-operating characteristic analysis for diagnostic tests.. Prev Vet Med 2000;45:23–41.
    doi: 10.1016/S0167-5877(00)00115-Xpubmed: 10802332google scholar: lookup
  13. Austin S. Newborn physical examination.. In: Wong DM, Wilkins PA, editors. Equine neonatal medicine. Hoboken (NJ, USA): John Wiley & Sons, Inc.; 2024. pp. 42–50.
  14. Wong DM, Katarzyna D. The premature and dysmature neonatal foal.. In: Wong DM, Wilkins PA, editors. Equine neonatal medicine. Hoboken (NJ, USA): John Wiley & Sons, Inc.; 2024. pp. 64–78.
    doi: 10.1002/9781119617228.ch3google scholar: lookup
  15. Harris M, Clark J, Coote N, Fletcher P, Harnden A, McKean M, Thomson A. British Thoracic Society guidelines for the management of community acquired pneumonia in children: update 2011.. Thorax 2011;66:ii1–23.
    doi: 10.1136/thoraxjnl-2011-200598pubmed: 21903691google scholar: lookup
  16. World Health Organization. Revised WHO Classification and Treatment of Pneumonia in Children at Health Facilities: Evidence Summaries.. Geneva: World Health Organization. 2014.
  17. Palafox M, Guiscafré H, Reyes H, Muñoz O, Martínez H. Diagnostic value of tachypnoea in pneumonia defined radiologically.. Arch Dis Child 2000;82:41–5.
    doi: 10.1136/adc.82.1.41pubmed: 10630911pmc: 1718193google scholar: lookup
  18. Shah S, Bachur R, Kim D, Neuman MI. Lack of predictive value of tachypnea in the diagnosis of pneumonia in children.. Pediatr Infect Dis J 2010;29:406–9.
    doi: 10.1097/INF.0b013e3181cb45a7pubmed: 20032805google scholar: lookup
  19. Karim R, Afridi JK, Yar SR, Zaman MB, Afridi BK. Clinical findings and radiological evaluation of WHO-defined severe pneumonia among hospitalized children.. Cureus 2023;15:e33804.
    pubmed: 36819341pmc: 9928894
  20. Reed C, Madhi SA, Klugman KP, Kuwanda L, Ortiz JR, Finelli L, Fry AM. Development of the respiratory index of severity in children (RISC) score among young children with respiratory infections in South Africa.. PLoS ONE 2012;7(1):e27793.
    doi: 10.1371/journal.pone.0027793pubmed: 22238570pmc: 3251620google scholar: lookup
  21. Zhang Q, Guo Z, Bai Z, MacDonald NE. A 4 year prospective study to determine risk factors for severe community acquired pneumonia in children in southern China.. Pediatr Pulmonol 2013;48:390–7.
    doi: 10.1002/ppul.22608pubmed: 22778084google scholar: lookup
  22. Gowraiah V, Awasthi S, Kapoor R, Sahana D, Venkatesh P, Gangadhar B, Awasthi A, Verma A, Pai N, Seear M. Can we distinguish pneumonia from wheezy diseases in tachypnoeic children under low-resource conditions? A prospective observational study in four Indian hospitals.. Arch Dis Child 2014;99:899–906.
  23. Araya S, Lovera D, Zarate C, Apodaca S, Acuña J, Sanabria G, Arbo A. Application of a prognostic scale to estimate the mortality of children hospitalized with community-acquired pneumonia.. Pediatr Infect Dis J 2016;35:369–73.
    doi: 10.1097/INF.0000000000001018pubmed: 26629871google scholar: lookup
  24. Navas de Solis C. Fetal circulation and cardiorespiratory transition.. In: Wong DM, Wilkins PA, editors. Equine neonatal medicine. Hoboken (NJ, USA): John Wiley & Sons, Inc.; 2024. pp. 8–11.
  25. Power M, Fell G, Wright M. Principles for high-quality, high-value testing.. BMJ Evid Based Med 2013;18:5–10.
    doi: 10.1136/eb-2012-100645google scholar: lookup
  26. Kumar CS, Subramanian S, Murki S, Rao JV, Bai M, Penagaram S, Singh H, Bondili NP, Madireddy A, Lingaldinna R. Predictors of mortality in neonatal pneumonia: an INCLEN childhood pneumonia study.. Indian Pediatr 2021;58:1040–5.
    doi: 10.1007/s13312-021-2370-8pubmed: 34837364google scholar: lookup
  27. Wong DM, Wilkins PA. Neonatal infection, section I: bacterial sepsis.. In: Wong DM, Wilkins PA, editors. Equine neonatal medicine. Hoboken (NJ, USA): John Wiley & Sons, Inc.; 2024. pp. 1126–55.

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