Factors associated with mortality and morbidity in small intestinal volvulus in horses.

The research investigates the historical, physical and clinical factors that may influence the mortality and morbidity rates in horses with small intestinal volvulus. The study indicates that neither age, breed, nor sex influence mortality and that improved survival rates are associated with superior cardiovascular status, lower hemoconcentration levels, and healthier peritoneal fluid properties.

Methodology

• The study is retrospective in nature and extensively utilizes data extracted from the medical records of 115 client-owned horses, aged between 1 month and 21 years.
• Earliest steps included identifying relevant data through both computer search and manual review.
• Continuous variables, such as heart rate and capillary refill time, were analyzed via Mann-Whitney U tests and non-continuous variables were compared via Fisher’s exact test, based on 2×2 tables, or chi-squared tests for larger tables.
• A stepwise logistic regression analysis was employed to develop a multivariable model of the risk factors with due consideration to confounding and interaction.

Results and Insights

• This investigation showed that 80% of horses which successfully recovered from surgery managed to survive until hospital discharge.
• Crucially, the research concluded that elements such as age, breed and sex have no bearing on mortality.
• Survivariate statistics suggest a direct correlation to a lower heart rate, shorter capillary refill time and better mucous membrane colour.
• A worsening cardiovascular status, increased hemoconcentration and exudation of cells and protein into the peritoneal fluid were significantly associated with non-survival.
• Colic was observed to be the most severe complication following recovery from surgery, significantly associated with non-survival. The likelihood of a second surgery was also noted to reduce survival rates.
• Furthermore, colic and a second surgery were both linked to a jejunocecostomy performed during initial surgical treatment.

Conclusions

• The research successfully identified significant differences in the clinical and clinicopathologic signs between survivors and non-survivors of small intestinal volvulus in horses.
• These findings provide practitioners with enhanced insight into the prognosis at various stages (pre-operative, operative, and post-operative) while managing cases of horses suffering from small intestinal volvulus.