Equine veterinary journal. Supplement2011; (39); 56-62; doi: 10.1111/j.2042-3306.2011.00409.x

Factors associated with survival of epiploic foramen entrapment colic: a multicentre, international study.

Abstract: Epiploic foramen entrapment (EFE) has been associated with reduced post operative survival compared to other types of colic but specific factors associated with reduced long-term survival of these cases have not been evaluated in a large number of horses using survival analysis. Objective: To describe post operative survival of EFE cases and to identify factors associated with long-term survival. Methods: A prospective, multicentre, international study was conducted using clinical data and long-term follow-up information for 126 horses diagnosed with EFE during exploratory laparotomy at 15 clinics in the UK, Ireland and USA. Descriptive data were generated and survival analysis performed to identify factors associated with reduced post operative survival. Results: For the EFE cohort that recovered following anaesthesia, survival to hospital discharge was 78.5%. Survival to 1 and 2 years post operatively was 50.6 and 34.3%, respectively. The median survival time of EFE cases undergoing surgery was 397 days. Increased packed cell volume (PCV) and increased length of small intestine (SI) resected were significantly associated with increased likelihood of mortality when multivariable analysis of pre- and intraoperative variables were analysed. When all pre-, intra- and post operative variables were analysed separately, only horses that developed post operative ileus (POI) were shown to be at increased likelihood of mortality. Conclusions: Increased PCV, increased length of SI resected and POI are all associated with increased likelihood of mortality of EFE cases. This emphasises the importance of early diagnosis and treatment and the need for improved strategies in the management of POI in order to reduce post operative mortality in these cases. Conclusions: The present study provides evidence-based information to clinicians and owners of horses undergoing surgery for EFE about long-term survival. These results are applicable to university and large private clinics over a wide geographical area.
Publication Date: 2011-08-04 PubMed ID: 21790755DOI: 10.1111/j.2042-3306.2011.00409.xGoogle Scholar: Lookup
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  • Journal Article
  • Multicenter Study
  • Research Support
  • Non-U.S. Gov't

Summary

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The research explores factors that affect the long-term survival of horses diagnosed with Epiploic Foramen Entrapment (EFE)- a type of colic. The findings reveal that increased Packed Cell Volume (PCV), lengthy small intestine resections, and Post-Operative Ileus (POI) significantly increase the likelihood of mortality among EFE cases, emphasizing the importance of early diagnosis and treatment.

Objective and Methodology

  • This study aimed to describe postoperative survival in EFE cases and identify factors that impact long-term survival among these horses.
  • The researchers took a prospective, international approach, conducting the study across 15 clinics in the UK, Ireland, and USA.
  • They collected and reviewed clinical data and long-lasting follow-up data from 126 horses diagnosed with EFE during exploratory laparotomy.
  • They used this information to generate descriptive data and perform a survival analysis to pinpoint factors associated with decreased postoperative survival.

Findings

  • Survival rate to hospital discharge was 78.5% for the EFE cohort that recovered following anesthesia.
  • Survival postoperatively to 1 and 2 years was 50.6% and 34.3% respectively.
  • The median survival time of EFE cases that underwent surgery was 397 days.
  • When pre- and intraoperative variables were analyzed, it was found that an increased Packed Cell Volume (PCV) and an increased length of small intestine (SI) resected were significantly linked to a higher chance of mortality.
  • However, when pre-, intra-, and postoperative variables were analyzed separately, only the horses that developed Post-Operative Ileus (POI) were identified as having an increased chance of mortality.

Conclusion

  • The study concludes that enhanced PCV, increased SI resection length, and POI are all associated with a higher risk of mortality in EFE cases.
  • This underscores the significance of early diagnosis and treatment, along with the need for better POI management strategies to reduce postoperative fatalities in EFE cases.
  • The study delivers evidence-based insights for clinicians and horse owners about long-term survival after EFE surgery, applicable to university and large private clinics across a wide geographic area.

Cite This Article

APA
Archer DC, Pinchbeck GL, Proudman CJ. (2011). Factors associated with survival of epiploic foramen entrapment colic: a multicentre, international study. Equine Vet J Suppl(39), 56-62. https://doi.org/10.1111/j.2042-3306.2011.00409.x

Publication

NlmUniqueID: 9614088
Country: United States
Language: English
Issue: 39
Pages: 56-62

Researcher Affiliations

Archer, D C
  • University of Liverpool, Leahurst Campus, Neston, Wirral, UK. darcher@liv.ac.uk
Pinchbeck, G L
    Proudman, C J

      MeSH Terms

      • Animals
      • Colic / epidemiology
      • Colic / mortality
      • Colic / pathology
      • Colic / veterinary
      • Euthanasia, Animal
      • Hematocrit / veterinary
      • Horse Diseases / epidemiology
      • Horse Diseases / mortality
      • Horse Diseases / pathology
      • Horses
      • Intestine, Small / surgery
      • Ireland / epidemiology
      • Postoperative Complications / mortality
      • Postoperative Complications / veterinary
      • Prospective Studies
      • Risk Factors
      • Survival Analysis
      • United Kingdom / epidemiology
      • United States / epidemiology

      Citations

      This article has been cited 6 times.
      1. Gomez DE, Leclere M, Arroyo LG, Li L, John E, Afonso T, Payette F, Darby S. Acute diarrhea in horses: A multicenter Canadian retrospective study (2015 to 2019).. Can Vet J 2022 Oct;63(10):1033-1042.
        pubmed: 36185796
      2. Asin J, Nyaoke AC, Samol MA, Arthur RM, Uzal FA. Clostridioides (Clostridium) difficile-associated disease, epiploic foramen entrapment, and gastric rupture in a Thoroughbred racehorse: case report and literature review.. J Vet Diagn Invest 2022 Sep;34(5):913-917.
        doi: 10.1177/10406387221118039pubmed: 35949155google scholar: lookup
      3. Grzeskowiak RM, Barrett EJ, Rodgerson DH. Cecal entrapment within the epiploic foramen in a mare.. Can Vet J 2017 Aug;58(8):842-844.
        pubmed: 28761191
      4. Immonen IA, Karikoski N, Mykku00e4nen A, Niemelu00e4 T, Junnila J, Tulamo RM. Long-term follow-up on recovery, return to use and sporting activity: a retrospective study of 236 operated colic horses in Finland (2006-2012).. Acta Vet Scand 2017 Jan 5;59(1):5.
        doi: 10.1186/s13028-016-0273-9pubmed: 28057022google scholar: lookup
      5. Salem SE, Proudman CJ, Archer DC. Has intravenous lidocaine improved the outcome in horses following surgical management of small intestinal lesions in a UK hospital population?. BMC Vet Res 2016 Jul 27;12(1):157.
        doi: 10.1186/s12917-016-0784-7pubmed: 27459996google scholar: lookup
      6. Wormstrand BH, Ihler CF, Diesen R, Krontveit RI. Surgical treatment of equine colic - a retrospective study of 297 surgeries in Norway 2005-2011.. Acta Vet Scand 2014 Jun 16;56(1):38.
        doi: 10.1186/1751-0147-56-38pubmed: 24934123google scholar: lookup