Factors associated with survival of horses following relaparotomy.

This study explores the factors that influence the survival rate of horses undergoing relaparotomy, a follow-up surgery performed after an initial operation to treat colic. Using data from a 10-year period, it identifies several variables that are linked to survival and non-survival, providing key insights for veterinarians and horse owners alike.

Methods

• The research employs a retrospective cohort study, reviewing records of horses that underwent exploratory laparotomy, a surgical procedure for colic treatment, between 2002 and 2012.
• The focus is on horses that had to undergo relaparotomy less than eight weeks after the initial surgery. This allowed the researchers to generate descriptive data and model the association with survival time using Cox proportional hazards models.

Results

• The study found that 6.3% of the horses that underwent the initial laparotomy needed a relaparotomy. This was most often performed due to signs of persistent post-operative colic.
• The rate of short-term survival varied based on the reason for the relaparotomy. It was highest for persistent colic and incisional dehiscence (53% and 50% respectively), while septic peritonitis resulted in zero survival.
• Median survival was six days for all horses undergoing relaparotomy, but it was significantly longer (778 days) for those that recovered following anesthesia.

Factors Associated with Survival and Non-Survival

• Negative survival factors included increased packed cell volume at 24 hours post-initial laparotomy, the presence of peritonitis as a reason for the relaparotomy, and the presence of adhesions found during the second surgery. These factors demonstrated a higher likelihood of non-survival according to Cox proportional hazards models.
• Conversely, the study identified colic signs being the reason for performing the relaparotomy and small intestinal distension found during the second operation as factors positively associated with survival.

Conclusions

• Through this research, critical information about the survival rates and risk factors for horses undergoing relaparotomy has been provided. The findings can assist clinicians and owners in making informed decisions about whether to perform a relaparotomy and in predicting the likely surgical outcome.