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Higher body mass index may increase the risk for the development of incisional complications in horses following emergency ventral midline celiotomy.
Abstract: Obesity is common in the equine population and it has been associated with increased surgical morbidity and mortality in humans. The effect of increased body mass index (BMI) on the incidence of surgical site infections has not been investigated in horses. Objective: To determine whether horses with increased body fat, as estimated by BMI, are more likely to develop post-operative complications, particularly incisional complications, following emergency ventral midline celiotomy. Methods: Retrospective, multi-institutional clinical study. Methods: Medical records of horses >2 years old presenting with colic that underwent ventral midline celiotomy between January 2010 and September 2018 with follow-up of a minimum of 30 post-operative days were reviewed. Extracted data included signalment, operative details and outcome. BMI was calculated by dividing the patient's weight (kg) by the withers height squared (m ). Results: In all, 287 horses fit inclusion criteria. Incisional complication prevalence was 23.7%. Horses with incisional complications had a higher BMI (median 203.6 kg/m , IQR = 191.5-217.4) compared with those without (median 199.1 kg/m , IQR = 184.7-210.2) (P = .03). Multi-variable analysis of the effects of age, sex, breed and presence of metabolic disease on the association between BMI and risk of incisional complications, identified a tendency towards increased risk with a higher BMI, but statistical significance decreased to P = .07. Breed had an association with BMI (P < .01), but not with incisional complication risk. Conclusions: BMI as an estimate of body fat has limitations. Retrospective studies with reliance on owners reporting data and complete medical records is imperfect. When the data were subjected to multi-variable analysis, the trend towards an increased incidence of incisional complications in horses with higher BMI persisted but it was not statistically significant. Conclusions: Higher BMI may increase the risk for the development of incisional complications in horses following emergency ventral midline celiotomy.
© 2020 EVJ Ltd.
Publication Date: 2020-02-21 PubMed ID: 31994775DOI: 10.1111/evj.13242Google Scholar: Lookup The Equine Research Bank provides access to a large database of publicly available scientific literature. Inclusion in the Research Bank does not imply endorsement of study methods or findings by Mad Barn.
- Journal Article
Summary
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The study investigates the influence of a higher body mass index (BMI) on postoperative complications, especially incisional complications, in horses that have undergone emergency ventral midline celiotomy, a type of abdominal surgery. The researchers conclude that although trends indicated an increase in complications among horses with a higher BMI, further multivariate analysis revealed that the correlation was not statistically significant.
The Objective and Methods of the Study
- The aim of this research was to assess whether higher body fat in horses, represented by BMI, is related to a higher incidence of postoperative complications following ventral midline celiotomy. This comes on the back of observations that obesity is common in horses, and in humans, it has been connected with increased surgical risks.
- A retrospective, multi-institutional clinical study was undertaken to meet this objective. The researchers examined medical records of horses over two years old that had undergone ventral midline celiotomy due to colic between January 2010 and September 2018 and had a minimum of 30 postoperative days of recorded follow-up.
- The data collected from the medical records included details of patients, operations, and outcomes. The research used the traditional formula to calculate BMI – weight (in kg) divided by the square of the animal’s height at the withers (a point on the horse’s body).
The Results of the Study
- From the medical records, 287 horses met the requirements for this study. The researchers found a prevalence of incisional complication in approximately 23.7% of the population.
- Horses that developed incisional complications had a higher median BMI (203.6 kg/m²) compared to those that did not (199.1 kg/m²). Thus the initial discovery showed a correlation between higher BMI and higher risk for incisional complications (P=.03).
- However, when other variables (age, sex, breed, and presence of metabolic disease) were factored in, the study disclosed a trend towards increased risk of complications with higher BMI, but its statistical significance decreased (P=.07).
- In this multivariable analysis, breed showed a significant association with BMI but not with the risk of incisional complications.
Conclusions of the Study
- The study acknowledges that using BMI as an exclusive measure of body fat has its limitations, and that retrospective studies like this one that depend on owners’ reported data and complete medical records are not perfect.
- While there seems to be a trend towards higher risk of incisional complications in horses with a higher BMI after undergoing emergency ventral midline celiotomy, the study concludes that the statistical significance of this correlation is insufficient.
- Therefore, while a higher BMI may suggest an increased risk for development of these complications in horses, further detailed and specific studies are necessary to establish a definitive causal relationship.
Cite This Article
APA
Hill JA, Tyma JF, Hayes GM, Radcliffe R, Fubini SL.
(2020).
Higher body mass index may increase the risk for the development of incisional complications in horses following emergency ventral midline celiotomy.
Equine Vet J, 52(6), 799-804.
https://doi.org/10.1111/evj.13242 Publication
Researcher Affiliations
- Cornell University College of Veterinary Medicine, Ithaca, NY, USA.
- University of Georgia College of Veterinary Medicine, Athens, GA, USA.
- Cornell University College of Veterinary Medicine, Ithaca, NY, USA.
- Cornell University College of Veterinary Medicine, Ithaca, NY, USA.
- Cornell University College of Veterinary Medicine, Ithaca, NY, USA.
MeSH Terms
- Animals
- Body Mass Index
- Colic / surgery
- Colic / veterinary
- Horse Diseases / epidemiology
- Horse Diseases / etiology
- Horse Diseases / surgery
- Horses
- Humans
- Laparotomy / veterinary
- Postoperative Complications / epidemiology
- Postoperative Complications / etiology
- Postoperative Complications / veterinary
- Retrospective Studies
Grant Funding
- Harry M. Zweig Memorial Fund for Equine Research
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