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Veterinary surgery : VS2022; 51(6); 891-902; doi: 10.1111/vsu.13839

Performance of predictive models of survival in horses undergoing emergency exploratory laparotomy for colic.

Abstract: To evaluate previously published predictive survival models in a population of horses undergoing colic surgery in the midwestern United States. Methods: Retrospective cohort study; single referral hospital. Methods: A total of 260 horses met the inclusion criteria. Methods: Medical records of horses undergoing surgical treatment for colic were reviewed. Previously published models were applied to cohort data to predict outcome. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy for prediction of short-term survival were calculated. Results: Single-variable and multivariable models performed similarly for prediction of survival, with a mean 79% sensitivity (range: 44%-94%), 48% specificity (range: 22%-83%), 63% PPV (range: 56%-72%), 73% NPV (range: 60%-83%), and 64% accuracy (range: 59%-72%). Blood lactate ≤6 mmol/l and the colic severity score (CSS) were highly sensitive for prediction of survival; however, both had poor specificity. Conclusions: Single-variable and multivariable predictive models did not perform as well for prediction of survival in the study cohort compared to original reports, suggesting that population-specific factors contribute to patient survival. Conclusions: Predictive models of survival developed in one population may be less reliable when used to predict outcome in horses undergoing colic surgery from an independent population. Additional model testing and refinement using data from multiple surgical centers could be considered to improve prediction of outcome for horses undergoing laparotomy for treatment of colic.
© 2022 The Authors. Veterinary Surgery published by Wiley Periodicals LLC on behalf of American College of Veterinary Surgeons.
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Publication Date: 2022-06-08 PubMed ID: 35674231PubMed Central: PMC9545965DOI: 10.1111/vsu.13839Google Scholar: Lookup
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  • Journal Article

Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

This research investigated the reliability of previous predictive survival models when applied to a different population, specifically those of horses undergoing surgery for colic in the midwestern United States. Findings indicate these models didn’t perform as well in this setting, leading to the suggestion of tailored models according to population-specific factors and further testing with data from multiple surgical centers for improvement.

Study Methodology

  • The study is a retrospective cohort study conducted in a single referral hospital.
  • A total of 260 horses qualified for the study’s inclusion criteria. All of these horses underwent surgical procedures as a treatment for colic.
  • The researchers reviewed the medical records of these horses and applied previously established survival prediction models to this cohort data, specifically aiming to predict short-term survival outcomes.
  • To evaluate the predictive models, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated.

Study Results

  • The findings show that both single-variable and multivariable models projected similar predictions of survival rates.
  • These models manifested a mean sensitivity of 79% and specificity of 48%. PPV was 63%, and NPV was 73%, resulting in an accuracy of 64%.
  • Among the various components analyzed, blood lactate levels of ≤6 mmol/l and the colic severity score (CSS) emerged as highly sensitive metrics for survival prediction, though they exhibited low specificity.

Conclusions and Recommendations

  • The study found that the evaluated single-variable and multivariable predictive models did not perform as well in predicting survival rates for the study cohort when compared to their performance in the original reports.
  • These results suggest that there may be population-specific factors that significantly impact patient survival.
  • For this reason, the study indicates that survival prediction models established in one equine population may not reliably predict outcomes in a different population, such as horses from the midwest of the U.S. undergoing colic surgery.
  • As a recommendation, the study suggests further testing and refinement of these models using data from various surgical centers, aiming to improve the prediction of outcomes for horses that undergo laparotomy as a treatment of colic.

Cite This Article

APA
Bishop RC, Gutierrez-Nibeyro SD, Stewart MC, McCoy AM. (2022). Performance of predictive models of survival in horses undergoing emergency exploratory laparotomy for colic. Vet Surg, 51(6), 891-902. https://doi.org/10.1111/vsu.13839

Publication

Veterinary surgery : VS
ISSN: 1532-950X
NlmUniqueID: 8113214
Country: United States
Language: English
Volume: 51
Issue: 6
Pages: 891-902

Researcher Affiliations

Bishop, Rebecca C
  • Department of Veterinary Clinical Medicine, University of Illinois, Urbana, Illinois, USA.
Gutierrez-Nibeyro, Santiago D
  • Department of Veterinary Clinical Medicine, University of Illinois, Urbana, Illinois, USA.
Stewart, Matthew C
  • Department of Veterinary Clinical Medicine, University of Illinois, Urbana, Illinois, USA.
McCoy, Annette M
  • Department of Veterinary Clinical Medicine, University of Illinois, Urbana, Illinois, USA.

MeSH Terms

  • Animals
  • Colic / surgery
  • Colic / veterinary
  • Horse Diseases / surgery
  • Horses
  • Laparotomy / veterinary
  • Postoperative Complications / epidemiology
  • Postoperative Complications / veterinary
  • Retrospective Studies

Conflict of Interest Statement

There was no funding specific to this work. The authors declare no conflict of interest related to this report.

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