Analyze Diet

Perioperative risk factors for mortality and length of hospitalization in mares with dystocia undergoing general anesthesia: a retrospective study.

Abstract: This study investigated associations between perioperative factors and probability of death and length of hospitalization of mares with dystocia that survived following general anesthesia. Demographics and perioperative characteristics from 65 mares were reviewed retrospectively and used in a risk factor analysis. Mortality rate was 21.5% during the first 24 h post-anesthesia. The mean ± standard deviation number of days of hospitalization of surviving mares was 6.3 ± 5.4 d. Several factors were found in the univariable analysis to be significantly associated (P < 0.1) with increased probability of perianesthetic death, including: low preoperative total protein, high temperature and severe dehydration on presentation, prolonged dystocia, intraoperative hypotension, and drugs used during recovery. Type of delivery and day of the week the surgery was performed were significantly associated with length of hospitalization in the multivariable mixed effects model. The study identified some risk factors that may allow clinicians to better estimate the probability of mortality and morbidity in these mares. Facteurs de risque périopératoires pour la mortalité et la durée d’hospitalisation chez les juments atteintes de dystocie subissant l’anesthésie générale : une étude rétrospective. Cette étude a étudié les associations entre les facteurs périopératoires et la probabilité de décès et la durée d’hospitalisation des juments atteintes de dystocie qui ont survécu après l’anesthésie générale. Les données démographiques et les caractéristiques périopératoires ont été examinées rétrospectivement et utilisées dans une analyse des facteurs de risque. Le taux de mortalité était de 21,5 % durant les 24 premières heures après l’anesthésie. La moyenne ± l’écart-type du nombre de jours d’hospitalisation des juments qui avaient survécu étaient de 6,3 ± 5,4 jours. Plusieurs facteurs ont été trouvés dans l’analyse à une variable comme présentant une association importante (P < 0,1) avec une probabilité accrue de mort péri-anesthésique, y compris : un taux total de protéines faible en stade préopératoire, une température élevée et une déshydratation grave à la présentation, une dystocie prolongée, de l’hypotension intra-opératoire et les médicaments utilisés pendant le réveil. Le type de mise bas et le jour de la semaine de l’intervention chirurgicale présentaient une association significative avec la durée d’hospitalisation dans le modèle des effets mixtes à variables multiples. L’étude a identifié certains facteurs de risque qui pourront permettre aux cliniciens de mieux prévoir la probabilité de mortalité et de morbidité chez ces juments. (Traduit par Isabelle Vallières)
Publication Date: 2012-11-02 PubMed ID: 23115362PubMed Central: PMC3327588
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

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.

The research assesses the influence of perioperative factors on survival and hospital stay length of mares suffering from dystocia (difficult childbirth) post general anesthesia. It reveals that variables such as preoperative protein level, presentation conditions, dystocia duration, intraoperative blood pressure, and recovery drugs, significantly affect survival chances, while the day and type of delivery determine the hospital stay length.

Research Background

  • The research was carried out to identify perioperative risk factors that affect the mortality rate and length of hospitalization in mares with dystocia undergoing general anesthesia.
  • Dystocia refers to difficulties or complications during childbirth. For mares, this can be a critical condition, often requiring general anesthesia and medical intervention.
  • Understanding the variables that influence the outcome and recovery of such procedures can allow veterinary clinicians to better prepare and manage these cases.

Research Methodology

  • As part of the study, data on demographic and perioperative characteristics of 65 mares was retrospectively analyzed.
  • This analysis focused on several possible risk factors, including preoperative total protein levels, animal’s condition on presentation (such as high temperature and severe dehydration), dystocia duration, intraoperative hypotension, and drugs used during recovery.
  • These factors were then correlated with the horse’s mortality rate and length of hospitalization using a risk factor analysis.

Key Findings

  • The research revealed that out of the 65 mares, the mortality rate was 21.5% during the initial 24 hours post-anesthesia.
  • For the surviving mares, the average length of hospital stay was 6.3 ± 5.4 days.
  • Several factors found in the univariable analysis were seen to be significantly associated with an increased probability of death during the perianesthetic period. These included: low preoperative total protein, high temperature, and severe dehydration at presentation, prolonged dystocia, and drugs used during recovery.
  • The multivariable mixed-effects model showed that the day of the week when the surgery was performed and the type of delivery were significantly associated with the length of hospitalization.

Research Implications

  • This study provides insightful data that can help clinicians better predict mortality and morbidity risk in mares with dystocia undergoing general anesthesia.
  • By understanding and considering these risk factors, it’s possible to take measures to potentially mitigate these risks, contributing to improve overall veterinary care for mares.

Cite This Article

APA
Rioja E, Cernicchiaro N, Costa MC, Valverde A. (2012). Perioperative risk factors for mortality and length of hospitalization in mares with dystocia undergoing general anesthesia: a retrospective study. Can Vet J, 53(5), 502-510.

Publication

ISSN: 0008-5286
NlmUniqueID: 0004653
Country: Canada
Language: English
Volume: 53
Issue: 5
Pages: 502-510

Researcher Affiliations

Rioja, Eva
  • Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada. eva.riojagarcia@up.ac.za
Cernicchiaro, Natalia
    Costa, Maria Carolina
      Valverde, Alexander

        MeSH Terms

        • Anesthesia, General / mortality
        • Anesthesia, General / veterinary
        • Animals
        • Dystocia / mortality
        • Dystocia / surgery
        • Dystocia / veterinary
        • Female
        • Horse Diseases / mortality
        • Horse Diseases / surgery
        • Horses
        • Hospitals, Animal / statistics & numerical data
        • Length of Stay
        • Obstetric Labor Complications / mortality
        • Obstetric Labor Complications / veterinary
        • Perioperative Care / veterinary
        • Perioperative Period / veterinary
        • Postoperative Complications / mortality
        • Postoperative Complications / veterinary
        • Pregnancy
        • Pregnancy Outcome / veterinary
        • Retrospective Studies
        • Risk Factors
        • Survival Analysis
        • Time Factors

        References

        This article includes 23 references
        1. Jones RS. Editorial II: Comparative mortality in anesthesia.. Br J Anaesth 2001;87:813–815.
          pubmed: 11878679
        2. Young SS, Taylor PM. Factors influencing the outcome of equine anesthesia: A review of 1,314 cases.. Equine Vet J 1993;25:147–151.
          pubmed: 8467775
        3. Mee AM, Cripps RS, Jones RS. A retrospective study of mortality associated with general anesthesia in horses: Emergency procedures.. Vet Rec 1998;142:307–309.
          pubmed: 9569498
        4. Mee AM, Cripps RS, Jones RS. A retrospective study of mortality associated with general anesthesia in horses: Elective procedures.. Vet Rec 1998;142:275–276.
          pubmed: 9569482
        5. Johnston GM, Taylor PM, Holmes MA, Wood JLN. Confidential enquiry of perioperative equine fatalities (CEPEF-1): Preliminary results.. Equine Vet J 1995;27:193–200.
          pubmed: 7556046
        6. Johnston GM, Eastment JK, Wood JLN, Taylor PM. The confidential enquiry into perioperative equine fatalities (CEPEF): Mortality results of Phases 1 and 2.. Vet Anaesth Analg 2002;29:159–170.
          pubmed: 28404360
        7. Bidwell LA, Bramlage LR, Rood WA. Equine perioperative fatalities associated with general anesthesia at a private practice — A retrospective case series.. Vet Anaesth Analg 2007;34:23–30.
          pubmed: 17238959
        8. Rothenbuhler R, Hawkins JF, Adams SB. Evaluation of surgical treatment for signs of acute abdominal pain in draft horses: 72 cases (1983–2002). J Am Vet Med Assoc 2006;228:1546–1550.
          pubmed: 16677124
        9. Edwards GB, Allen WE, Newcombe JR. Elective caesarean section in the mare for the production of gnotobiotic foals.. Equine Vet J 1974;6:122–126.
          pubmed: 4851801
        10. Juzwiak JS, Slone DE, Santschi EM, Moll HD. Caesarean section in 19 mares. Results and postoperative fertility.. Vet Surg 1990;19:50–52.
          pubmed: 2301160
        11. Freeman DE, Hungerford LL, Schaeffer D. Caesarean section and other methods for assisted delivery: Comparison of effects on mare mortality and complications.. Equine Vet J 1999;31:203–207.
          pubmed: 10402132
        12. Byron CR, Embertson RM, Bernard WV, Hance SR, Bramlage LR, Hopper SA. Dystocia in a referral hospital setting: Approach and results.. Equine Vet J 2002;35:82–85.
          pubmed: 12553468
        13. Maaskant A, De Bruijn CM, Schutrups AH, Stout TAE. Dystocia in Friesian mares: Prevalence, causes and outcome following caesarean section.. Equine Vet Educ 2010;22:190–195.
        14. Rabe-Hesketh S, Skrondal A, Pickles A. UC Berkeley Division of Biostatistics, Working Paper Series: Working Paper.. 2004. GLLAMM Manual; p. 160.
        15. Guyton AC, Hall JE. Protein metabolism.. Textbook of Medical Physiology 2006. 11th ed. Philadelphia, Pennsylvania: Elsevier Saunders; pp. 852–858.
        16. Stoelting RK, Hillier SC. Pharmacokinetics and pharmacodynamics of injected and inhaled drugs.. Pharmacology and Physiology in Anesthetic Practice 2006. 4th ed. Philadelphia, Pennsylvania: Lippincott Williams & Wilkins; pp. 3–41.
        17. Cross DT, Threlfall WR, Kline RC. Body temperature fluctuations in the periparturient horse mare.. Theriogenology 1992;37:1041–1048.
          pubmed: 16727102
        18. Lindsay WA, Robinson GM, Brunson DB, Majors LJ. Induction of equine postanesthetic myositis after halothane-induced hypotension.. Am J Vet Res 1989;50:404–410.
          pubmed: 2930029
        19. Richey MT, Holland MS, McGrath CJ. Equine post-anesthetic lameness. A retrospective study.. Vet Surg 1990;19:392–397.
          pubmed: 2219677
        20. Bidwell LA, Bone NL, Steele RD. Electrolyte abnormalities in mares presenting for dystocia birth.. Proc Annu Meet Am Coll Vet Anesth 2009;717.
        21. Santos M, Fuente M, Garcia-Iturralde P, Herran R, Lopez-Sanroman J, Tendillo FJ. Effects of alpha-2 adrenoceptor agonists during recovery from isoflurane anesthesia in horses.. Equine Vet J 2003;35:170–175.
          pubmed: 12638794
        22. Wagner AE, Mama KR, Steffey EP, Hellyer PW. A comparison of equine recovery characteristics after isoflurane or isoflurane followed by a xylazine-ketamine infusion.. Vet Anaesth Analg 2008;35:154–160.
          pubmed: 18275487
        23. Norton JL, Dallap BL, Johnston JK. Retrospective study of dystocia in mares at a referral hospital.. Equine Vet J 2007;39:37–41.
          pubmed: 17228593

        Citations

        This article has been cited 9 times.
        1. Oliveira IM, da Rosa DS, da Silva LRR, de Souza YSK, Ribeiro MS, Castro GNS. Evaluation of the analgesic potential of serratus block associated with tap block in female dogs undergoing mastectomy. Braz J Vet Med 2025;47:e000925.
          doi: 10.29374/2527-2179.bjvm000925pubmed: 40936646google scholar: lookup
        2. de la Rebière de Pouyade G, Binard M, Deleuze S, Ponthier J. Survey on outcomes of emergency standing caesarean section in equids. Front Vet Sci 2025;12:1548978.
          doi: 10.3389/fvets.2025.1548978pubmed: 40343373google scholar: lookup
        3. Feyisa CT, Dadi YD, Kitessa JD. Multiple cesarean section in Jenny. BMC Vet Res 2025 Feb 26;21(1):114.
          doi: 10.1186/s12917-025-04552-ypubmed: 40011907google scholar: lookup
        4. Henderson ARP, Valverde A, Koenig J, Sears W. Effects of anesthetic protocol, procedure, and recovery stall and interval on the quality of recovery in repeatedly anesthetized horses. Can J Vet Res 2025 Jan;89(1):17-25.
          pubmed: 39744466
        5. Ellerbrock M, Krohn J, Büttner K, Wehrend A. Isolated and multiple causes of equine dystocia. Acta Vet Scand 2024 Oct 11;66(1):55.
          doi: 10.1186/s13028-024-00772-8pubmed: 39394153google scholar: lookup
        6. Radhakrishnan S, Lorenzutti AM, Araos JD, Martin-Flores M. Evaluation of noninvasive blood pressure in anesthetized horses: Bias, limits of agreement, and comparative detection of a predetermined mean blood pressure warranting treatment. Can Vet J 2021 Sep;62(9):994-998.
          pubmed: 34475586
        7. Vermedal H, Valverde A, Sears W. Effect of anesthesia duration on the quality of recovery in horses undergoing elective and emergency surgeries using the same anesthetic protocol. Can J Vet Res 2021 Jul;85(3):193-200.
          pubmed: 34248263
        8. Gozalo-Marcilla M, Ringer SK. Recovery after General Anaesthesia in Adult Horses: A Structured Summary of the Literature. Animals (Basel) 2021 Jun 14;11(6).
          doi: 10.3390/ani11061777pubmed: 34198637google scholar: lookup
        9. Li Q, Zhang X, Xu M, Wu J. A retrospective analysis of 62,571 cases of perioperative adverse events in thoracic surgery at a tertiary care teaching hospital in a developing country. J Cardiothorac Surg 2019 May 31;14(1):98.
          doi: 10.1186/s13019-019-0921-zpubmed: 31151461google scholar: lookup