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Animals : an open access journal from MDPI2022; 12(11); 1375; doi: 10.3390/ani12111375

Predictive Models for Equine Emergency Exploratory Laparotomy in Spain: Pre-, Intra-, and Post-Operative-Mortality-Associated Factors.

Abstract: The extrinsic and intrinsic characteristics of an equine population may influence the onset of gastrointestinal lesions and affect the survival rate of patients. The equine population in Spain has been the focus of a small number of studies, none of which have involved more than one surgical center. In this retrospective cohort study, we aimed to analyze the survival rate, identify the variables that influenced death, and generate multivariate models using clinical variables. Data were collected from the clinical records of two surgical referral centers in the same region, and a total of 566 horses met the inclusion criteria. The statistical analysis was divided into three parts: The first and second included logistic analysis, in order to identify the variables most closely associated with survival. The third part assessed all previous variables in terms of survival and hospitalization time, using a COX survival analysis. The main risk factors associated with intra-operative mortality were related to seasonality (winter and summer), patient age (older than 9 years), distance from the hospital, the presence of a strangulating lesion, and the bowel segment affected (small intestine). Furthermore, the main factors associated with mortality during hospitalization were the characteristics of the lesions (strangulating) and the differences between surgical centers. The models generated in this study have good predictive value and use only reliable and easily obtainable variables. The most reliable characteristics are those related to the type of colic and the location of the lesion.
Publication Date: 2022-05-27 PubMed ID: 35681838PubMed Central: PMC9179522DOI: 10.3390/ani12111375Google Scholar: Lookup
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  • Journal Article

Summary

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This research article investigates factors that influence survival rates in horses undergoing emergency exploratory surgery in Spain. The study highlights that the main risk factors associated with intra-operative mortality are seasonal, age of the horse, distance to the hospital, presence of a strangulating lesion and the affected bowel segment.

Study Overview

  • The study is retrospective in nature and involves a cohort design. The researchers examined past clinical records from two different surgical referral centers in the same region.
  • The aim of the study was to analyze survival rate, identify variables that influenced death and develop multivariate models using clinical variables.
  • The study’s sample comprised 566 horses, all of which met the inclusion criteria set by the researchers.

Methodology

  • The research involved dividing the statistical analysis into three parts. The first and second parts utilized logistic analysis with the purpose of identifying the variables most associated with survival.
  • The third part evaluated all the previous variables regarding survival and hospitalization time, utilizing a COX survival analysis.

Key Findings

  • The research identified several risk factors linked with intra-operative mortality, including: seasonality (specifically winter and summer), patient age (particularly horses older than 9 years old), distance from the hospital, the presence of a strangulating lesion, and the bowel segment affected (notably the small intestine).
  • The main factors associated with mortality during hospitalization were the lesion characteristics (specifically strangulating lesions) and the differences between surgical centers.
  • The models developed in this study, based on these identified factors, showed good predictive value and employed only reliable and easily obtainable variables. Notably, the most reliable characteristics related to the type of colic and the location of the lesion.

Cite This Article

APA
Iglesias-García M, Rodríguez Hurtado I, Ortiz-Díez G, De la Calle Del Barrio J, Fernández Pérez C, Gómez Lucas R. (2022). Predictive Models for Equine Emergency Exploratory Laparotomy in Spain: Pre-, Intra-, and Post-Operative-Mortality-Associated Factors. Animals (Basel), 12(11), 1375. https://doi.org/10.3390/ani12111375

Publication

ISSN: 2076-2615
NlmUniqueID: 101635614
Country: Switzerland
Language: English
Volume: 12
Issue: 11
PII: 1375

Researcher Affiliations

Iglesias-García, Manuel
  • Department of Equine Surgery, University of Extremadura, 10004 Caceres, Spain.
Rodríguez Hurtado, Isabel
  • Large Animal Department, Alfonso X el Sabio University, 28691 Madrid, Spain.
Ortiz-Díez, Gustavo
  • Department of Animal Medicine and Surgery, Complutense University of Madrid, 28040 Madrid, Spain.
De la Calle Del Barrio, Jorge
  • Large Animal Department, Alfonso X el Sabio University, 28691 Madrid, Spain.
Fernández Pérez, Cristina
  • Servicio de Medicina Preventiva, Área de Santiago y Barbanza, Instituto de Investigaciones Sanitarias de Santiago (IDIS), 15706 Santiago de Compostela, Spain.
Gómez Lucas, Raquel
  • Large Animal Department, Alfonso X el Sabio University, 28691 Madrid, Spain.

Grant Funding

  • GR21085 / Junta de Extremadura

Conflict of Interest Statement

The authors declare no conflict of interest. The research presented in this article was part of the first author’s PhD studies.

References

This article includes 35 references
  1. Tinker MK, White NA, Lessard P, Thatcher CD, Pelzer KD, Davis B, Carmel DK. Prospective study of equine colic incidence and mortality.. Equine Vet J 1997 Nov;29(6):448-53.
  2. Freeman DE. Fifty years of colic surgery.. Equine Vet J 2018 Jul;50(4):423-435.
    doi: 10.1111/evj.12817pubmed: 29405434google scholar: lookup
  3. Proudman CJ. A two year, prospective survey of equine colic in general practice.. Equine Vet J 1992 Mar;24(2):90-3.
  4. Hudson JM, Cohen ND, Gibbs PG, Thompson JA. Feeding practices associated with colic in horses.. J Am Vet Med Assoc 2001 Nov 15;219(10):1419-25.
    doi: 10.2460/javma.2001.219.1419pubmed: 11724182google scholar: lookup
  5. Archer DC, Proudman CJ. Epidemiological clues to preventing colic.. Vet J 2006 Jul;172(1):29-39.
    doi: 10.1016/j.tvjl.2005.04.002pubmed: 15939639google scholar: lookup
  6. Curtis L, Burford JH, Thomas JS, Curran ML, Bayes TC, England GC, Freeman SL. Prospective study of the primary evaluation of 1016 horses with clinical signs of abdominal pain by veterinary practitioners, and the differentiation of critical and non-critical cases.. Acta Vet Scand 2015 Oct 6;57:69.
    doi: 10.1186/s13028-015-0160-9pmc: PMC4596518pubmed: 26444675google scholar: lookup
  7. Proudman CJ, Smith JE, Edwards GB, French NP. Long-term survival of equine surgical colic cases. Part 2: modelling postoperative survival.. Equine Vet J 2002 Jul;34(5):438-43.
    doi: 10.2746/042516402776117881pubmed: 12358044google scholar: lookup
  8. Proudman CJ, Smith JE, Edwards GB, French NP. Long-term survival of equine surgical colic cases. Part 1: patterns of mortality and morbidity.. Equine Vet J 2002 Jul;34(5):432-7.
    doi: 10.2746/042516402776117845pubmed: 12358043google scholar: lookup
  9. Hillyer MH, Taylor FG, French NP. A cross-sectional study of colic in horses on thoroughbred training premises in the British Isles in 1997.. Equine Vet J 2001 Jul;33(4):380-5.
    doi: 10.2746/042516401776249499pubmed: 11469771google scholar: lookup
  10. Mair TS, Smith LJ. Survival and complication rates in 300 horses undergoing surgical treatment of colic. Part 2: Short-term complications.. Equine Vet J 2005 Jul;37(4):303-9.
    doi: 10.2746/0425164054529364pubmed: 16028617google scholar: lookup
  11. Santschi EM, Slone DE, Embertson RM, Clayton MK, Markel MD. Colic surgery in 206 juvenile thoroughbreds: survival and racing results.. Equine Vet J Suppl 2000 Jun;(32):32-6.
  12. Traub-Dargatz JL, Kopral CA, Seitzinger AH, Garber LP, Forde K, White NA. Estimate of the national incidence of and operation-level risk factors for colic among horses in the United States, spring 1998 to spring 1999.. J Am Vet Med Assoc 2001 Jul 1;219(1):67-71.
    doi: 10.2460/javma.2001.219.67pubmed: 11439773google scholar: lookup
  13. Kaneene JB, Miller R, Ross WA, Gallagher K, Marteniuk J, Rook J. Risk factors for colic in the Michigan (USA) equine population.. Prev Vet Med 1997 Apr;30(1):23-36.
    doi: 10.1016/S0167-5877(96)01102-6pubmed: 9234409google scholar: lookup
  14. 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: 10.1186/1751-0147-56-38pmc: PMC4077634pubmed: 24934123google scholar: lookup
  15. Sutton GA, Ertzman-Ginsburg R, Steinman A, Milgram J. Initial investigation of mortality rates and prognostic indicators in horses with colic in Israel: a retrospective study.. Equine Vet J 2009 May;41(5):482-6.
    doi: 10.2746/042516409X391060pubmed: 19642409google scholar: lookup
  16. Salem SE, Proudman CJ, Archer DC. Prevention of post operative complications following surgical treatment of equine colic: Current evidence.. Equine Vet J 2016 Mar;48(2):143-51.
    doi: 10.1111/evj.12517pubmed: 26440916google scholar: lookup
  17. Muñoz E, Argüelles D, Areste L, Miguel LS, Prades M. Retrospective analysis of exploratory laparotomies in 192 Andalusian horses and 276 horses of other breeds.. Vet Rec 2008 Mar 8;162(10):303-6.
    doi: 10.1136/vr.162.10.303pubmed: 18326841google scholar: lookup
  18. Vázquez Guerra R, López San Román J, Holmbak-petersen R. Supervivencia a Corto Plazo En Caballos Sometidos a Cirugía Abdominal. Investig. Cienc. Univ. Auton. Aguascalientes 2009;17:11–16.
  19. Immonen IA, Karikoski N, Mykkänen A, Niemelä 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/s13028-016-0273-9pmc: PMC5216577pubmed: 28057022google scholar: lookup
  20. Abutarbush SM, Carmalt JL, Shoemaker RW. Causes of gastrointestinal colic in horses in western Canada: 604 cases (1992 to 2002).. Can Vet J 2005 Sep;46(9):800-5.
    pmc: PMC1187790pubmed: 16231649
  21. Santiago Llorente I. Variables Anestésicas Como Predictores de Mortalidad en Caballos Operados de Cólico. Ph.D. Dissertation. Universidad Complutense de Madrid; Madrid, Spain: 2016.
  22. Mair TS, Smith LJ. Survival and complication rates in 300 horses undergoing surgical treatment of colic. Part 4: Early (acute) relaparotomy.. Equine Vet J 2005 Jul;37(4):315-8.
    doi: 10.2746/0425164054529454pubmed: 16028619google scholar: lookup
  23. Dunkel B, Mair T, Marr CM, Carnwath J, Bolt DM. Indications, complications, and outcome of horses undergoing repeated celiotomy within 14 days after the first colic surgery: 95 cases (2005-2013).. J Am Vet Med Assoc 2015 Mar 1;246(5):540-6.
    doi: 10.2460/javma.246.5.540pubmed: 25671287google scholar: lookup
  24. Klohnen A. New perspectives in postoperative complications after abdominal surgery.. Vet Clin North Am Equine Pract 2009 Aug;25(2):341-50.
    doi: 10.1016/j.cveq.2009.05.003pubmed: 19580944google scholar: lookup
  25. Dukti S, White N. Surgical Complications of Colic Surgery. Vet. Clin. N. Am. Equine Pract. 2008;24:515–534.
  26. Lindegaard C, Karlsson L, Ekstrøm C.T., Fjeldborg J. Primary Closure of Equine Laryngotomy Incisions: Healing Characteristics and Complications of 180 Cases. Equine Veter. Educ. 2016;28:512–519.
    doi: 10.1111/eve.12570google scholar: lookup
  27. Mezerova J, Zert Z. Long-Term Survival and Complications of Colic Surgery in Horses: Analysis of 331 Cases. Vet. Med. 2008;53:43–52.
    doi: 10.17221/1936-VETMEDgoogle scholar: lookup
  28. Drumm NJ, Embertson RM, Woodie JB, Ruggles AJ, Hopper SA, Fimmers R, Handler J. Factors influencing foaling rate following colic surgery in pregnant Thoroughbred mares in Central Kentucky.. Equine Vet J 2013 May;45(3):346-9.
  29. Gazzerro DM, Southwood LL, Lindborg S. Short-term complications after colic surgery in geriatric versus mature non-geriatric horses.. Vet Surg 2015 Feb;44(2):256-64.
  30. Van der Linden M, Laffont C.M., Sloet van Oldruitenborgh-Oosterbaan M.M., van Oldruitenborgh-Oosterbaan M.M.S. Prognosis in Equine Medical and Surgical Colic. J. Vet. Intern. Med. 2003;17:343–348.
  31. Hackett ES, Embertson RM, Hopper SA, Woodie JB, Ruggles AJ. Duration of disease influences survival to discharge of Thoroughbred mares with surgically treated large colon volvulus.. Equine Vet J 2015 Nov;47(6):650-4.
    doi: 10.1111/evj.12358pubmed: 25257041google scholar: lookup
  32. Espinosa P, Le Jeune SS, Cenani A, Kass PH, Brosnan RJ. Investigation of perioperative and anesthetic variables affecting short-term survival of horses with small intestinal strangulating lesions.. Vet Surg 2017 Apr;46(3):345-353.
    doi: 10.1111/vsu.12618pubmed: 28152199google scholar: lookup
  33. McConachie EL, Giguère S, Rapoport G, Barton MH. Heart rate variability in horses with acute gastrointestinal disease requiring exploratory laparotomy.. J Vet Emerg Crit Care (San Antonio) 2016 Mar-Apr;26(2):269-80.
    doi: 10.1111/vec.12362pubmed: 26260488google scholar: lookup
  34. Freeman DE, Hammock P, Baker GJ, Goetz T, Foreman JH, Schaeffer DJ, Richter RA, Inoue O, Magid JH. Short- and long-term survival and prevalence of postoperative ileus after small intestinal surgery in the horse.. Equine Vet J Suppl 2000 Jun;(32):42-51.
  35. Garcia-Seco E, Wilson DA, Kramer J, Keegan KG, Branson KR, Johnson PJ, Tyler JW. Prevalence and risk factors associated with outcome of surgical removal of pedunculated lipomas in horses: 102 cases (1987-2002).. J Am Vet Med Assoc 2005 May 1;226(9):1529-37.
    doi: 10.2460/javma.2005.226.1529pubmed: 15882006google scholar: lookup

Citations

This article has been cited 2 times.
  1. Rockow M, Griffenhagen G, Landolt G, Hendrickson D, Pezzanite L. Current Antimicrobial Use in Horses Undergoing Exploratory Celiotomy: A Survey of Board-Certified Equine Specialists.. Animals (Basel) 2023 Apr 22;13(9).
    doi: 10.3390/ani13091433pubmed: 37174470google scholar: lookup
  2. Spadari A, Gialletti R, Gandini M, Valle E, Cerullo A, Cavallini D, Bertoletti A, Rinnovati R, Forni G, Scilimati N, Giusto G. Short-Term Survival and Postoperative Complications Rates in Horses Undergoing Colic Surgery: A Multicentre Study.. Animals (Basel) 2023 Mar 20;13(6).
    doi: 10.3390/ani13061107pubmed: 36978647google scholar: lookup