Prognostic value of clinicopathologic variables obtained at admission and effect of antiendotoxin plasma on survival in septic and critically ill foals.
Abstract: This prospective study compared survival rates of critically ill and septic foals receiving 1 of 2 different types of commercial equine plasma and analyzed admission variables as possible predictors of survival. Standardized clinical, hematologic, biochemical, and hemostatic admission data were collected and foals received either conventional commercially available hyperimmune equine plasma or equine plasma specifically rich in antiendotoxin antibodies in a double-blinded, coded fashion. Sepsis was defined as true bacteremia or sepsis score >11. Overall survival rate to discharge was 72% (49/68). Foals that were nonbacteremic and demonstrated a sepsis score of 11 as a predictor of bacteremia were 74 and 52%, respectively. For the entire study population, a higher survival rate to discharge was documented for those foals receiving hyperimmune plasma rich in antiendotoxin antibodies (P = .012, odds ratio [OR] 6.763, 95% confidence interval [CI]: 1.311, 34.903). Administration of plasma rich in antiendotoxin antibodies also was associated with greater survival in septic foals (P = .019, OR 6.267, 95% CI: 1.186, 33.109). Statistical analyses demonstrated that, among 53 clinical and clinicopathologic admission variables, high sepsis score (P < .001), low measured IgG concentration (P = .01), high fibrinogen concentration (P = .018), low segmented neutrophil count (P = .028), and low total red blood cell numbers (P = .048) were the most significant predictors of overall mortality.
Publication Date: 2006-06-01 PubMed ID: 16734091DOI: 10.1892/0891-6640(2006)20[569:pvocvo]2.0.co;2Google Scholar: Lookup
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- Evaluation Study
- Journal Article
- Research Support
- Non-U.S. Gov't
Summary
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The research study investigates survival rates among critically ill and septic foals (young horses) using different types of treatments involving equine plasma and evaluates factors at admission to predict survival. The study reveals that septic foals receiving plasma rich in antiendotoxin antibodies have a higher survival rate, with specific clinicopathologic variables including high sepsis score, low IgG concentration, and low red blood cell count as significant predictors of overall mortality.
Study Design and Variables
- The study is a prospective one, comparing survival rates of critically ill and septic foals.
- Two broad categories of commercial equine plasma were used for treatment: conventional plasma and plasma rich in antiendotoxin antibodies.
- Foals included in the study were evaluated against a range of standardized clinical, hematologic, biochemical, and hemostatic data collected at admission.
- Sepsis was defined as true bacteremia (presence of bacteria in the blood) or having a sepsis score of more than 11.
Key Findings
- Of a total of 68 foals, a total survival rate to discharge of 72% was observed.
- Foals that were nonbacteremic (no bacteria in blood) and showed a sepsis score of 11 or less had a significantly high survival rate of 95%.
- Septic foals generally had a discharge survival rate of just 57%. Within this, the survival rate of truly bacteremic foals was slightly higher (58%) compared to nonbacteremic septic foals (56%).
- The study revealed that a sepsis score of more than 11 had a sensitivity of 74% and specificity of 52% in predicting bacteremia.
Effect of Plasma Types on Survival
- Foals treated with plasma rich in antiendotoxin antibodies had a higher survival rate than those treated with conventional plasma. The odds of survival for those treated with antiendotoxin plasma were over six times higher.
- Furthermore, this plasma type was also associated with greater survival in septic foals specifically.
Predictors Of Mortality
- After analyzing 53 clinical and clinicopathologic admission variables, the most significant predictors for overall mortality were found.
- These included a high sepsis score, low measured IgG concentration (a type of antibody), high fibrinogen concentration (a protein that aids blood clotting), low segmented neutrophil count (a type of white blood cell key in fighting infection), and low total red blood cell numbers.
Cite This Article
APA
Peek SF, Semrad S, McGuirk SM, Riseberg A, Slack JA, Marques F, Coombs D, Lien L, Keuler N, Darien BJ.
(2006).
Prognostic value of clinicopathologic variables obtained at admission and effect of antiendotoxin plasma on survival in septic and critically ill foals.
J Vet Intern Med, 20(3), 569-574.
https://doi.org/10.1892/0891-6640(2006)20[569:pvocvo]2.0.co;2 Publication
Researcher Affiliations
- Department of Medical Sciences, University of Wisconsin-Madison, School of Veterinary Medicine, WI 53706, USA. peeks@svm.vetmed.wisc.edu
MeSH Terms
- Animals
- Animals, Newborn
- Blood Chemical Analysis / veterinary
- Blood Transfusion / veterinary
- Critical Illness
- Double-Blind Method
- Emergency Treatment / veterinary
- Horse Diseases / blood
- Horse Diseases / diagnosis
- Horse Diseases / mortality
- Horse Diseases / pathology
- Horse Diseases / therapy
- Horses
- Immunoglobulin G / administration & dosage
- Immunoglobulins / administration & dosage
- Patient Admission
- Predictive Value of Tests
- Prognosis
- Sensitivity and Specificity
- Sepsis / diagnosis
- Sepsis / veterinary
- Severity of Illness Index
- Survival Analysis
- Wisconsin
Citations
This article has been cited 10 times.- Blangy-Letheule A, Vergnaud A, Dupas T, Rozec B, Lauzier B, Leroux AA. Spontaneous Sepsis in Adult Horses: From Veterinary to Human Medicine Perspectives.. Cells 2023 Mar 30;12(7).
- Taylor SD, Serpa PBS, Santos AP, Hart KA, Vaughn SA, Moore GE, Mukhopadhyay A, Page AE. Effects of intravenous administration of peripheral blood-derived mesenchymal stromal cells after infusion of lipopolysaccharide in horses.. J Vet Intern Med 2022 Jul;36(4):1491-1501.
- Wong D, Malik C, Dembek K, Estell K, Marchitello M, Wilson K. Evaluation of a continuous glucose monitoring system in neonatal foals.. J Vet Intern Med 2021 Jul;35(4):1995-2001.
- Furr M, McKenzie H 3rd. Factors associated with the risk of positive blood culture in neonatal foals presented to a referral center (2000-2014).. J Vet Intern Med 2020 Nov;34(6):2738-2750.
- Anderson MJ, Ibrahim AS, Cooper BR, Woolcock AD, Moore GE, Taylor SD. Effects of administration of ascorbic acid and low-dose hydrocortisone after infusion of sublethal doses of lipopolysaccharide to horses.. J Vet Intern Med 2020 Nov;34(6):2710-2718.
- Taylor S. A review of equine sepsis.. Equine Vet Educ 2015 Feb;27(2):99-109.
- Sheats MK. A Comparative Review of Equine SIRS, Sepsis, and Neutrophils.. Front Vet Sci 2019;6:69.
- Toth B, Slovis NM, Constable PD, Taylor SD. Plasma adrenomedullin concentrations in critically ill neonatal foals.. J Vet Intern Med 2014 Jul-Aug;28(4):1294-300.
- Werners AH, Bryant CE. Pattern recognition receptors in equine endotoxaemia and sepsis.. Equine Vet J 2012 Jul;44(4):490-8.
- Castagnetti C, Veronesi MC. Prognostic factors in the sick neonatal foal.. Vet Res Commun 2008 Sep;32 Suppl 1:S87-91.
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