Prognostic value of clinicopathologic variables obtained at admission and effect of antiendotoxin plasma on survival in septic and critically ill foals.

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.