Prognostic variables for survival of neonatal foals under intensive care.
Abstract: The costly nature of intensive care for neonatal foals prompted a study of predictive variables for survival in a referral hospital. Applying stepforward logistic regression to parameters that differed significantly (P less than 0.10) between survivors (S) and nonsurvivors (NS) in a retrospective study (n = 56), two variables retained statistical significance [anion gap (AG, P = 0.0047) and venous PO2 (PvO2, P = 0.0342)], thus forming the basis for a predictive equation for survival: the Pn (probability of NS) = eA/(1 + eA) where A = -1.46 - 0.107 (PvO2) + 0.213 (AG). The predictive equation was evaluated prospectively in foals (n = 48), irrespective of diagnosis, that underwent intensive care. Sepsis was the most common medical problem identified in both groups of foals (51/104). In the prospective study, a Pn less than or equal to 0.5 predicted S (positive test) and Pn greater than 0.5 predicted NS (negative test). The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the predictive equation were 100%, 40%, 62%, and 100%, respectively. All foals with Pn greater than 0.4 (n = 14) did not survive. Erroneous predictions were consistently false positives (predicted S, outcome NS). The predictive equation for survival may aid in identification of high risk neonates, i.e., unlikely to survive. The prognostic merits of anion gap and PvO2 imply that tissue oxygen debt was a significant problem for these critically ill foals.
Publication Date: 1992-03-01 PubMed ID: 1588547DOI: 10.1111/j.1939-1676.1992.tb03157.xGoogle Scholar: Lookup 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
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This research study is focused on determining variables that accurately predict the survival of neonatal foals under intensive care. The study developed a statistical model based on anion gap and venous PO2 levels that can predict the probability of non-survival with a high level of certainty.
Study Overview
- The study was motivated by the high costs associated with intensive care for neonatal foals, with the aim of identifying predictive factors for survival.
- The research team used a logistic regression approach to identify key parameters that significantly differed between survivors (S) and nonsurvivors (NS).
- Out of the parameters examined in a retrospective study of 56 foals, only anion gap (AG) and venous PO2 (PvO2) retained statistical significance.
Predictive Equation
- The researchers developed a predictive equation for survival based on these two significant variables: AG and PvO2.
- The equation takes the form of Pn (probability of NS) = eA/(1 + eA) where A = -1.46 – 0.107 (PvO2) + 0.213 (AG).
- This equation was then evaluated prospectively in 48 foals that underwent intensive care, irrespective of their diagnoses.
Results and Findings
- Sepsis was identified as the most common medical issue in both groups of foals.
- In the prospective study, a Pn less than or equal to 0.5 predicted survival, while a Pn greater than 0.5 predicted non-survival.
- The sensitivity, specificity, positive predictive value and negative predictive value of the predictive equation were found to be 100%, 40%, 62%, and 100%, respectively.
- All foals with a Pn greater than 0.4 did not survive, illustrating the accuracy of the equation in predicting non-survival. Mistaken predictions were consistently false positives, projecting survival when the eventual outcome was non-survival.
Implications
- This predictive equation could be an effective tool in identifying neonates at high risk of not surviving, thereby helping in deciding the course of action and resource allocation in veterinary hospitals.
- The significant roles of anion gap and PvO2 in this prediction suggest that tissue oxygen debt was a significant issue for these severely ill foals, indicating potential areas for targeted treatment.
Cite This Article
APA
Hoffman AM, Staempfli HR, Willan A.
(1992).
Prognostic variables for survival of neonatal foals under intensive care.
J Vet Intern Med, 6(2), 89-95.
https://doi.org/10.1111/j.1939-1676.1992.tb03157.x Publication
Researcher Affiliations
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Canada.
MeSH Terms
- Acid-Base Equilibrium
- Animals
- Animals, Newborn
- Bacterial Infections / mortality
- Bacterial Infections / therapy
- Bacterial Infections / veterinary
- Breeding
- Cohort Studies
- Critical Care
- Female
- Horse Diseases / mortality
- Horse Diseases / therapy
- Horses
- Male
- Oxygen / blood
- Probability
- Prognosis
- Prospective Studies
- Regression Analysis
- Retrospective Studies
Citations
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- Bookbinder LC, Mani R, Carr EA. Antibiograms of field and hospital acquired equine neonatal bacterial fluid cultures in the Midwestern United States: 149 samples (2007-2018).. J Vet Intern Med 2023 May-Jun;37(3):1193-1200.
- Trefz FM, Lausch CK, Rieger A, Giertzuch S, Lorch A, Constable PD. Acid-base imbalances and the association of blood-gas variables, electrolytes, and biochemical analytes with outcome in hospitalized calves undergoing abdominal surgery.. J Vet Intern Med 2023 Mar;37(2):740-756.
- Cummings CO, Krucik DDR, Price E. Clinical predictive models in equine medicine: A systematic review.. Equine Vet J 2023 Jul;55(4):573-583.
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