Repeated measurements of blood lactate concentration as a prognostic marker in horses with acute colitis evaluated with classification and regression trees (CART) and random forest analysis.
Abstract: The objective of this study was to investigate the prognostic value of single and repeated measurements of blood l-lactate (Lac) and ionised calcium (iCa) concentrations, packed cell volume (PCV) and plasma total protein (TP) concentration in horses with acute colitis. A total of 66 adult horses admitted with acute colitis (<24 h) to a referral hospital in the 2002-2011 period were included. The prognostic value of Lac, iCa, PCV and TP recorded at admission and 6 h post admission was analysed with univariate analysis, logistic regression, classification and regression trees, as well as random forest analysis. Ponies and Icelandic horses made up 59% of the population, whilst the remaining 41% were horses. Blood lactate concentration at admission was the only individual parameter significantly associated with probability of survival to discharge (P < 0.001). In a training sample, a Lac cut-off value of 7 mmol/L had a sensitivity of 0.66 and a specificity of 0.92 in predicting survival. In independent test data, the sensitivity was 0.69 and the specificity was 0.76. At the observed survival rate (38%), the optimal decision tree identified horses as non-survivors when the Lac at admission was ≥4.3 mmol/L and the Lac 6 h post admission stayed at >2 mmol/L (sensitivity, 0.72; specificity, 0.8). In conclusion, blood lactate concentration measured at admission and repeated 6 h later aided the prognostic evaluation of horses with acute colitis in this population with a very high mortality rate. This should allow clinicians to give a more reliable prognosis for the horse.
Copyright © 2016 Elsevier Ltd. All rights reserved.
Publication Date: 2016-03-15 PubMed ID: 27240909DOI: 10.1016/j.tvjl.2016.03.012Google Scholar: Lookup
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- Journal Article
Summary
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The research article focuses on investigating the value of single and repeated blood lactate (Lac) and ionised calcium (iCa) measurements, packed cell volume (PCV) and plasma total protein (TP) levels as prognostic markers in horses suffering from acute colitis. The findings suggest that blood lactate concentration, particularly when measured at admission and again 6 hours later, significantly aids in prognostic evaluation.
Objective and Sample
- The study aims to analyze the prognostic value of single and repeated measurements of blood l-lactate (Lac), ionised calcium (iCa) concentrations, packed cell volume (PCV), and plasma total protein (TP) concentration in horses with acute colitis.
- The researchers included 66 adult horses admitted with acute colitis (<24 h) to a referral hospital from 2002-2011 period in the study.
- Among the total horses studied, 59% were ponies and Icelandic horses, while the remaining 41% were other breeds.
Analysis and Results
- The measurements of Lac, iCa, PCV, and TP recorded at admission and 6 hours post admission were analyzed using univariate analysis, logistic regression, classification, and regression trees, as well as random forest analysis.
- Blood lactate concentration at admission was found to be the only individual parameter significantly associated with the horse’s probability of survival to discharge (P < 0.001).
- A blood lactate cutoff value of 7 mmol/L was found to have a sensitivity of 0.66 and a specificity of 0.92 in predicting survival in a training sample. In independent test data, the same cutoff value showed a sensitivity of 0.69 and a specificity of 0.76.
Optimal Decision Tree Outcome
- Considering the observed survival rate (38%), the research identified an optimal decision tree which classifies horses as non-survivors when the Lac at admission was ≥4.3 mmol/L and the Lac 6 hours post admission remained at >2 mmol/L.
- This decision tree showed a sensitivity of 0.72 and specificity of 0.8, thus, offering a strong predictive model.
Conclusion and Impact
- The study concluded that blood lactate concentration measured at admission and repeated 6 hours later significantly aids the prognostic evaluation of horses suffering from acute colitis.
- This finding is particularly crucial for this population of horses given their high mortality rate and extends valuable insight to veterinarians to provide a more reliable prognosis.
Cite This Article
APA
Petersen MB, Tolver A, Husted L, Tølbøll TH, Pihl TH.
(2016).
Repeated measurements of blood lactate concentration as a prognostic marker in horses with acute colitis evaluated with classification and regression trees (CART) and random forest analysis.
Vet J, 213, 18-23.
https://doi.org/10.1016/j.tvjl.2016.03.012 Publication
Researcher Affiliations
- Department of Large Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Grønnegårdsvej 8, 1870 Frederiksberg, Denmark. Electronic address: mbp@sund.ku.dk.
- Department of Mathematical Sciences, Faculty of Science, University of Copenhagen, Universitetsparken 5, 2100 København Ø, Denmark, Denmark.
- Department of Large Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Højbakkegård Alle 5, 2630 Taastrup, Denmark.
- Department of Large Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Højbakkegård Alle 5, 2630 Taastrup, Denmark.
- Department of Large Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Højbakkegård Alle 5, 2630 Taastrup, Denmark.
MeSH Terms
- Acute Disease
- Animals
- Biomarkers / blood
- Blood Proteins / analysis
- Calcium / blood
- Calcium Compounds / blood
- Colitis / diagnosis
- Colitis / etiology
- Decision Trees
- Denmark
- Female
- Hematocrit / veterinary
- Horse Diseases / diagnosis
- Horse Diseases / etiology
- Horses
- Ions / blood
- Lactic Acid / blood
- Machine Learning
- Male
- Models, Theoretical
- Prognosis
Citations
This article has been cited 6 times.- Bishop RC, Arrington JV, Wilkins PA, McCoy AM. Alterations in the Peritoneal Fluid Proteome of Horses with Colic Attributed to Ischemic and Non-Ischemic Intestinal Disease. Animals (Basel) 2025 May 30;15(11).
- Giraldo AF, Carballo R, Serrenho RC, Tran V, Valverde A, Renaud DL, Gomez DE. Association of the type of metabolic acidosis and non-survival of horses with colitis. Can Vet J 2023 Nov;64(11):1044-1050.
- Dybkjær E, Steffensen KF, Honoré ML, Dinesen MA, Christophersen MT, Pihl TH. Short-term survival rates of 1397 horses referred for colic from 2010 to 2018. Acta Vet Scand 2022 May 7;64(1):11.
- Witkowska-Piłaszewicz O, Cywińska A, Michlik-Połczyńska K, Czopowicz M, Strzelec K, Biazik A, Parzeniecka-Jaworska M, Crisman M, Witkowski L. Variations in haematological and biochemical parameters in healthy ponies. BMC Vet Res 2021 Jan 19;17(1):38.
- DeNotta SL, Divers TJ. Clinical Pathology in the Adult Sick Horse: The Gastrointestinal System and Liver. Vet Clin North Am Equine Pract 2020 Apr;36(1):105-120.
- Roy MF, Kwong GP, Lambert J, Massie S, Lockhart S. Prognostic Value and Development of a Scoring System in Horses With Systemic Inflammatory Response Syndrome. J Vet Intern Med 2017 Mar;31(2):582-592.
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