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Home / Equine Research Bank / J Vet Intern Med / Retrospective cohort study on diseases and risk factors asso...
Journal of veterinary internal medicine2024; 39(1); e17269; doi: 10.1111/jvim.17269

Retrospective cohort study on diseases and risk factors associated with death in hospitalized neonatal foals.

Abstract: The care of sick neonatal foals is labor-intensive and costly. Prediction of risk of death upon admission is often difficult but might support decision-making. Objective: To determine diseases and risk factors associated with death in neonatal hospitalized foals. Methods: Two hundred twenty-two hospitalized foals, ≤7 days old. Methods: Retrospective cohort study. Clinical and laboratory variables were evaluated for their association with death by means of Cox survival analysis and by classification and regression tree (CART) analysis. Results: Most prevalent diseases were sepsis (43.9%), enteritis (14.0%), and omphalitis (9.0%). Case fatality rate was 33.3%. Neonatal sepsis significantly increased the risk of death (hazard ratio [HR] = 1.9; 95% confidence interval [CI] = 1.2-3.0; P = .009). Multivariable Cox regression in foals ≤7 days old revealed comatose mental state (HR = 2.9; 95% CI = 1.1-8.1; P = .04), L-lactatemia (≥373.8 mg/L [4.2 mmol/L]; HR = 4.4; 95% CI = 1.7-11.7; P = .003) and increased serum amyloid A (SAA; ≥2054 μg/mL; HR = 3.9; 95% CI = 1.2-12.7; P = .02) as risk factors for death, with a sensitivity and specificity of 7.5% and 95.7%, respectively. The CART analysis highlighted L-lactatemia, comatose mental state, and hypercapnia as risk factors for death, with a sensitivity of 38.1% and specificity of 86.1% after validation. Conclusions: In this study sample, sepsis was associated with the highest risk of death. Identified risk factors such as SAA, L-lactate, and comatose mental state might guide veterinarians and owners in better decision-making for economic or welfare reasons. Frequently measured laboratory variables, such as blood glucose concentration and Immunoglobulin G, were not sensitive and specific enough to provide reliable decision support for survival estimation.
© 2024 The Author(s). Journal of Veterinary Internal Medicine published by Wiley Periodicals LLC on behalf of American College of Veterinary Internal Medicine.
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Publication Date: 2024-12-18 PubMed ID: 39690128PubMed Central: PMC11652109DOI: 10.1111/jvim.17269Google Scholar: Lookup
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  • Journal Article

Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

The study aimed to identify diseases and related risk factors that increase the risk of death in hospitalized newborn horses (foals). The researchers found that sepsis presented the highest mortality risk, and factors like l-lactatemia, comatose mental state, and increased serum amyloid A (SAA) levels also elevated the chances of death. They concluded that these risk factors could aid in making decisions for treatment or welfare purposes.

Study Methodology

  • The study was a retrospective cohort investigation involving 222 hospitalized foals aged 7 days or less.
  • The researchers evaluated several clinical and laboratory variables to determine their association with mortality, employing statistical techniques, namely Cox survival analysis and classification and regression tree (CART) analysis.

Key Findings

  • The most frequently observed diseases among the hospitalized foals were sepsis, enteritis, and omphalitis.
  • The case fatality rate reported was 33.3%.
  • Sepsis significantly increased the mortality risk with a hazard ratio of 1.9.
  • For foals aged 7 days or less, the factors posing a high risk of death included a comatose mental state, elevated levels of L-lactate (l-lactatemia), and higher serum amyloid A (SAA) concentrations.
  • These three factors demonstrated a specificity of 95.7% and a rather low sensitivity of 7.5% in the multivariable Cox regression analysis.
  • The CART analysis reaffirmed L-lactatemia and a comatose mental state as mortality risk factors. Also, it introduced hypercapnia (excessive carbon dioxide in the bloodstream) as another risk factor, with a sensitivity and specificity of 38.1% and 86.1% respectively.

Conclusions and Implications

  • Among the diseases assessed, sepsis accounted for the highest risk of death in the study.
  • Identified risk factors, including elevated levels of SAA and L-lactate as well as a comatose mental state, could assist veterinarians and owners in making better treatment decisions for economical or welfare purposes.
  • Typical laboratory variables like blood glucose concentration and Immunoglobulin G levels did not prove to be sensitive or specific enough to effectively predict survival.

Cite This Article

APA
Castelain DL, Dufourni A, Pas ML, Bokma J, de Bruijn E, Paulussen E, Lefère L, van Loon G, Pardon B. (2024). Retrospective cohort study on diseases and risk factors associated with death in hospitalized neonatal foals. J Vet Intern Med, 39(1), e17269. https://doi.org/10.1111/jvim.17269

Publication

Journal of veterinary internal medicine
ISSN: 1939-1676
NlmUniqueID: 8708660
Country: United States
Language: English
Volume: 39
Issue: 1
Pages: e17269

Researcher Affiliations

Castelain, Donatienne L
  • Department of Internal Medicine, Reproduction and Population Medicine, Ghent University, Salisburylaan 133, Merelbeke 9820, Belgium.
Dufourni, Alexander
  • Department of Internal Medicine, Reproduction and Population Medicine, Ghent University, Salisburylaan 133, Merelbeke 9820, Belgium.
Pas, Mathilde L
  • Department of Internal Medicine, Reproduction and Population Medicine, Ghent University, Salisburylaan 133, Merelbeke 9820, Belgium.
Bokma, Jade
  • Department of Internal Medicine, Reproduction and Population Medicine, Ghent University, Salisburylaan 133, Merelbeke 9820, Belgium.
de Bruijn, Eva
  • Department of Internal Medicine, Reproduction and Population Medicine, Ghent University, Salisburylaan 133, Merelbeke 9820, Belgium.
Paulussen, Ellen
  • Department of Internal Medicine, Reproduction and Population Medicine, Ghent University, Salisburylaan 133, Merelbeke 9820, Belgium.
Lefère, Laurence
  • Department of Internal Medicine, Reproduction and Population Medicine, Ghent University, Salisburylaan 133, Merelbeke 9820, Belgium.
van Loon, Gunther
  • Department of Internal Medicine, Reproduction and Population Medicine, Ghent University, Salisburylaan 133, Merelbeke 9820, Belgium.
Pardon, Bart
  • Department of Internal Medicine, Reproduction and Population Medicine, Ghent University, Salisburylaan 133, Merelbeke 9820, Belgium.

MeSH Terms

  • Animals
  • Retrospective Studies
  • Horses
  • Horse Diseases / mortality
  • Risk Factors
  • Animals, Newborn
  • Male
  • Female
  • Cohort Studies
  • Sepsis / veterinary
  • Sepsis / mortality
  • Hospitalization

Grant Funding

  • RF 21/6351 / FOD Volksgezondheid, Veiligheid van de Voedselketen en Leefmilieu
  • Ghent University

Conflict of Interest Statement

Authors declare no conflict of interest.

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