Risk factors for acute abdominal pain (colic) in the adult horse: A scoping review of risk factors, and a systematic review of the effect of management-related changes.
Abstract: Acute abdominal pain (colic) is the most common reason for emergency veterinary treatment in the horse. Consolidation of data through a systematic review is important to inform evidence-based medicine and clinical guidelines, but there are currently no published systematic reviews on colic in the horse. The aim of this study was to identify, categorize and appraise the evidence on factors associated with increased risk of developing abdominal pain (colic) due to gastrointestinal disease in the adult horse. A scoping review was performed to identify and categorize evidence on all risk factors for colic. A systematic review of management-related risk factors was then performed following PRISMA guidelines. Both searches were conducted in Medline, CAB Abstracts and Web of Science databases, and publications were assessed against inclusion and exclusion criteria. For the scoping review, study and participant characteristics of included publications and key results were extracted and tabulated. For the systematic review, cohort, case-control or cross-sectional studies investigating acute abdominal pain in horses within two weeks of management changes were assessed. Study characteristics, participant characteristics and study results of included publications for the systematic review were extracted and tabulated. Included publications were appraised using the Joanna Briggs Institute Critical Appraisal Tools for cohort, case-control and cross-sectional studies. The scoping review search identified 3,756 publications. Fifty eight studies met final inclusion criteria, and 22 categories of risk factors were identified. These were grouped into three broad areas: horse-related factors, management-related factors and environment-related factors. The largest body of evidence related to management change. The systematic review of management change identified 410 publications: 14 met inclusion criteria for analysis. These consisted of one cohort, eight case-control and five cross-sectional studies. The studies were conducted between 1990-2008, and the majority of studies were located in the USA (8/14) or UK (3/14). The risk factors related to management change that were assessed were feed, carer, exercise, pasture, water and housing. The largest bodies of evidence for increased risk of colic associated with management change were changes in feed (5/14 publications) and recent change in housing (3/14). Most studies (8/14) did not meet the JBI criterion on confounding factors. There was marked heterogeneity of study methodologies and measures. This is the first study to use a combined scoping and systematic review to analyse evidence for modifiable risk factors for a common condition in the horse. It provides a comprehensive review that will be a key resource for researchers, veterinary practitioners and horse owners. It identified modifiable risk factors associated with an increased risk of colic which should be a key target for preventative health programmes. The findings from the critical appraisal were used to develop recommendations for future research to improve the quality of evidence-based veterinary medicine.
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This research study provides a comprehensive review on the risk factors associated with acute abdominal pain (colic) in adult horses. After identifying and categorizing these factors, the researchers conducted a systematic review of the risk factors related to management changes. The study, the first of its kind, provides useful information for researchers, veterinary practitioners and horse owners alike.
About the Study
The researchers aimed to identify and categorize the evidence on factors associated with increased risk of developing abdominal pain (colic) due to gastrointestinal diseases in adult horses. They conducted a scoping review to identify and categorize evidence on all risk factors for colic.
Subsequently, a systematic review of management-related risk factors was performed. They fulfilled PRISMA guidelines, and all searches were conducted in Medline, CAB Abstracts, and Web of Science databases.
Scoping Review
The scoping review search yielded 3,756 publications. After meeting the inclusion and exclusion criteria, 58 studies were appraised.
The researchers found 22 categories of risk factors which were grouped into three broad areas: horse-related factors, management-related factors, and environment-related factors.
Most of the evidence indicated that management change poses the highest risk.
Systematic Review
For the systematic review of management change, 410 publications were identified. Only 14 of these articles were included in the analysis, consisting of one cohort, eight case-control, and five cross-sectional studies.
The risk factors related to management change assessed were: feed, carer, exercise, pasture, water, and housing.
The study found that changes in feed and recent changes in housing comprised the largest bodies of evidence for increased risk of colic linked to management change.
However, the majority of the studies did not meet the Joanna Briggs Institute criterion on confounding factors, and significant heterogeneity was observed in the methodologies and measures employed in these studies.
Significance and Implications
This research is the first of its kind to use a combined scoping and systematic review to evaluate evidence for modifiable risk factors for colic, a common condition in horses.
The findings serve as a vital resource for all those working with horses—from researchers and veterinarians to horse owners.
It pinpoints modifiable risk factors associated with an increased risk of colic—information that could be crucial for preventative health programs for horses.
The findings were also utilized to develop recommendations for improving the quality of future research, thereby aiding the progress of evidence-based veterinary medicine.
Cite This Article
APA
Curtis L, Burford JH, England GCW, Freeman SL.
(2019).
Risk factors for acute abdominal pain (colic) in the adult horse: A scoping review of risk factors, and a systematic review of the effect of management-related changes.
PLoS One, 14(7), e0219307.
https://doi.org/10.1371/journal.pone.0219307
School of Veterinary Medicine and Science, University of Nottingham, Sutton Bonnington, Loughborough, Leicestershire, United Kingdom.
Burford, John H
School of Veterinary Medicine and Science, University of Nottingham, Sutton Bonnington, Loughborough, Leicestershire, United Kingdom.
England, Gary C W
School of Veterinary Medicine and Science, University of Nottingham, Sutton Bonnington, Loughborough, Leicestershire, United Kingdom.
Freeman, Sarah L
School of Veterinary Medicine and Science, University of Nottingham, Sutton Bonnington, Loughborough, Leicestershire, United Kingdom.
MeSH Terms
Abdominal Pain / epidemiology
Abdominal Pain / physiopathology
Abdominal Pain / veterinary
Animals
Colic / epidemiology
Colic / physiopathology
Colic / veterinary
Horses / physiology
Risk Factors
Conflict of Interest Statement
The authors have declared that no competing interests exist.
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