FREE SHIPPING over $40
OVER 9000 FIVE-STAR REVIEWS
5% OFF ALL SUBSCRIPTIONS
100% HAPPINESS GUARANTEE
Analyze Diet
0
Home / Equine Research Bank / Front Vet Sci / Risk Factors of Anesthesia-Related Mortality and Morbidity i...
Frontiers in veterinary science2020; 6; 514; doi: 10.3389/fvets.2019.00514

Risk Factors of Anesthesia-Related Mortality and Morbidity in One Equine Hospital: A Retrospective Study on 1,161 Cases Undergoing Elective or Emergency Surgeries.

Abstract: A retrospective analysis was performed to determine mortality and morbidity rates for elective and emergency cases in an equine university teaching hospital. It investigated the effect of horse-, anesthetic-, timing, and clinician experience-related variables on anesthetic complications. In total, 1,161 horses undergoing general anesthesia between January 2012 and December 2016 were included in the study. Patient information and details of the anesthetic, recovery period and immediate complications were retrieved from an archival database. Statistical analysis of qualitative and quantitative factors affecting anesthetic complications was performed using an univariable and multivariable ordinal logistic regression. Odds ratio of variables primarily affecting mortality and complications were calculated. Statistical significance was set at p < 0.05. General anesthesia-related global mortality rate was 1.4% (95% CI [7.1-10.4]) but was only 0.96% (95% CI [0.44-1.82]) for non-colic cases. The complication rate was 17.5% (n = 204; 95% CI [15.2-20.0]) of which 46.9% [39.4-54.5] were neuromuscular, 22.6% [16.7-29.5] were respiratory, 15.8% [10.8-22.0] were systemic, 13.6% [8.9-19.5] were cardiovascular, 1.1% [0.1-4.0] were other complications. Ninety two percent of complications occurred during recovery. Major risk factors for mortality and complications included high weight, surgeon experience, increasing age, high ASA score, long duration of anesthesia, quality of induction, lateral recumbency, orthopedic surgery, and hypotension. In these models, colic surgery did not influence the rate of any complications.
Copyright © 2020 Laurenza, Ansart and Portier.
Get Full Text
Publication Date: 2020-01-22 PubMed ID: 32039253PubMed Central: PMC6990105DOI: 10.3389/fvets.2019.00514Google 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.
LinkedInCopy
  • 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 research aims to identify the risk factors associated with mortality and morbidity in horses during and after anesthesia for surgeries. The study used data from past cases in an equine university teaching hospital.

Study Design and Sample

  • The study was a retrospective analysis of 1,161 cases of horses that underwent general anesthesia for surgery from 2012 to 2016 in the same equine hospital.
  • Both elective and emergency surgeries were included in the study.

Data Collection

  • The researchers collected data on the patient’s details, anesthetic used, length of recovery, and immediate complications from their archival database.

Statistical Analysis

  • Using both univariable and multivariable logistic regression, they analyzed the impact of several variables such as horse-related factors, anesthetic-related factors, timing, and the experience of the clinician on anesthetic complications.
  • The researchers calculated the odds ratio of each variable with reference to mortality and complications.
  • A statistical significance level was set at <0.05.

Results

  • The general mortality rate due to anesthesia was found to be 1.4% but was marginally less at 0.96% for non-colic cases.
  • The overall complication rate stood at 17.5% out of which the majority were neuromuscular and respiratory complications.
  • About 92% of these complications occurred during the recovery stage after surgery.

Major Risk Factors

  • The study identified major risk factors for mortality and complication which were the horse’s weight, the experience of the surgeon, the horse’s increasing age, high ASA score, the length of anesthesia, quality of induction, lateral recumbency during surgery, orthopedic surgery, and hypotension.
  • Interestingly, whether the surgery was for colic or not didn’t have an impact on complication rates.

Consequently, the research provides a guide for equine medical practitioners to be aware of and manage the identified risk factors for anesthesia-related mortality or morbidity in horses undergoing surgery.

Cite This Article

APA
Laurenza C, Ansart L, Portier K. (2020). Risk Factors of Anesthesia-Related Mortality and Morbidity in One Equine Hospital: A Retrospective Study on 1,161 Cases Undergoing Elective or Emergency Surgeries. Front Vet Sci, 6, 514. https://doi.org/10.3389/fvets.2019.00514

Publication

Frontiers in veterinary science
ISSN: 2297-1769
NlmUniqueID: 101666658
Country: Switzerland
Language: English
Volume: 6
Pages: 514

Researcher Affiliations

Laurenza, Chiara
  • Section of Anesthésiologie, Université de Lyon, VetAgro Sup, Marcy l'Étoile, France.
Ansart, Lèa
  • Section of Anesthésiologie, Université de Lyon, VetAgro Sup, Marcy l'Étoile, France.
Portier, Karine
  • Section of Anesthésiologie, Université de Lyon, VetAgro Sup, Marcy l'Étoile, France.
  • GREAT, Laboratoire Carmen, INSERM U1060, INRA U1235, INSA Lyon, Université Claude Bernard Lyon 1, Villeurbanne, France.

References

This article includes 28 references
  1. Senior JM. Barking up the wrong tree: would international guidelines improve safety in equine anesthesia?. Equine Vet J (2015) 47:14–5.
    doi: 10.1111/evj.12348pubmed: 25534547google scholar: lookup
  2. Johnston GM, Eastment J, Wood J, Taylor P. The confidential enquiry into perioperative equine fatalities (CEPEF): mortality results of Phases 1 and 2. Vet Anaesth Analg (2002) 29:159–70.
    doi: 10.1046/j.1467-2995.2002.00106.xpubmed: 28404360google scholar: lookup
  3. Dugdale AH, Obhrai J, Cripps PJ. Twenty years later: a single-centre, repeat retrospective analysis of equine perioperative mortality and investigation of recovery quality. Vet Anaesth Analg (2016) 43:171–8.
    doi: 10.1111/vaa.12285pubmed: 26081190google scholar: lookup
  4. Dugdale AH, Taylor PM. Equine anesthesia-associated mortality: where are we now?. Vet Anaesth Analg (2016) 43:242–55.
    doi: 10.1111/vaa.12372pubmed: 26970940google scholar: lookup
  5. Brodbelt DC, Blissitt KJ, Hammond RA, Neath PJ, Young LE, Pfeiffer DU. The risk of death: the confidential enquiry into perioperative small animal fatalities. Vet Anaesth Analg (2008) 35:365–73.
    doi: 10.1111/j.1467-2995.2008.00397.xpubmed: 18466167google scholar: lookup
  6. Lienhart A, Auroy Y, Péquignot F, Benhamou D, Warszawski J, Bovet M. Survey of anesthesia-related mortality in France. Anesthesiology (2006) 105:1087–97.
    doi: 10.1097/00000542-200612000-00008pubmed: 17122571google scholar: lookup
  7. American College of Veterinary Anesthesia and Analgesia. Guidelines for Anesthesia in Horses. (2019).
  8. Association of Veterinary Anaesthetists. Recommended Requirements When Performing General Anesthesia of Dogs, Cats and Horses. (2019).
  9. Portier K, Ida KK. The ASA physical status classification: what is the evidence for recommending its use in veterinary anesthesia? -A systematic review. Front Vet Sci (2018) 5:204.
    doi: 10.3389/fvets.2018.00204pmc: PMC6128170pubmed: 30234133google scholar: lookup
  10. Young SS, Taylor PM. Factors influencing the outcome of equine anesthesia: a review of 1,314 cases. Equine Vet J (1993) 25:147–51.
    doi: 10.1111/j.2042-3306.1993.tb02926.xpubmed: 8467775google scholar: lookup
  11. Portier KG, Séna A, Senior M, Clutton RE. A study of the correlation between objective and subjective indices of recovery quality after inhalation anesthesia in equids. Vet Anaesth Analg (2010) 37:329–36.
    doi: 10.1111/j.1467-2995.2010.00542.xpubmed: 20529009google scholar: lookup
  12. Gent TC, Bettschart-Wolfensberger R. Peri-anesthetic mortality in horses - the need for CEPEF-4. Vet Anaesth Analg (2013) 40:e1–2.
    doi: 10.1111/vaa.12070pubmed: 23869801google scholar: lookup
  13. Mee AM, Cripps PJ, Jones RS. A retrospective study of mortality associated with general anesthesia in horses: emergency procedures. Vet Rec (1998) 142:307–9.
    doi: 10.1136/vr.142.12.307pubmed: 9569498google scholar: lookup
  14. Kim A. Retrospective analysis of equine general anesthesia performed at korea racing authority. J Vet Clin (2014) 31:102.
    doi: 10.17555/ksvc.2014.04.31.2.102google scholar: lookup
  15. Johnston GM, Taylor PM, Holmes MA, Wood JL. Confidential enquiry of perioperative equine fatalities (CEPEF-1): preliminary results. Equine Vet J (1995) 27:193–200.
    doi: 10.1111/j.2042-3306.1995.tb03062.xpubmed: 7556046google scholar: lookup
  16. Seddighi R, Doherty TJ. Anesthesia of the geriatric equine. Vet Med Res Rep (2012) 3:53–64.
    doi: 10.2147/VMRR.S34162pmc: PMC6067663pubmed: 30101084google scholar: lookup
  17. Rothenbuhler R, Hawkins JF, Adams SB, Lescun TB, Weil AB, Glickman LT. Evaluation of surgical treatment for signs of acute abdominal pain in draft horses: 72 cases (1983-2002). J Am Vet Med Assoc (2006) 228:1546–50.
    doi: 10.2460/javma.228.10.1546pubmed: 16677124google scholar: lookup
  18. Wawra E, Senior J, Clutton RE. Factors influencing the duration and quality of recovery from general anesthesia in horses: a retrospective study of 590 cases. In: Presented at the Proceedings of the 10th World Congress of Veterinary Anesthesia. Glasgow: (2009). p. 48..
  19. Mee AM, Cripps PJ, Jones RS. A retrospective study of mortality associated with general anesthesia in horses: elective procedures. Vet Rec (1998) 142:275–6.
    doi: 10.1136/vr.142.11.275pubmed: 9569482google scholar: lookup
  20. Senior JM, Pinchbeck GL, Allister R, Dugdale AH, Clark L, Clutton RE. Reported morbidities following 861 anesthetics given at four equine hospitals. Vet Rec (2007) 160:407–8.
    doi: 10.1136/vr.160.12.407pubmed: 17384293google scholar: lookup
  21. Young SS. Post anesthetic myopathy. Equine Vet Educ (2010) 15:60–3.
    doi: 10.1111/j.2042-3292.2005.tb01829.xgoogle scholar: lookup
  22. Johnston GM, Eastment JK, Taylor PM, Wood JL. Is isoflurane safer than halothane in equine anesthesia? Results from a prospective multicenter randomized controlled trial. Equine Vet J (2004) 36:64–71.
    doi: 10.2746/0425164044864723pubmed: 14756374google scholar: lookup
  23. Bidwell LA, Bramlage LR, Rood WA. Equine perioperative fatalities associated with general anesthesia at a private practice–a retrospective case series. Vet Anaesth Analg (2007) 34:23–30.
    doi: 10.1111/j.1467-2995.2005.00283.xpubmed: 17238959google scholar: lookup
  24. Grandy JL, Steffey EP, Hodgson DS, Woliner MJ. Arterial hypotension and the development of postanesthetic myopathy in halothane-anesthetized horses. Am J Vet Res (1987) 48:192–7.
    pubmed: 3826855
  25. Koenig J, Cote N. Equine gastrointestinal motility–ileus and pharmacological modification. Can Vet J (2006) 47:551–9.
    pmc: PMC1461410pubmed: 16808227
  26. Senior M. Post-anesthetic pulmonary edema in horses: a review. Vet Anaesth Analg (2005) 32:193–200.
    doi: 10.1111/j.1467-2995.2005.00186.xpubmed: 16008716google scholar: lookup
  27. Dupont J, Serteyn D, Sandersen C. Prolonged recovery from general anesthesia possibly related to persistent hypoxemia in a draft horse. Front Vet Sci (2018) 5:235.
    doi: 10.3389/fvets.2018.00235pmc: PMC6174201pubmed: 30327770google scholar: lookup
  28. Lane JK, Cohen JM, Zedler ST, Hollis AR, Southwood LL. Right dorsal colon resection and bypass for treatment of right dorsal colitis in a horse. Vet Surg (2010) 39:879–83.
    doi: 10.1111/j.1532-950X.2010.00723.xpubmed: 20825597google scholar: lookup

Citations

This article has been cited 30 times.
  1. Zhang Y, Wang C, Khan MZ, Ju Z, Huang J. Current Understanding of Bovine Ketosis: From Molecular Basis to Farm-Level Management. Animals (Basel) 2025 Dec 18;15(24).
    doi: 10.3390/ani15243644pubmed: 41463929google scholar: lookup
  2. Joseph EJ, Love L, Mayakis M, Varner K. Preanesthetic Administration of Trazodone Does Not Impact Anesthetic Recovery Scores in Horses. Animals (Basel) 2025 Oct 6;15(19).
    doi: 10.3390/ani15192907pubmed: 41096502google scholar: lookup
  3. Boocock H, Flyps J, Escobar A, Redondo JI, Taylor PM, Gozalo-Marcilla M, Johnston GM, Bettschart-Wolfensberger R, Sullivan R. Donkey and Hybrid Anaesthetic Mortality in an Observational, Prospective, Multicentre Cohort Study. Animals (Basel) 2025 Jun 25;15(13).
    doi: 10.3390/ani15131880pubmed: 40646777google scholar: lookup
  4. Szewczyk AM, Fernandez Barrientos MA, Bradbrook C. Anaesthetic Complications in Dogs Undergoing Total Ear Canal Ablation and Ventral Bulla Osteotomy: A Single-Centre Retrospective Study. Animals (Basel) 2025 May 13;15(10).
    doi: 10.3390/ani15101401pubmed: 40427278google scholar: lookup
  5. Gaida JL, Steinberg T, Stieger-Vanegas SM, Merle R, Lischer CJ. Equine Standing Multidetector Computed Tomography of the Distal Thoracic Limb and Tarsus Has a Lower Cumulative Radiation Dose than Digital Radiography. Vet Radiol Ultrasound 2025 Jul;66(4):e70049.
    doi: 10.1111/vru.70049pubmed: 40420323google scholar: lookup
  6. Román Durá B, Dunham O, Grulke S, Salciccia A, Dupont J, Sandersen C. A Retrospective Study on Pre- and Intraoperative Predictors on the Recovery Quality of Horses After General Anesthesia. Vet Sci 2025 Mar 11;12(3).
    doi: 10.3390/vetsci12030262pubmed: 40266986google scholar: lookup
  7. Turek B, Jankowski K, Pawlikowski M, Jasiński T, Domino M. Innovative approach in the treatment of comminuted proximal phalanx fractures in horses based on biomechanical modelling. Sci Rep 2025 Apr 19;15(1):13562.
    doi: 10.1038/s41598-025-95577-8pubmed: 40253474google scholar: lookup
  8. Quinn CT. Incidence of complications from perioperative urinary catheterisation in horses. Aust Vet J 2025 Jun;103(6):319-321.
    doi: 10.1111/avj.13445pubmed: 40186515google scholar: lookup
  9. Obrochta B, Tapio H, Raekallio M, Gracia Calvo LA, Pöyhönen RR, Hagman K, Jantunen N, Karikoski N. Effects of vatinoxan on gastrointestinal motility, sedation, and antinociception during and after long-lasting detomidine infusion in horses. Equine Vet J 2026 Jan;58(1):212-219.
    doi: 10.1111/evj.14499pubmed: 40110892google scholar: lookup
  10. Woods TDC, Dixon J, Fraser BSL, Melvaine C. Computed Tomographic Tenography of the Equine Carpal Flexor Tendon Sheath. Vet Radiol Ultrasound 2025 Mar;66(2):e70019.
    doi: 10.1111/vru.70019pubmed: 40059445google scholar: lookup
  11. Henderson ARP, Valverde A, Koenig J, Sears W. Effects of anesthetic protocol, procedure, and recovery stall and interval on the quality of recovery in repeatedly anesthetized horses. Can J Vet Res 2025 Jan;89(1):17-25.
    pubmed: 39744466
  12. Cassiers V, McNally T. Technique description and outcome evaluation of Thoroughbred racehorses following soft palate thermocautery performed under standing sedation. Vet Med Sci 2024 Sep;10(5):e70018.
    doi: 10.1002/vms3.70018pubmed: 39285763google scholar: lookup
  13. Manning H, Sampson S. Peri-anaesthetic complications in 1798 equids undergoing high-field elective orthopaedic MRI at a tertiary referral hospital. Equine Vet J 2025 May;57(3):666-673.
    doi: 10.1111/evj.14208pubmed: 39143703google scholar: lookup
  14. Delvescovo B, McOnie R, Pearson G, Pugliese B, Hackett ES. Emergency Standing Laparoscopic Treatment of Uncontrolled Post-Castration Hemorrhage in Two Geldings. Animals (Basel) 2024 Aug 2;14(15).
    doi: 10.3390/ani14152252pubmed: 39123778google scholar: lookup
  15. Brumund L, Wittenberg-Voges L, Rohn K, Kästner SBR. Risk assessment in equine anesthesia: a first evaluation of the usability, utility and predictivity of the two-part CHARIOT. Front Vet Sci 2024;11:1384525.
    doi: 10.3389/fvets.2024.1384525pubmed: 38846780google scholar: lookup
  16. Ruíz-López P, Cuypers C, Schauvliege S. Xylazine Infusion during Equine Colic Anesthesia with Isoflurane and Lidocaine: A Retrospective Study. Animals (Basel) 2023 Sep 13;13(18).
    doi: 10.3390/ani13182902pubmed: 37760302google scholar: lookup
  17. Brandly JE, Midon M, Douglas HF, Hopster K. Flow-controlled expiration reduces positive end-expiratory pressure requirement in dorsally recumbent, anesthetized horses. Front Vet Sci 2023;10:1135452.
    doi: 10.3389/fvets.2023.1135452pubmed: 37124564google scholar: lookup
  18. Ternisien T, Dunn M, Vachon C, Manguin E, Bonilla AG, Jean D. Minimally invasive removal of obstructive ureteral stones by intracorporeal lithotripsy in horses: 3 patients. Can Vet J 2023 Jan;64(1):25-30.
    pubmed: 36593938
  19. Straticò P, Varasano V, Palozzo A, Guerri G, Celani G, Revelant O, Petrizzi L. Retrospective Study on Risk Factors and Short-Term Outcome of Horses Referred for Colic from 2016 to 2022. Vet Sci 2022 Oct 3;9(10).
    doi: 10.3390/vetsci9100545pubmed: 36288158google scholar: lookup
  20. Abass M, Ibrahim H, Salci H, Hamed MA. Evaluation of the effect of different sedative doses of dexmedetomidine on the intestinal motility in clinically healthy donkeys (Equus asinus). BMC Vet Res 2022 Jul 14;18(1):274.
    doi: 10.1186/s12917-022-03376-4pubmed: 35836159google scholar: lookup
  21. Stieger-Vanegas SM, Hanna AL. The Role of Computed Tomography in Imaging Non-neurologic Disorders of the Head in Equine Patients. Front Vet Sci 2022;9:798216.
    doi: 10.3389/fvets.2022.798216pubmed: 35321060google scholar: lookup
  22. Colmer SF, Wulster K, Johnson AL, Levine DG, Underwood C, Watkins TW, Van Eps AW. Treatment of primary hyperparathyroidism in a Miniature Horse using chemical ablation of abnormal parathyroid tissue localized by 3-phase computed tomography. J Vet Intern Med 2022 Mar;36(2):798-804.
    doi: 10.1111/jvim.16390pubmed: 35150016google scholar: lookup
  23. Goto A, Tagami M, Kato F, Suzuki T, Yamaga T, Murase H, Sato F, Tsogtgerel M, Niikura T, Moriyama T, Chiba A, Watanabe KI, Tsuzuki N, Nambo Y. Equine nonneoplastic abnormal ovary in a draft mare with high serum anti-Müllerian hormone: a case study. J Equine Sci 2021 Dec;32(4):147-151.
    doi: 10.1294/jes.32.147pubmed: 35023993google scholar: lookup
  24. Fages A, Soler C, Fernández-Salesa N, Conte G, Degani M, Briganti A. Perioperative Outcome in Dogs Undergoing Emergency Abdominal Surgery: A Retrospective Study on 82 Cases (2018-2020). Vet Sci 2021 Sep 28;8(10).
    doi: 10.3390/vetsci8100209pubmed: 34679039google scholar: lookup
  25. Gozalo-Marcilla M, Bettschart-Wolfensberger R, Johnston M, Taylor PM, Redondo JI. Data Collection for the Fourth Multicentre Confidential Enquiry into Perioperative Equine Fatalities (CEPEF4) Study: New Technology and Preliminary Results. Animals (Basel) 2021 Aug 30;11(9).
    doi: 10.3390/ani11092549pubmed: 34573515google scholar: lookup
  26. Stefanik E, Drewnowska O, Lisowska B, Turek B. Causes, Effects and Methods of Monitoring Gas Exchange Disturbances during Equine General Anaesthesia. Animals (Basel) 2021 Jul 9;11(7).
    doi: 10.3390/ani11072049pubmed: 34359177google scholar: lookup
  27. Tsogtgerel M, Tagami M, Watanabe K, Murase H, Hirosawa Y, Kobayashi Y, Nambo Y. Case report: The case of a 17 kg ovarian granulosa cell tumor in a Breton draft mare. J Equine Sci 2021 Jun;32(2):67-72.
    doi: 10.1294/jes.32.67pubmed: 34220274google scholar: lookup
  28. Gozalo-Marcilla M, Ringer SK. Recovery after General Anaesthesia in Adult Horses: A Structured Summary of the Literature. Animals (Basel) 2021 Jun 14;11(6).
    doi: 10.3390/ani11061777pubmed: 34198637google scholar: lookup
  29. Wiederkehr A, Barbarossa A, Ringer SK, Jörger FB, Bryner M, Bettschart-Wolfensberger R. Clinical Randomized Comparison of Medetomidine and Xylazine for Isoflurane Balanced Anesthesia in Horses. Front Vet Sci 2021;8:603695.
    doi: 10.3389/fvets.2021.603695pubmed: 33959647google scholar: lookup
  30. Ferrer LM, Lacasta D, Ortín A, Ramos JJ, Tejedor MT, Borobia M, Pérez M, Castells E, Ruiz de Arcaute M, Ruiz H, Windsor PA. Impact of a Topical Anaesthesia Wound Management Formulation on Pain, Inflammation and Reduction of Secondary Infections after Tail Docking in Lambs. Animals (Basel) 2020 Jul 24;10(8).
    doi: 10.3390/ani10081255pubmed: 32722010google scholar: lookup
Subscribe to our newsletter
Join 99,359 horse owners like you who receive our email updates on horse health and nutrition.