Serum amyloid A and fibrinogen as markers for early detection of surgical site infection associated with internal fixation in the horse.
Abstract: The objective of this study was to determine the diagnostic ability of serum amyloid A (SAA) and fibrinogen for early detection of surgical site infection (SSI) after equine internal fixation. Horses undergoing internal fixation for fracture, arthrodesis, or osteotomy with internal fixation for limb deformity were included in the study. SAA and fibrinogen were measured on blood samples preoperatively and on days 1, 3, 5, 7, 10, and 14 postoperatively. Statistical analysis included use of Spearman's rank correlation, logistic regression, and calculating the area under the receiver operating characteristic (ROC) curve. SAA and fibrinogen measurements were both associated with SSI, with SAA being considered an excellent marker (area under the ROC curve 0.8) and fibrinogen being considered acceptable (<0.8). As the amount of time postoperatively increased, SAA elevations indicated a higher likelihood of SSI (area under the ROC curve 0.8 compared with fibrinogen 0.7). SAA and fibrinogen were predictive markers of SSI and SAA is of greater diagnostic utility when compared with fibrinogen. Persistent elevations of SAA postoperatively are associated with the development of SSI. Serial monitoring of SAA can be used to help predict the development of SSI in horses undergoing internal fixation. This may lead to earlier suspicion, and therefore recognition and treatment of SSI.
Copyright © 2022 Thurston, Stefanovski, MacKinnon, Chapman, Richardson and Levine.
Publication Date: 2022-10-10 PubMed ID: 36299628PubMed Central: PMC9589505DOI: 10.3389/fvets.2022.960865Google Scholar: Lookup
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Summary
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This research is about the examination of serum amyloid A (SAA) and fibrinogen as potential early indicators of surgical site infection (SSI) in horses that have undergone an internal fixation procedure.
The study and its objectives
- The primary goal was to gauge the diagnostic potential of SAA and fibrinogen, with particular emphasis on the early identification of SSI following equine internal fixation surgeries.
Applicable surgeries and participants
- In the study, horses that underwent surgeries such as fracture repair, arthrodesis (joint fusion), or osteotomy (bone cutting) with ensuing internal fixation for limb deformities have been included.
Data collection and analysis
- SAA and fibrinogen levels were recorded from the horses’ blood samples taken both before the operation and on various days post-operation (1, 3, 5, 7, 10, and 14).
- Statistical analysis was completed using Spearman’s rank correlation, logistic regression, and computing the area under the receiver operating characteristic (ROC) curve.
Research findings
- The SAA and fibrinogen measurements were found to be closely linked with SSI.
- SAA was considered to be an excellent indicator based on its high score on the ROC curve (0.8), while fibrinogen was accepted as a slightly less reliable measure (an area under the ROC curve less than 0.8).
- The study also found that as the postoperative days increased, elevations in SAA levels indicated a higher likelihood of SSI (0.8 ROC curve value compared with 0.7 for fibrinogen).
Conclusion and recommendations
- SAA and fibrinogen were found to be predictors of SSI, with SAA demonstrating higher diagnostic utility than fibrinogen.
- Continuous elevations in SAA levels post-surgery were identified in relation to the development of SSI. It was recommended that regular monitoring of SAA could aid in predicting SSI onset in horses post-internal fixation.
- This finding could result in an earlier suspicion, recognition, and treatment of SSI, thus increasing the likelihood for a more positive outcome for the horse’s recovery.
Cite This Article
APA
Thurston CC, Stefanovski D, MacKinnon MC, Chapman HS, Richardson DW, Levine DG.
(2022).
Serum amyloid A and fibrinogen as markers for early detection of surgical site infection associated with internal fixation in the horse.
Front Vet Sci, 9, 960865.
https://doi.org/10.3389/fvets.2022.960865 Publication
Researcher Affiliations
- New Bolton Center, Department of Clinical Studies, University of Pennsylvania, Kennett Square, PA, United States.
- New Bolton Center, Department of Clinical Studies, University of Pennsylvania, Kennett Square, PA, United States.
- Department of Population Medicine, University of Waterloo, Waterloo, ON, Canada.
- Pferdeklinik Leichlingen, Leichlingen, Germany.
- New Bolton Center, Department of Clinical Studies, University of Pennsylvania, Kennett Square, PA, United States.
- New Bolton Center, Department of Clinical Studies, University of Pennsylvania, Kennett Square, PA, United States.
Conflict of Interest Statement
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
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