Surgical and postoperative factors influencing short-term survival of horses following small intestinal resection: 92 cases (1994-2001).
Abstract: Although short-term survival rates following small intestinal resection reportedly range from 48-88%, there is little information on predicting which horse may or may not survive small intestinal (SI) resection and anastomosis. The aim of this study was to identify factors that contribute to nonsurvival in horses following small intestinal resection. Medical records of horses which recovered from anaesthesia following SI resection were reviewed. Clinical and surgical variables were evaluated for their association with short-term survival using logistic regression and were reported as odds ratios (OR), including the 95% confidence interval (CI), indicating the likelihood of horses not surviving to hospital discharge. Ninety-two records met the criteria for inclusion. Thirty-six (81.8%) of the horses that underwent jejunojejunostomy (JJ) and 34 (70.8%) of the horses that underwent jejunocaecostomy (JC) survived to discharge. Multiple logistic analysis indicated that postoperative ileus (OR = 29.7; 95% CI 2.5-354.6), repeat celiotomy (OR = 18; CI 1.7-187.6), and an elevated heart rate of > or = 60 beats/min (OR = 5.6; CI 1.5-20.6) were the principal factors associated with nonsurvival. A low total plasma protein of <55 g/l (OR = 1.8; CI 0.-7.6) was incorporated in the final model because its inclusion improved the overall validity of the model, Clinicians should be aware of the factors associated with the greatest likelihood of nonsurvival following small intestinal resection, so that they can institute aggressive treatment and accurately inform owners on the likelihood of survival.
Publication Date: 2002-10-03 PubMed ID: 12358046DOI: 10.2746/042516402776117700Google Scholar: Lookup
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- Journal Article
Summary
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The research study investigated factors that influence a horse’s survival after undergoing small intestinal resection, typically used for conditions such as hernia or intestinal blockage. The researchers found that postoperative ileus, repeat celiotomy, and an elevated heart rate were significantly associated with nonsurvival.
Study Purpose and Methodology
- The aim of the study was to identify factors contributing to nonsurvival in horses after they have undergone small intestinal resection.
- Researchers reviewed the medical records of horses which have undergone this procedure and recovered from anaesthesia.
- Several clinical and surgical variables were examined to identify their relation with short-term survival.
- An odds ratio (OR) was used to represent the likelihood of a horse’s nonsurvival to hospital discharge. The higher the OR, the higher the likelihood of nonsurvival.
Findings of the Study
- A total of 92 records met the criteria for inclusion in the study.
- Amongst these horses, 81.8% that underwent the surgical procedure jejunojejunostomy (JJ, anastomosis of two parts of the jejunum) and 70.8% that underwent jejunocaecostomy (JC, anastomosis between the jejunum and caecum) survived to discharge.
- Three key factors were found to be associated with nonsurvival: postoperative ileus (disruption in the normal propulsive ability of the gastrointestional tract after surgery) with an OR = 29.7, repeat celiotomy (a surgical procedure that opens the abdominal cavity) with an OR = 18, and an elevated heart rate of > or = 60 beats/min with an OR = 5.6.
- A low total plasma protein of <55 g/l (OR = 1.8) was also noted due to the improvement it brought to the overall validity of the statistical prediction model.
Implications of the Study
- Identifying these factors enables clinicians to implement aggressive treatment strategies to counteract these risks.
- The findings also enable accurate communication with pet owners about the survival chances of the horse after the procedure.
- These findings have the potential to improve the survival rates of horses undergoing small intestinal resections.
Cite This Article
APA
Morton AJ, Blikslager AT.
(2002).
Surgical and postoperative factors influencing short-term survival of horses following small intestinal resection: 92 cases (1994-2001).
Equine Vet J, 34(5), 450-454.
https://doi.org/10.2746/042516402776117700 Publication
Researcher Affiliations
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh 27606, USA.
MeSH Terms
- Anastomosis, Surgical / mortality
- Anastomosis, Surgical / veterinary
- Animals
- Confidence Intervals
- Female
- Horse Diseases / mortality
- Horse Diseases / surgery
- Horses
- Intestinal Obstruction / epidemiology
- Intestinal Obstruction / mortality
- Intestinal Obstruction / surgery
- Intestinal Obstruction / veterinary
- Intestine, Small / surgery
- Male
- Odds Ratio
- Postoperative Complications / epidemiology
- Postoperative Complications / mortality
- Postoperative Complications / veterinary
- Postoperative Period
- Retrospective Studies
- Risk Factors
- Survival Rate
- Time Factors
Citations
This article has been cited 11 times.- Bardell D, Rocchigiani G, Ressel L, Milner P. Histological Evaluation of Resected Tissue as a Predictor of Survival in Horses with Strangulating Small Intestinal Disease.. Animals (Basel) 2023 Aug 26;13(17).
- Spadari A, Gialletti R, Gandini M, Valle E, Cerullo A, Cavallini D, Bertoletti A, Rinnovati R, Forni G, Scilimati N, Giusto G. Short-Term Survival and Postoperative Complications Rates in Horses Undergoing Colic Surgery: A Multicentre Study.. Animals (Basel) 2023 Mar 20;13(6).
- Veerasammy B, Gonzalez G, Báez-Ramos P, Schaaf CR, Stewart AS, Ludwig EK, McKinney-Aguirre C, Freund J, Robertson J, Gonzalez LM. Changes in equine intestinal stem/progenitor cell number at resection margins in cases of small intestinal strangulation.. Equine Vet J 2023 Jan 30;.
- 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.
- Kos VK, Kramaric P, Brloznik M. Packed cell volume and heart rate to predict medical and surgical cases and their short-term survival in horses with gastrointestinal-induced colic.. Can Vet J 2022 Apr;63(4):365-372.
- Hellstrom EA, Ziegler AL, Blikslager AT. Postoperative Ileus: Comparative Pathophysiology and Future Therapies.. Front Vet Sci 2021;8:714800.
- Averay K, van Galen G, Ward M, Verwilghen D. Effect of three different needle holders on gastrointestinal anastomosis construction time and bursting pressure in equine jejunal segments.. BMC Vet Res 2021 Apr 15;17(1):167.
- Steinmann M, Bezugley RJ, Bond SL, Pomrantz JS, Léguillette R. A wireless endoscopy capsule suitable for imaging of the equine stomach and small intestine.. J Vet Intern Med 2020 Jul;34(4):1622-1630.
- Kaufman JM, Nekouei O, Doyle AJ, Biermann NM. Clinical findings, diagnoses, and outcomes of horses presented for colic to a referral hospital in Atlantic Canada (2000-2015).. Can Vet J 2020 Mar;61(3):281-288.
- Salem SE, Proudman CJ, Archer DC. Has intravenous lidocaine improved the outcome in horses following surgical management of small intestinal lesions in a UK hospital population?. BMC Vet Res 2016 Jul 27;12(1):157.
- Anderson SL, Blackford JT, Kelmer SG. Clinical evaluation of a closed, one-stage, stapled, functional, end-to-end jejuno-ileal anastomosis in 5 horses.. Can Vet J 2012 Sep;53(9):987-91.
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