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Veterinary anaesthesia and analgesia2016; 29(4); 159-170; doi: 10.1046/j.1467-2995.2002.00106.x

The confidential enquiry into perioperative equine fatalities (CEPEF): mortality results of Phases 1 and 2.

Abstract: To document the equine perioperative mortality rate and to highlight any factor associated with an increased risk of death up to 7 days after anaesthesia. Methods: A prospective observational epidemiological multicentre study. Methods: Data were recorded from all equidae undergoing general anaesthesia in 62 clinics. Power calculations indicated that 45 000 cases were required to detect the significance of important variables. Details of each horse, operation, anaesthetic agents and clinic personnel were recorded. Outcome at 7 days was recorded as: alive, put to sleep (PTS) or dead. Data were analysed by a standard multilevel logistic regression approach, considering the effects of clustering at the level of clinic. Results: Data were collected from 41 824 cases over 6 years. A total of 39 025 (93.3%) were alive on day 7 and 785 were dead giving an overall death rate of 1.9% (95% CI: 1.8-2.0) and 2014 (4.8%) were PTS. About 5846 horses undergoing emergency abdominal surgeries ('colics') were excluded from subsequent analyses. A total of 35 107 'noncolic' horses were alive at 7 days and 328 dead giving a death rate for noncolics of 0.9% (95% CI: 0.8-1.0). Five hundred and forty-three (1.5%) noncolic horses classified PTS were excluded from further analyses. There were 109 (33%) deaths from cardiac arrest or post-operative cardiovascular collapse, with 107 (32%) from fractures and myopathies. Fracture repair, out of hours surgery, and age below 1 month was associated with increased risk of dying whereas the use of acepromazine and intravenous anaesthetic agent maintenance of anaesthesia was associated with reduced risk. Conclusions: A number of potential contributors to the high risk of anaesthetic-related mortality have been identified. Further investigation of the underlying mechanism for their apparent harmful effects and development of alternative techniques is merited.
Copyright © 2002 Association of Veterinary Anaesthetists and American College of Veterinary Anesthesia and Analgesia. Published by Elsevier Ltd. All rights reserved.
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Publication Date: 2016-11-15 PubMed ID: 28404360DOI: 10.1046/j.1467-2995.2002.00106.xGoogle 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 research sought to document the mortality rate around the time of surgeries in horses and to discover any factors that might be associated with an increased risk of death within a week after anesthesia.

Research Methodology

  • The design for this study was an observational epidemiological work done across multiple centres.
  • Research information was gathered from every horse that underwent general anesthesia in 62 different clinics.
  • The study aimed to evaluate the importance of different variables, requiring the inclusion of 45,000 cases in order to do so.
  • The team gathered extensive data on each horse including the nature of the surgery, the anesthetics used, and details about the personnel involved at the clinic.
  • All outcomes were noted after 7 days. The outcomes were classified under these categories: alive, put to sleep (PTS), or dead.
  • Data was analyzed using a multilevel logistic regression approach, which takes into account the clinic level clustering effects.

Results

  • Information was gathered from a total of 41,824 cases over a period of 6 years.
  • A large portion (93.3%), equivalent to 39,025 of the cases, where alive on day 7 while 785 were recorded as dead resulting in an overall death rate of approximately 1.9%.
  • In addition, about 2014 horses, representing 4.8%, were euthanized.
  • Cases involving emergency abdominal surgeries, known colloquially as ‘colics’, were eliminated from further analysis, resulting in the removal of around 5846 cases.
  • For the remaining ‘noncolic’ horses, 35,107 were alive at the end of the 7-day period while 328 had died. This represents a ‘noncolic’ death rate of roughly 0.9%.
  • Additional 543 ‘noncolic’ horses that were classified as PTS were also excluded from further analyses.
  • Key contributors to the recorded deaths were cardiac arrest or post-operative cardiovascular collapse (33% of deaths), and fractures and myopathies (32% of deaths).
  • The study identified a few factors that were associated with a higher risk of death. These included surgery for fracture repair, surgery performed out of regular hours, and age below 1 month.
  • Conversely, the study found that the use of acepromazine and maintenance of anesthesia with intravenous agents were linked to reduced risk.

Conclusions

  • The study successfully identified several potential contributors to the high risk associated with anesthesia-related mortality in equines.
  • The researchers conclude by recommending further investigation into the mechanisms behind the harmful effects observed and development of alternative techniques.

Cite This Article

APA
Johnston GM, Eastment JK, Wood J, Taylor PM. (2016). The confidential enquiry into perioperative equine fatalities (CEPEF): mortality results of Phases 1 and 2. Vet Anaesth Analg, 29(4), 159-170. https://doi.org/10.1046/j.1467-2995.2002.00106.x

Publication

Veterinary anaesthesia and analgesia
ISSN: 1467-2995
NlmUniqueID: 100956422
Country: United States
Language: English
Volume: 29
Issue: 4
Pages: 159-170

Researcher Affiliations

Johnston, G M
  • Department of Clinical Veterinary Medicine, University of Cambridge, Cambridge, UK.
Eastment, J K
  • Epidemiology Unit, The Animal Health Trust, Newmarket, UK.
Wood, Jln
  • Epidemiology Unit, The Animal Health Trust, Newmarket, UK.
Taylor, P M
  • Department of Clinical Veterinary Medicine, University of Cambridge, Cambridge, UK.

Citations

This article has been cited 79 times.
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