The risks of the game: the confidential enquiry into perioperative equine fatalities.

This research is about a study conducted to understand the causes and frequency of unexpected fatalities due to surgery or anesthesia within a week of surgery in horses, ponies, and donkeys. It gathers detailed data on over 14,500 operations in a 3-year period from multiple surgical practices around the world. It also looks at measures to reduce the mortality and morbidity rate in these animals.

Research Background

• The study titled “The Confidential Enquiry into Perioperative Equine Fatalities (CEPEF)” seeks to investigate the incidence of unexpected deaths in horses, ponies, and donkeys after surgery or anesthesia intake within one week.
• The motivation for the study arises from anecdotal evidence and personal experiences that indicate a significant number of such deaths happen even in fit animals undergoing routine operations. Moreover, due to lack of quantifiable risk assessment, these fatalities are unexpected rather than sudden.
• The need to quantify the risk associated with anesthesia in equine surgeries becomes more important considering the relatively higher mortality rate of approximately 1% in equine species compared to other animals, and humans.

Study Design and Implementation

• The research employs two types of study designs—cohort and nested case control studies. Cohort studies track a group of individuals undergoing surgeries to evaluate the occurrence of endpoints (alive or dead). Nested case control studies, on the other hand, compare patients already having a particular disease process with randomly selected other patients.
• To maintain the authenticity of information and encourage open sharing, stringent efforts were made to guarantee the anonymity of all participants and patients.
• CEPEF extended its research network to include equine surgical practices in various countries around the world.

Research Key Findings

• The results were heterogenous, with the 95 deaths categorized under cardiac arrests, myopathies, fractures during induction or recovery, colitis cases, respiratory obstructions, spinal cord malacia, etc.
• The research also highlights the difference between mortality (death) and morbidity (complication leading to ill health or death) and suggests that serious complications frequently leading to fatalities have been included as a morbidity aspect in CEPEF-2.

Future Work

• The second part of the study, CEPEF-2, aims to increase the sample size to understand better the causes of unexpected perioperative fatalities and to bring the high mortality and morbidity rate down.
• The study also plans to segregate emergency abdominal surgeries from regular surgeries, based on their previous findings of increased risk in the former category.
• The data from the research are analyzed every six months and circulated to all participants, with the aim of minimizing the risk of unexpected equine fatalities.

Call to Action

• The research concludes with a call to fellow practitioners to participate in the study, indicating your contribution can significantly impact the validity of the research.