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Journal of veterinary internal medicine2025; 39(2); e70004; doi: 10.1111/jvim.70004

The Systemic Inflammatory Response Syndrome and Predictors of Infection and Mortality in 1068 Critically Ill Newborn Foals.

Abstract: Sepsis has been defined in humans as the concurrent proven or suspected presence of microbial infection and the systemic inflammatory response syndrome (SIRS). Sepsis is the leading cause of morbidity and mortality in neonatal foals. The clinical utility of using SIRS or its individual components to predict infection and mortality in critically ill foals is currently unknown. Objective: Assess the ability of history and signalment, clinical findings, laboratory results, and SIRS-related indices to predict infection and mortality in critically ill foals. Methods: Retrospective, multi-center, cross-sectional study using a convenience sample of 1068 critically ill foals < 3 days of age admitted to 16 veterinary referral hospitals in 4 countries. Methods: Data were retrieved from medical records. Infection was defined as the presence of bacteremia (positive blood culture) or clinical identification of an infected focus on admission. Univariate non-parametric and categorical methods, multivariate logistic regression, and classification tree methods were used for statistical analysis. Results: Foal age at admission and presence of toxic neutrophils were independent predictors of infection, whereas SIRS-related indices were not predictive of infection. In-hospital mortality was 24%. Independent predictors for mortality were hypokinetic pulses, cold extremities, presence of seizures, blood L-lactate concentration > 6.0 mmol/L, and increased serum potassium and total bilirubin concentrations. Conclusions: The presence of infection in critically ill newborn foals was not predicted by SIRS indices. Cardiovascular dysfunction was strongly associated with mortality, suggesting that maintaining adequate perfusion and pulse pressure should be important treatment goals.
© 2025 The Author(s). Journal of Veterinary Internal Medicine published by Wiley Periodicals LLC on behalf of American College of Veterinary Internal Medicine.
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Publication Date: 2025-03-17 PubMed ID: 40091577PubMed Central: PMC11911538DOI: 10.1111/jvim.70004Google Scholar: Lookup
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  • Journal Article
  • Multicenter Study

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 predictors of infection and mortality in critically ill newborn foals, particularly focusing on the relevance of the Systemic Inflammatory Response Syndrome (SIRS). The study demonstrates that SIRS-related indices are not predictive of infection, but cardiovascular dysfunction significantly contributes to mortality rates.

Study Objective and Methodology

  • This retrospective, multi-center, cross-sectional study was conducted on a sample size of 1068 critically ill foals younger than three days, admitted to 16 veterinary referral hospitals in four countries.
  • The objective of the study was to assess the usefulness of various factors such as history and signalment, clinical findings, laboratory results, and SIRS-related indices in predicting infection and mortality in critically ill foals.
  • Data for the study was gathered by retrieving information from medical records. Infection was defined as the presence of bacteremia or clinical identification of an infected focus on admission.
  • Statistical methods such as univariate non-parametric and categorical methods, multivariate logistic regression, and classification tree methods were used for analysis.

Study Results

  • According to the findings, the age of a foal at the time of admission and the presence of toxic neutrophils were independent predictors of infection, while SIRS-related indices did not predict infection.
  • The in-hospital mortality rate among these foals was found to be 24%.
  • Factors such as hypokinetic pulses, cold extremities, the presence of seizures, blood L-lactate concentration exceeding 6.0 mmol/L, and increased serum potassium and total bilirubin concentrations were identified as independent predictors for mortality.

Conclusions

  • The study concludes that SIRS, which is considered a significant indicator in human patients, does not effectively predict the presence of infection in critically ill newborn foals.
  • The research highlights the critical role of cardiovascular dysfunction, identified through symptoms such as hypokinetic pulses and cold extremities, in influencing mortality rates.
  • The results suggest that treatment protocols should focus on maintaining adequate perfusion and pulse pressure as key goals to enhance survival potential.

Cite This Article

APA
Wilkins PA, Wong D, Slovis NM, Collins N, Barr BS, MacKenzie C, De Solis CN, Castagnetti C, Mariella J, Burns T, Perkins G, Delvescovo B, Sanchez LC, Kemper AM, Magdesian KG, Bedenice D, Taylor SD, Gold J, Dunkel B, Pranzo G, Constable PD. (2025). The Systemic Inflammatory Response Syndrome and Predictors of Infection and Mortality in 1068 Critically Ill Newborn Foals. J Vet Intern Med, 39(2), e70004. https://doi.org/10.1111/jvim.70004

Publication

Journal of veterinary internal medicine
ISSN: 1939-1676
NlmUniqueID: 8708660
Country: United States
Language: English
Volume: 39
Issue: 2
Pages: e70004

Researcher Affiliations

Wilkins, Pamela A
  • College of Veterinary Medicine, University of Illinois at Urbana-Champaign, Ubana, Illinois, USA.
Wong, David
  • Veterinary Clinical Sciences, Lloyd Veterinary Medical Center, Iowa State University, Ames, Iowa, USA.
Slovis, Nathan M
  • Hagyard Equine Medical Institute, Lexington, Kentucky, USA.
Collins, Niamh
  • Scone Equine Hospital, Scone, New South Wales, United Kingdom of Great Britain and Northern Ireland.
Barr, Bonnie S
  • Rood and Riddle Equine Hospital, Lexington, Kentucky, USA.
MacKenzie, Catriona
  • Rossdales Equine Hospital, Newmarket, United Kingdom of Great Britain and Northern Ireland.
De Solis, Cristobal Navas
  • Texas A&M, College Station, Texas, USA.
Castagnetti, Carolina
  • Department of Veterinary Medical Sciences, University of Bologna, Bologna, Italy.
Mariella, Jole
  • Department of Veterinary Medical Sciences, University of Bologna, Bologna, Italy.
Burns, Teresa
  • Veterinary Clinical Sciences, The Ohio State University, Columbus, Ohio, USA.
Perkins, Gillian
  • Department of Clinical Sciences, Cornell University, Ithaca, New York, USA.
Delvescovo, Barbara
  • Department of Clinical Sciences, Cornell University, Ithaca, New York, USA.
Sanchez, L Chris
  • Large Animal Clinical Sciences, University of Florida, Gainesville, Florida, USA.
Kemper, Ann M
  • College of Veterinary Medicine, University of Illinois at Urbana-Champaign, Ubana, Illinois, USA.
Magdesian, K Gary
  • Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, Davis, California, USA.
Bedenice, Daniela
  • Cummings School of Veterinary Medicine, Tufts University, North Grafton, Massachusetts, USA.
Taylor, Sandra D
  • Department of Veterinary Clinical Sciences, Purdue University, West Lafayette, Indiana, USA.
Gold, Jenifer
  • Washington State University, Pullman, Washington, USA.
Dunkel, Bettina
  • Veterinary Basic Sciences, Royal Veterinary College, North Mymms, Hertsfordshire, United Kingdom of Great Britain and Northern Ireland.
Pranzo, Gene
  • Dorothy Russell Havemeyer Foundation, New York, USA.
Constable, Peter D
  • College of Veterinary Medicine, University of Illinois at Urbana-Champaign, Ubana, Illinois, USA.

MeSH Terms

  • Animals
  • Horses
  • Horse Diseases / mortality
  • Systemic Inflammatory Response Syndrome / veterinary
  • Systemic Inflammatory Response Syndrome / mortality
  • Animals, Newborn
  • Retrospective Studies
  • Critical Illness / mortality
  • Cross-Sectional Studies
  • Female
  • Male

Conflict of Interest Statement

Authors declare no off‐label use of antimicrobials. The authors declare no conflicts of interest.

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Citations

This article has been cited 3 times.
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