Use of a multivariable model to estimate the probability of discharge in hospitalized foals that are 7 days of age or less.
Abstract: To create a mathematical model to assist in early prediction of the probability of discharge in hospitalized foals < or= 7 days old. Methods: Prospective study. Methods: 1,073 foals. Methods: Medical records from 910 hospitalized foals < or = 7 days old for which outcome was recorded as died or discharged alive were reviewed. Thirty-four variables including historical information, physical examination findings, and laboratory results were examined for association with survival. Variables associated with being discharged alive were entered into a multivariable logistic regression model. Accuracy of the model was validated prospectively on data from 163 foals. Results: Factors in the final model included age group, ability to stand, presence of a suckle reflex, WBC count, serum creatinine concentration, and anion gap. Sensitivity and specificity of the model to predict live discharge were 92% and 74%, respectively, in the retrospective population and 90% and 46%, respectively, in the prospective population. Accuracy of an equine clinician's initial prediction of the foal being discharged alive was 83%, and accuracy of the model's prediction was 81%. Combining the clinician's prediction of probability of live discharge with that of the model significantly increased (median increase, 12%) the accuracy of the prediction for foals that were discharged and nonsignificantly decreased (median decrease, 9%) the accuracy of the predication for nonsurvivors. Conclusions: Combining the clinician's initial predication of the probability of a foal being discharged alive with that of the model appeared to provide a more precise early estimate of the probability of live discharge for hospitalized foals.
Publication Date: 2006-06-03 PubMed ID: 16740076DOI: 10.2460/javma.228.11.1748Google Scholar: Lookup
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- Journal Article
- Research Support
- Non-U.S. Gov't
- Clinical Examination
- Clinical Pathology
- Clinical Study
- Creatinine
- Diagnosis
- Disease Diagnosis
- Disease Management
- Disease Treatment
- Equine Health
- Foals
- Horses
- Hospitalization
- Mortality
- Predictive Model
- Prognosis
- Regression Analysis
- Veterinary Care
- Veterinary Medicine
- Veterinary Practice
- Veterinary Research
- White Blood Cells
Summary
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The research paper presents a mathematical model developed to predict the probability of discharge for newborn foals hospitalized within their first week of life, using 34 variables associated with survivability.
Methodology
- The research included a review of the medical records of 910 hospitalized foals aged seven days or less.
- Outcome data was recorded as either the foal died or it was discharged alive.
- The researchers examined 34 different variables that include history, physical examination findings, and laboratory results for their association with survival.
- The variables found to be associated with a foal’s discharge were used in a multivariable logistic regression model.
- The accuracy of the model was validated prospectively on data from an additional 163 foals.
Results
- Factors included in the final model were age group, ability to stand, presence of a suckle reflex, white blood cell count, serum creatinine concentration, and anion gap.
- The model achieved a sensitivity and specificity of 92% and 74% respectively in the retrospective population, and 90% and 46% respectively in the prospective population.
- Accuracy of an equine clinician’s initial prediction of a foal being discharged alive was found to be 83% while the accuracy of the model’s prediction was slightly lower at 81%.
- When combining the clinician’s prediction with the model’s prediction, the accuracy of predicting which foals would be discharged alive significantly increased (median increase, 12%), however it also non-significantly decreased the accuracy of predicting for nonsurvivors (median decrease, 9%).
Conclusion
- The study concludes that combining the clinician’s initial predication of the probability of a foal being discharged alive with that of the model provides a more precise early estimate.
- Thus the combination of clinical judgement and the mathematical model can be an effective tool for predicting the survival rate of hospitalized foals aged seven days or less.
Cite This Article
APA
Rohrbach BW, Buchanan BR, Drake JM, Andrews FM, Bain FT, Byars DT, Bernard WV, Furr MO, Paradis MR, Lawler J, Giguère S, Dunkel B.
(2006).
Use of a multivariable model to estimate the probability of discharge in hospitalized foals that are 7 days of age or less.
J Am Vet Med Assoc, 228(11), 1748-1756.
https://doi.org/10.2460/javma.228.11.1748 Publication
Researcher Affiliations
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, TN 37996, USA.
MeSH Terms
- Age Factors
- Animals
- Animals, Newborn / physiology
- Confidence Intervals
- Female
- Horse Diseases / mortality
- Horses
- Hospitals, Animal / statistics & numerical data
- Likelihood Functions
- Male
- Mathematics
- Models, Statistical
- Multivariate Analysis
- Odds Ratio
- Predictive Value of Tests
- Prognosis
- Prospective Studies
- Regression Analysis
- Severity of Illness Index
- Survival Analysis
Citations
This article has been cited 11 times.- Probo M, Veronesi MC. Clinical Scoring Systems in the Newborn Calf: An Overview. Animals (Basel) 2022 Nov 3;12(21).
- Cummings CO, Krucik DDR, Price E. Clinical predictive models in equine medicine: A systematic review. Equine Vet J 2023 Jul;55(4):573-583.
- Stewart AJ, Hackett E, Bertin FR, Towns TJ. Cortisol and adrenocorticotropic hormone concentrations in horses with systemic inflammatory response syndrome. J Vet Intern Med 2019 Sep;33(5):2257-2266.
- Bohlin A, Saegerman C, Hoeberg E, Sånge A, Nostell K, Durie I, Husted L, Öhman A, van Galen G. Evaluation of the foal survival score in a Danish-Swedish population of neonatal foals upon hospital admission. J Vet Intern Med 2019 May;33(3):1507-1513.
- Wong DM, Ruby RE, Dembek KA, Barr BS, Reuss SM, Magdesian KG, Olsen E, Burns T, Slovis NM, Wilkins PA. Evaluation of updated sepsis scoring systems and systemic inflammatory response syndrome criteria and their association with sepsis in equine neonates. J Vet Intern Med 2018 May;32(3):1185-1193.
- Dembek KA, Hurcombe SD, Frazer ML, Morresey PR, Toribio RE. Development of a likelihood of survival scoring system for hospitalized equine neonates using generalized boosted regression modeling. PLoS One 2014;9(10):e109212.
- Toth B, Slovis NM, Constable PD, Taylor SD. Plasma adrenomedullin concentrations in critically ill neonatal foals. J Vet Intern Med 2014 Jul-Aug;28(4):1294-300.
- Vengust M. Hypercapnic respiratory acidosis: a protective or harmful strategy for critically ill newborn foals?. Can J Vet Res 2012 Oct;76(4):275-80.
- Castagnetti C, Veronesi MC. Prognostic factors in the sick neonatal foal. Vet Res Commun 2008 Sep;32 Suppl 1:S87-91.
- Parra MT, Ayala MSF. Retrospective five-year study of equine casuistry in a Colombian perinatology center. Braz J Vet Med 2025;47:e005824.
- Castelain DL, Dufourni A, Pas ML, Bokma J, de Bruijn E, Paulussen E, Lefère L, van Loon G, Pardon B. Retrospective cohort study on diseases and risk factors associated with death in hospitalized neonatal foals. J Vet Intern Med 2025 Jan-Feb;39(1):e17269.
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