Use of pelvic flexure biopsy scores to predict short-term survival after large colon volvulus.

This research sought to determine whether the histological evaluation of pelvic flexure biopsies in horses with large colon volvulus (LCV) could predict short-term survival, and also if any clinical variables could be predictive of survival. However, the results indicated that such evaluations do not accurately predict short-term survival in a significant proportion of horses with LCV.

Research Methodology

• The researchers used a case series approach, reviewing the medical records of 28 horses suffering from LCV. The chosen horses had a pelvic flexure rotation of 360 degrees or more.
• Data collection covered an eight-year span from January 2000 to February 2008.
• Pelvic flexure biopsies extracted from the subjected horses were reviewed by two board-certified veterinary pathologists who were not privy to the clinical history and outcomes of the cases in order to remove bias.
• Two separate scoring systems were used by the veterinary pathologists for the histopathology scores.
• Using exact logistic regression analysis, the researchers studied any potential relationship between the tissue viability (histopathology scores), clinical data, and short-term survival (the time from admission until hospital discharge).

Findings and Conclusion

• The study found that out of the 28 horses, 24 (or 86%) survived until hospital discharge.
• Contrary to expectation, neither of the two histopathology scoring systems used was able to predict this short-term survival accurately. One scoring system inaccurately predicted the clinical outcome for 5 out of the corresponding 25 horses (20%) and the second incorrectly predicted for 6 out of the 28 horses (22.4%).
• Instead, the variables significantly associated with short-term survival were discovered to be the heart rate at admission and 24 hours post-surgery, as well as the packed cell volume (a measure of the concentration of red blood cells in blood) 24 hours post-surgery.
• In conclusion, although it was hypothesized that a histopathologic evaluation of pelvic flexure biopsies could provide some predictive value for short-term survival in horses with LCV, this study found that that was not the case for a significant proportion of the subjects.