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大肠疾病手术后马匹长期存活情况的建模

Modelling long-term survival of horses following surgery for large intestinal disease.

作者信息

Proudman C J, Edwards G B, Barnes J, French N P

机构信息

Faculty of Veterinary Science, University of Liverpool, Leahurst, Neston, Wirral CH64 7TE, UK.

出版信息

Equine Vet J. 2005 Jul;37(4):366-70. doi: 10.2746/0425164054529328.

Abstract

REASONS FOR PERFORMING STUDY

Large intestinal diseases are an important cause of equine colic that require surgical management, but there is little published information about long-term survival of such cases.

OBJECTIVES

To identify variables associated with post operative mortality and to develop a model for post operative survival following surgery for large intestinal disease.

METHODS

Clinical data and long-term follow-up information from 275 horses undergoing surgery for large intestinal disease were used. A multivariable, Cox proportional hazards model for post operative death was developed and the fit of the model evaluated.

RESULTS

The continuous variables age, heart rate and packed cell volume (PCV) were associated positively with the risk of post operative death, as were the categorical variables resection (odds ratio [OR] 2.4, 95% confidence interval [CI] 1.2-5.1) and relaparotomy (OR 3.5, 95% CI 1.4-8.4).

CONCLUSIONS

In the population studied, the probability of post operative survival following surgery for large intestinal disease was associated with the cardiovascular parameters heart rate and PCV on admission, age of the horse and whether it underwent resection or relaparotomy.

POTENTIAL RELEVANCE

The prognosis for post operative survival for horses with large intestinal disease may be improved by early surgery, prior to the development of cardiovascular compromise. Surgeons should be aware that increasing age, resection of large colon and relaparotomy are all associated with a worsening prognosis for survival.

摘要

开展本研究的原因

大肠疾病是马属动物绞痛的一个重要病因,需要手术治疗,但关于此类病例长期存活情况的公开信息很少。

目的

确定与术后死亡率相关的变量,并建立大肠疾病手术后存活情况的模型。

方法

使用了275匹接受大肠疾病手术的马匹的临床数据和长期随访信息。建立了一个多变量Cox比例风险模型用于术后死亡情况分析,并对模型的拟合情况进行了评估。

结果

连续变量年龄、心率和血细胞比容(PCV)与术后死亡风险呈正相关,分类变量切除(比值比[OR] 2.4,95%置信区间[CI] 1.2 - 5.1)和再次剖腹手术(OR 3.5,95% CI 1.4 - 8.4)也与术后死亡风险呈正相关。

结论

在所研究的群体中,大肠疾病手术后的存活概率与入院时的心血管参数心率和PCV、马匹年龄以及是否进行了切除或再次剖腹手术有关。

潜在意义

对于患有大肠疾病的马匹,在心血管功能出现损害之前尽早进行手术可能会改善术后存活的预后。外科医生应意识到,年龄增长、大肠切除和再次剖腹手术均与存活预后恶化有关。

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