Sutton G A, Ertzman-Ginsburg R, Steinman A, Milgram J
Koret School of Veterinary Medicine, Hebrew University of Jerusalem, Faculty of Agricultural, Food and Environmental Quality Sciences, POB 12, Rehovot 76100, Israel.
Equine Vet J. 2009 May;41(5):482-6. doi: 10.2746/042516409x391060.
Initial assessment of the mortality rates and prognostic indicators in horses with colic presented to a referral hospital in Israel.
To determine mortality rates and to identify potential prognostic indicators in horses undergoing treatment for colic.
The medical records of 208 colic cases were reviewed and mortality rates calculated including 95% confidence intervals. Mortality rates in surgical cases were calculated separately for strangulating and nonstrangulating lesions as well as for lesions of the large and small intestines. Potential prognostic indicators were identified and evaluated by Student's t test or chi2 test, where appropriate. Those found to be significant (P < 0.05) were evaluated in 2 logistic regression models; one including all horses with colic and one for surgical cases only.
The overall mortality rate was 51/208 (25%); 5/72 (7%) in medically treated cases, 46/136 (34%) in surgical cases, 30/50 (60%) in strangulating lesions and 15/85 (18%) in nonstrangulating lesions, 17/27 (63%) in cases involving small intestinal lesions and 28/108 (26%) in cases with large intestinal lesions. Clinical parameters found to be significantly associated with death by univariate analysis were medical/surgical treatment, location of lesion, severity of lesion, mucous membrane colour (MM), capillary refill time (CRT) and heart rate. Using a multivariate logistic regression model, including all cases, medical/surgical treatment, CRT and MM were found to be prognostic indicators and when using the surgical cases alone, only CRT and lesion severity remained related to mortality.
Mortality rates were similar or better than those previously reported in most cases, however, studies from the USA and the UK published better success rates for small intestinal surgeries. Cultural attitudes toward euthanasia may be associated with mortality rates.
These results assist clinicians in providing an immediate prognosis based on clinical findings at presentation and contribute to an international database that may aid future research in improving treatment of colic.
对送至以色列一家转诊医院的患急腹症马匹的死亡率及预后指标进行初步评估。
确定接受急腹症治疗马匹的死亡率，并识别潜在的预后指标。
回顾了208例急腹症病例的病历，并计算了死亡率，包括95%置信区间。分别计算了绞窄性和非绞窄性病变以及大肠和小肠病变的手术病例死亡率。在适当情况下，通过学生t检验或卡方检验识别并评估潜在的预后指标。发现具有显著性（P<0.05）的指标在两个逻辑回归模型中进行评估；一个包括所有患急腹症的马匹，另一个仅针对手术病例。
总死亡率为51/208（25%）；内科治疗病例中为5/72（7%），手术病例中为46/136（34%），绞窄性病变中为30/50（60%），非绞窄性病变中为15/85（18%），小肠病变病例中为17/27（63%），大肠病变病例中为28/108（26%）。单因素分析发现与死亡显著相关的临床参数有内科/外科治疗、病变位置、病变严重程度、黏膜颜色（MM）、毛细血管再充盈时间（CRT）和心率。使用包括所有病例的多因素逻辑回归模型，发现内科/外科治疗、CRT和MM是预后指标，而仅使用手术病例时，只有CRT和病变严重程度与死亡率相关。
在大多数情况下，死亡率与先前报道的相似或更低，然而，美国和英国的研究公布的小肠手术成功率更高。对安乐死的文化态度可能与死亡率有关。
这些结果有助于临床医生根据就诊时的临床发现提供即时预后，并为一个国际数据库做出贡献，该数据库可能有助于未来改善急腹症治疗的研究。
