Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO 80523, USA.
J Vet Intern Med. 2009 Nov-Dec;23(6):1261-5. doi: 10.1111/j.1939-1676.2009.0395.x. Epub 2009 Sep 22.
Glucose homeostasis is dysregulated in critically ill humans resulting in hyperglycemia and decreased survival. Hyperglycemia is common in horses presenting with abdominal crisis, and this might be associated with a worse prognosis for survival.
To determine if hyperglycemia in horses with acute abdominal disease is associated with increased odds of failure to survive to hospital discharge.
Two hundred and twenty-eight adult horses with acute gastrointestinal disease.
Observational retrospective study. Records of horses > 1 year of age presenting for treatment of colic over a 3-year period were reviewed. Data collected included age, duration of colic, glucose, heart rate, PCV, total protein, anion gap, cost of hospitalization, breed, sex, pain at admission, diagnosis, whether surgery was performed, and life status at hospital discharge. Potential risk factors for nonsurvival were screened by univariable logistic regression and the best-fitting univariable model was used as the basis for multivariable regression modeling.
Mean blood glucose was 155 mg/dL (8.5 mM) with 45% of the population above the reference range; 16.7% (38 of 228) of horses had severe hyperglycemia (>195 mg/dL; 10.7 mM). Factors associated with increased odds of failure to survive included glucose, severity of pain at admission, heart rate, PCV, anion gap, and diagnosis. The best-fitting multivariable model included glucose and diagnosis, with age included as a confounding variable. The model correctly classified outcome for 92.5% of horses.
This study has confirmed prior reports that hyperglycemia is common in horses with colic and is associated with a worse prognosis for survival to hospital discharge.
危重病患者的葡萄糖稳态失调会导致高血糖和生存率降低。马在出现腹部危象时经常出现高血糖，这可能与预后不良有关。
确定急性腹部疾病的马的高血糖是否与存活至出院的可能性增加有关。
228 匹患有急性胃肠道疾病的成年马。
观察性回顾性研究。对 3 年内接受过治疗的 1 岁以上患有腹痛的马的记录进行了回顾。收集的数据包括年龄、腹痛持续时间、血糖、心率、PCV、总蛋白、阴离子间隙、住院费用、品种、性别、入院时的疼痛、诊断、是否进行手术以及出院时的生命状况。通过单变量逻辑回归筛选出非存活的潜在危险因素，并将最佳拟合的单变量模型作为多变量回归建模的基础。
平均血糖为 155 mg/dL（8.5 mM），其中 45%的人群血糖值高于参考范围；45%（228 例中的 38 例）的马存在严重高血糖（>195 mg/dL；10.7 mM）。与存活可能性增加相关的因素包括血糖、入院时疼痛的严重程度、心率、PCV、阴离子间隙和诊断。最佳拟合的多变量模型包括血糖和诊断，年龄作为混杂变量。该模型正确分类了 92.5%的马的结果。
本研究证实了之前的报告，即高血糖在腹痛的马中很常见，并且与存活至出院的预后不良有关。
