Archer D C, Pinchbeck G L, Proudman C J
University of Liverpool, Leahurst Campus, Neston, Wirral, UK.
Equine Vet J Suppl. 2011 Aug(39):56-62. doi: 10.1111/j.2042-3306.2011.00409.x.
Epiploic foramen entrapment (EFE) has been associated with reduced post operative survival compared to other types of colic but specific factors associated with reduced long-term survival of these cases have not been evaluated in a large number of horses using survival analysis.
To describe post operative survival of EFE cases and to identify factors associated with long-term survival.
A prospective, multicentre, international study was conducted using clinical data and long-term follow-up information for 126 horses diagnosed with EFE during exploratory laparotomy at 15 clinics in the UK, Ireland and USA. Descriptive data were generated and survival analysis performed to identify factors associated with reduced post operative survival.
For the EFE cohort that recovered following anaesthesia, survival to hospital discharge was 78.5%. Survival to 1 and 2 years post operatively was 50.6 and 34.3%, respectively. The median survival time of EFE cases undergoing surgery was 397 days. Increased packed cell volume (PCV) and increased length of small intestine (SI) resected were significantly associated with increased likelihood of mortality when multivariable analysis of pre- and intraoperative variables were analysed. When all pre-, intra- and post operative variables were analysed separately, only horses that developed post operative ileus (POI) were shown to be at increased likelihood of mortality.
Increased PCV, increased length of SI resected and POI are all associated with increased likelihood of mortality of EFE cases. This emphasises the importance of early diagnosis and treatment and the need for improved strategies in the management of POI in order to reduce post operative mortality in these cases.
The present study provides evidence-based information to clinicians and owners of horses undergoing surgery for EFE about long-term survival. These results are applicable to university and large private clinics over a wide geographical area.
与其他类型的急腹症相比，网膜孔绞窄（EFE）与术后生存率降低有关，但尚未通过生存分析在大量马匹中评估与这些病例长期生存降低相关的具体因素。
描述EFE病例的术后生存率，并确定与长期生存相关的因素。
一项前瞻性、多中心、国际性研究利用了英国、爱尔兰和美国15家诊所对126匹在剖腹探查术中被诊断为EFE的马匹的临床数据和长期随访信息。生成描述性数据并进行生存分析，以确定与术后生存率降低相关的因素。
对于麻醉后恢复的EFE队列，出院生存率为78.5%。术后1年和2年的生存率分别为50.6%和34.3%。接受手术的EFE病例的中位生存时间为397天。当对术前和术中变量进行多变量分析时，红细胞压积（PCV）升高和小肠（SI）切除长度增加与死亡可能性增加显著相关。当分别分析所有术前、术中和术后变量时，仅显示发生术后肠梗阻（POI）的马匹死亡可能性增加。
PCV升高、SI切除长度增加和POI均与EFE病例死亡可能性增加相关。这强调了早期诊断和治疗的重要性，以及改进POI管理策略以降低这些病例术后死亡率的必要性。
本研究为接受EFE手术的马匹的临床医生和主人提供了关于长期生存的循证信息。这些结果适用于广泛地理区域的大学和大型私人诊所。
