Ateca Laura B, Drobatz Kenneth J, King Lesley G
Department of Clinical Studies - Philadelphia, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA 19104.
J Vet Emerg Crit Care (San Antonio). 2014 Nov-Dec;24(6):705-14. doi: 10.1111/vec.12256.
To identify mortality risk factors, determine mortality rate, and to describe the treatment, incidence, and type of organ dysfunction in dogs with severe bite wounds.
Retrospective case study from 2000 to 2009.
University veterinary teaching hospital.
Ninety-four dogs admitted to the intensive care unit (ICU) with bite wounds.
None.
In all dogs, physical parameters, diagnostic testing, surgery and anesthesia timing, and treatment details were recorded at presentation and during ICU hospitalization. The overall mortality rate was 15%. A majority of dogs (68%) were <10 kg. A majority of the wounds (53%) yielded no growth on bacterial culture. Prolonged time from admission to anesthesia was associated with a need for longer postoperative ICU hospitalization (P = 0.0099). Prolonged anesthesia time was associated with mortality (P = 0.0044). Systemic inflammatory response syndrome (SIRS) occurred in 54.3% of dogs and multiple organ dysfunction syndrome (MODS) occurred in 27.7% of dogs. The presence of SIRS was significantly associated with mortality (P = 0.01), with a mortality rate of 24% in dogs that developed SIRS. MODS was associated with risk of mortality (P < 0.001) with a mortality rate of 67% in dogs with dysfunction of 4 or more organs. Dogs with dysfunction of 1 organ system had a mortality rate of 9%. The body system most commonly affected was the respiratory system (37%). Cardiovascular dysfunction was highly predictive of mortality (odds ratio [OR]: 29).
Patients with extensive bite wounds have a significant risk of developing severe secondary complications such as SIRS, disseminated intravascular coagulopathy, and MODS. Longer time to anesthesia was associated with a longer recovery and longer anesthetic times were associated with mortality, disseminated intravascular coagulopathy, and MODS. Injury to the respiratory system was most commonly encountered and mortality increased with cardiovascular injury, MODS, and SIRS.
确定严重咬伤犬的死亡风险因素、死亡率，并描述其治疗、器官功能障碍的发生率及类型。
2000年至2009年的回顾性病例研究。
大学兽医教学医院。
94只因咬伤伤口入住重症监护病房（ICU）的犬。
无。
记录所有犬在就诊时及ICU住院期间的身体参数、诊断检测、手术及麻醉时间，以及治疗细节。总体死亡率为15%。大多数犬（68%）体重<10千克。大多数伤口（53%）细菌培养无生长。从入院到麻醉的时间延长与术后ICU住院时间延长相关（P = 0.0099）。麻醉时间延长与死亡率相关（P = 0.0044）。54.3%的犬发生全身炎症反应综合征（SIRS），27.7%的犬发生多器官功能障碍综合征（MODS）。SIRS的出现与死亡率显著相关（P = 0.01），发生SIRS的犬死亡率为24%。MODS与死亡风险相关（P < 0.001），4个或更多器官功能障碍的犬死亡率为67%。1个器官系统功能障碍的犬死亡率为9%。最常受影响的身体系统是呼吸系统（37%）。心血管功能障碍对死亡率具有高度预测性（优势比[OR]：29）。
广泛咬伤伤口的患者有发生严重继发性并发症如SIRS、弥散性血管内凝血和MODS的显著风险。麻醉时间延长与恢复时间延长相关，麻醉时间过长与死亡率、弥散性血管内凝血和MODS相关。呼吸系统损伤最为常见，心血管损伤、MODS和SIRS会增加死亡率。
