Swann J W, Skelly B J
Royal Veterinary College, University of London, London, UK.
J Vet Intern Med. 2015 Jan;29(1):7-13. doi: 10.1111/jvim.12514. Epub 2015 Jan 13.
Treatment of dogs with primary immune-mediated hemolytic anemia (IMHA) is difficult and frequently unrewarding. Prognostic factors have been evaluated in a number of previous studies, and identification of such factors would be beneficial to enable selection of appropriate therapeutic regimens and supportive care.
The aim of the current study was to undertake a critical appraisal of the risk of bias in evidence relating to prognostic indicators for mortality in dogs with IMHA.
Three hundred and eighty client-owned dogs with spontaneous primary idiopathic IMHA reported in 6 previous studies.
A systematic review was conducted to evaluate evidence relating to prognostic factors for mortality in dogs with primary IMHA. Search tools were employed to identify articles and a validated appraisal tool was used to assess the quality of individual studies by considering inclusion and exclusion criteria, measurement of prognostic, outcome and confounding variables, and statistical methods.
Few studies evaluated prognostic indicators for IMHA in dogs, and all of these suffered from methodologic flaws in at least 1 major area. Fifteen different variables were identified as prognostic indicators, with 2 variables identified by >1 study.
There are few pieces of high-quality evidence available to enable estimation of prognosis for dogs presenting with primary IMHA.
原发性免疫介导性溶血性贫血（IMHA）犬的治疗困难且常常效果不佳。以往已有多项研究对预后因素进行了评估，确定这些因素将有助于选择合适的治疗方案和支持性护理。
本研究的目的是对与IMHA犬死亡率预后指标相关证据的偏倚风险进行批判性评估。
先前6项研究中报告的380只客户拥有的自发性原发性特发性IMHA犬。
进行系统评价以评估与原发性IMHA犬死亡率预后因素相关的证据。使用检索工具识别文章，并使用经过验证的评估工具，通过考虑纳入和排除标准、预后、结局和混杂变量的测量以及统计方法来评估个体研究的质量。
很少有研究评估IMHA犬的预后指标，并且所有这些研究在至少一个主要领域都存在方法学缺陷。确定了15个不同的变量作为预后指标，其中2个变量在>1项研究中被确定。
几乎没有高质量的证据可用于估计原发性IMHA犬的预后。
