Matthews Nora S, Mohn Thomas J, Yang Mingyin, Spofford Nathaniel, Marsh Alison, Faunt Karen, Lund Elizabeth M, Lefebvre Sandra L
J Am Vet Med Assoc. 2017 Mar 15;250(6):655-665. doi: 10.2460/javma.250.6.655.
OBJECTIVE To identify risk factors for anesthetic-related death in pet dogs and cats. DESIGN Matched case-control study. ANIMALS 237 dogs and 181 cats. PROCEDURES Electronic medical records from 822 hospitals were examined to identify dogs and cats that underwent general anesthesia (including sedation) or sedation alone and had death attributable to the anesthetic episode ≤ 7 days later (case animals; 115 dogs and 89 cats) or survived > 7 days afterward (control animals [matched by species and hospital]; 122 dogs and 92 cats). Information on patient characteristics and data related to the anesthesia session were extracted. Conditional multivariable logistic regression was performed to identify factors associated with anesthetic-related death for each species. RESULTS The anesthetic-related death rate was higher for cats (11/10,000 anesthetic episodes [0.11%]) than for dogs (5/10,000 anesthetic episodes [0.05%]). Increasing age was associated with increased odds of death for both species, as was undergoing nonelective (vs elective) procedures. Odds of death for dogs were significantly greater when preanesthetic physical examination results were not recorded (vs recorded) or when preanesthetic Hct was outside (vs within) the reference range. Odds of death for cats were greater when intra-anesthesia records for oxygen saturation as measured by pulse oximetry were absent. Underweight dogs had almost 15 times the odds of death as nonunderweight dogs; for cats, odds of death increased with increasing body weight (but not with overweight body condition). CONCLUSIONS AND CLINICAL RELEVANCE Several factors were associated with anesthetic-related death in cats and dogs. This information may be useful for development of strategies to reduce anesthetic-related risks when possible and for education of pet owners about anesthetic risks.
目的 确定宠物狗和猫麻醉相关死亡的危险因素。 设计 匹配病例对照研究。 动物 237 只狗和 181 只猫。 程序 检查了 822 家医院的电子病历,以识别接受全身麻醉(包括镇静)或仅接受镇静且在麻醉事件后≤7 天内死亡(病例动物;115 只狗和 89 只猫)或在 7 天后存活(对照动物[按物种和医院匹配];122 只狗和 92 只猫)的狗和猫。提取了患者特征信息和与麻醉过程相关的数据。对每个物种进行条件多变量逻辑回归,以识别与麻醉相关死亡相关的因素。 结果 猫的麻醉相关死亡率(每 10,000 次麻醉事件中有 11 例[0.11%])高于狗(每 10,000 次麻醉事件中有 5 例[0.05%])。年龄增长与两个物种的死亡几率增加相关,接受非择期(相对于择期)手术也是如此。当未记录麻醉前体格检查结果(相对于记录)或麻醉前血细胞比容超出(相对于在)参考范围时,狗的死亡几率显著更高。当缺乏通过脉搏血氧饱和度测量的麻醉期间氧饱和度记录时,猫的死亡几率更高。体重过轻的狗死亡几率几乎是非体重过轻狗的 15 倍;对于猫,死亡几率随着体重增加而增加(但与超重身体状况无关)。 结论及临床意义 猫和狗的麻醉相关死亡与几个因素有关。这些信息可能有助于制定尽可能降低麻醉相关风险的策略,并用于对宠物主人进行麻醉风险教育。