Goggs Robert, De Rosa Sage, Fletcher Daniel J
1 Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA.
2 Department of Clinical Studies, University of Pennsylvania School of Veterinary Medicine, Philadelphia, PA, USA.
J Feline Med Surg. 2018 Dec;20(12):1072-1081. doi: 10.1177/1098612X17743564. Epub 2017 Dec 5.
Electrolyte disorders have been individually associated with mortality in small populations of cats with specific conditions, but the associations and interactions between electrolyte disturbances and outcome have not been evaluated in a large, heterogeneous population. It was hypothesized that abnormalities of sodium, chloride, potassium and calcium concentrations would be independently and proportionately associated with death from natural causes and with all-cause mortality in cats.
An electronic database containing 7064 electrolyte profiles was constructed to assess the association between disorders of sodium, potassium, corrected-chloride and ionized calcium concentrations with non-survival by multivariable modelling. A second database containing 2388 records was used to validate the models constructed from the first database.
All four electrolytes assessed had non-linear U-shaped associations with case fatality rates, wherein concentrations clustered around the reference interval had the lowest case fatality rates, while progressively abnormal concentrations were associated with proportionately increased risk of non-survival (area under the receiver operator characteristic curve [AUROC] 0.689) or death (AUROC 0.750).
Multivariable modelling suggested that these electrolyte disturbances were associated with non-survival and with death from natural causes independent of each other. The present study suggests that measurement of electrolyte concentrations is an important component of the assessment of cats in emergency rooms or intensive care units. Future studies should focus on confirming these associations in a prospective manner accounting for disease severity.
电解质紊乱已分别与特定疾病的少量猫群的死亡率相关，但尚未在大量异质猫群中评估电解质紊乱与预后之间的关联和相互作用。据推测，钠、氯、钾和钙浓度异常将分别且成比例地与猫的自然死亡和全因死亡率相关。
构建一个包含7064份电解质分析资料的电子数据库，通过多变量建模评估钠、钾、校正氯和离子钙浓度紊乱与非存活之间的关联。使用包含2388条记录的第二个数据库来验证从第一个数据库构建的模型。
所评估的所有四种电解质与病死率均呈非线性U形关联，其中聚集在参考区间附近的浓度病死率最低，而浓度逐渐异常则与非存活（受试者工作特征曲线下面积[AUROC]为0.689）或死亡（AUROC为0.750）风险成比例增加相关。
多变量建模表明，这些电解质紊乱彼此独立地与非存活和自然死亡相关。本研究表明，电解质浓度测量是急诊室或重症监护病房中猫评估的重要组成部分。未来的研究应集中于以前瞻性方式证实这些关联，并考虑疾病严重程度。
