Steerforth Daniel-Dean, Van Winden Steven
Pathobiology and Population Sciences, The Royal Veterinary College, University of London, Hatfield,Hertfordshire, UK.
Vet Rec. 2018 May 12;182(19):549. doi: 10.1136/vr.104213. Epub 2018 Feb 19.
Omphalitis contributes significantly to morbidity and mortality in neonatal calves. Diagnosis of omphalitis is based on the local signs of inflammation-pain, swelling, local heat and purulent discharge. An abattoir trial identified an optimal, sign-based, scoring system for diagnosis of omphalitis. A sample of 187 calves aged between 7 and 15 days old were clinically examined for signs of umbilical inflammation and compared with postmortem examination of navels. On postmortem findings, 64 calves (34.2 per cent) had omphalitis. In the examined omphalitis cases, the most commonly affected umbilical structure was the urachus (78.1 per cent). Multivariable logistic regression revealed that thickening of the umbilical stump over 1.3 cm (P<0.001), discharge (P<0.001), raised local temperature (P=0.003) and the presence of umbilical hernia (P=0.024) were correlated and positive predictors of omphalitis. Discharge from the umbilical stump was associated with intra-abdominal inflammation (P=0.004). Assigning weights based on the multivariable logistic regression coefficients, a clinical scoring algorithm was developed. The cumulative score ranged from 0 to 9. Using this scoring system, calves were categorised as positive if their total score was ≥2. This scoring method had a sensitivity of 85.9 per cent, specificity of 74.8 per cent and correctly classified 78.6 per cent of all calves.
脐炎是新生犊牛发病和死亡的重要原因。脐炎的诊断基于炎症的局部体征——疼痛、肿胀、局部发热和脓性分泌物。一项屠宰场试验确定了一种用于诊断脐炎的基于体征的最佳评分系统。对187头7至15日龄的犊牛进行临床检查,以查找脐部炎症体征,并与脐部的尸检结果进行比较。根据尸检结果,64头犊牛(34.2%)患有脐炎。在所检查的脐炎病例中,最常受影响的脐部结构是脐尿管(78.1%)。多变量逻辑回归显示,脐残端增厚超过1.3厘米(P<0.001)、有分泌物(P<0.001)、局部温度升高(P=0.003)以及存在脐疝(P=0.024)与脐炎相关且是其阳性预测指标。脐残端有分泌物与腹腔内炎症相关(P=0.004)。根据多变量逻辑回归系数赋予权重,制定了一种临床评分算法。累积评分范围为0至9分。使用该评分系统,总分≥2分的犊牛被归类为阳性。这种评分方法的敏感性为85.9%,特异性为74.8%,正确分类了所有犊牛的78.6%。