Bohlin Anna, Saegerman Claude, Hoeberg Emma, Sånge Alexandra, Nostell Katarina, Durie Inge, Husted Louise, Öhman Anna, van Galen Gaby
Evidensia Equine Specialist Hospital Helsingborg, Helsingborg, Sweden.
Faculty of Veterinary Medicine, Research Unit in Epidemiology and Risk Analysis Applied to Veterinary Sciences (UREAR-ULg), Fundamental and Applied Research for Animal and Health (FARAH) Center, University of Liege, Liege, Belgium.
J Vet Intern Med. 2019 May;33(3):1507-1513. doi: 10.1111/jvim.15487. Epub 2019 Apr 19.
It is highly desirable to assess the probability of survival in sick neonatal foals upon admission. The foal survival score (FSS) is a published scoring system used to estimate the probability of survival in hospitalized neonatal foals <4 days old.
HYPOTHESIS/OBJECTIVES: To evaluate the ability of the FSS to predict survival in older foals from a geographically different area compared to the original study.
Five-hundred ninety hospitalized neonatal foals ≤14 days of age.
Retrospective Danish-Swedish multicenter study that included details of signalment, history, clinical examination, laboratory results, necropsy findings, and outcome. Scores and score variables were compared between survivors and nonsurvivors using logistic regression. The optimal cutoff and its test parameters were calculated using a receiver operator characteristic curve.
Prematurity, cold extremities, ≥2 infectious or inflammatory sites, blood glucose concentration, and total white blood cell counts were significantly associated with nonsurvival (P ≤ .02). The optimal cutoff to predict survival was ≥6, resulting in sensitivity 78%, specificity 58%, 92% positive predictive value, and 31% negative predictive value. The test performed equally well in foals <4 days old compared to those 4-14 days old.
Using the suggested optimal cutoff of ≥6, the FSS performed moderately well and may aid in early determination of prognosis for survival. However, the FSS did perform differently in another population and therefore should be assessed under local conditions so that its diagnostic potential is not overestimated.
入院时评估患病新生驹的存活概率非常必要。驹存活评分（FSS）是一种已发表的评分系统，用于估计住院的4日龄以下新生驹的存活概率。
假设/目的：与原研究相比，评估FSS预测来自地理区域不同的大龄驹存活情况的能力。
590头年龄≤14日龄的住院新生驹。
丹麦-瑞典多中心回顾性研究，纳入了特征、病史、临床检查、实验室检查结果、尸检结果及转归的详细信息。使用逻辑回归比较存活者和非存活者的评分及评分变量。使用受试者工作特征曲线计算最佳截断值及其检验参数。
早产、四肢冰冷、≥2个感染或炎症部位、血糖浓度及白细胞总数与非存活显著相关（P≤0.02）。预测存活的最佳截断值为≥6，灵敏度为78%，特异度为58%，阳性预测值为92%，阴性预测值为31%。与4-14日龄的驹相比，该检验在4日龄以下的驹中表现同样良好。
使用建议的最佳截断值≥6时，FSS表现中等，可能有助于早期判断存活预后。然而，FSS在另一群体中的表现有所不同，因此应在当地条件下进行评估，以免高估其诊断潜力。
