Internal Medicine, Hebrew University of Jerusalem Koret School of Veterinary Medicine, Rehovot, Israel
Internal Medicine, Hebrew University of Jerusalem Koret School of Veterinary Medicine, Rehovot, Israel.
Vet Rec. 2020 Jul 25;187(2):e13. doi: 10.1136/vr.105364. Epub 2019 Oct 29.
Acute pancreatitis (AP) is common in dogs. Nevertheless, validated clinical severity index (CSI) scoring systems to assess severity and guide treatment in current, large-scale studies are unavailable.
This is a retrospective study including 109 dogs. Pancreatitis was diagnosed based on clinical signs, abdominal sonographic evidence, positive pancreatic lipase assays and experts' assessment consensus.
The survival rate was 75 per cent (82 dogs). Azotaemia and presence of local complications (ie, ascites) and secondary complications (ie, acute kidney injury and acute respiratory distress syndrome) were significantly associated with death. In agreement with the previously published CSI, respiratory anomalies were significantly associated with death. However, in disagreement with that study, high scores in the kidney and local abdominal complication categories and the sum of scores of all nine categories, but not high gastrointestinal category score, were also significantly associated with death. A final CSI score of at least 4 was associated with death.
This study has validated a nine-category CSI, proven a useful assessment tool in dogs with AP. Several previously reported and novel prognostic markers were assessed.
犬急性胰腺炎(AP)较为常见。然而,目前尚无经过验证的临床严重程度指数(CSI)评分系统来评估严重程度并指导治疗,尽管此类系统在当前的大规模研究中非常需要。
这是一项回顾性研究,共纳入 109 例犬。基于临床症状、腹部超声证据、阳性胰脂肪酶检测结果以及专家评估共识来诊断胰腺炎。
生存率为 75%(82 例)。氮质血症和局部并发症(即腹水)以及继发性并发症(即急性肾损伤和急性呼吸窘迫综合征)的存在与死亡显著相关。与先前发表的 CSI 一致,呼吸异常与死亡显著相关。但与该研究不同的是,肾脏和局部腹部并发症类别的高评分以及所有九个类别的评分总和与死亡显著相关,而胃肠道类别的高评分与死亡无关。CSI 评分至少为 4 与死亡相关。
本研究验证了一种九分类 CSI,证明其是一种评估犬 AP 的有用工具。评估了一些先前报道的和新的预后标志物。