Cornell University College of Veterinary Medicine, Ithaca, NY, USA.
University of Georgia College of Veterinary Medicine, Athens, GA, USA.
Equine Vet J. 2020 Nov;52(6):799-804. doi: 10.1111/evj.13242. Epub 2020 Feb 21.
Obesity is common in the equine population and it has been associated with increased surgical morbidity and mortality in humans. The effect of increased body mass index (BMI) on the incidence of surgical site infections has not been investigated in horses.
To determine whether horses with increased body fat, as estimated by BMI, are more likely to develop post-operative complications, particularly incisional complications, following emergency ventral midline celiotomy.
Retrospective, multi-institutional clinical study.
Medical records of horses >2 years old presenting with colic that underwent ventral midline celiotomy between January 2010 and September 2018 with follow-up of a minimum of 30 post-operative days were reviewed. Extracted data included signalment, operative details and outcome. BMI was calculated by dividing the patient's weight (kg) by the withers height squared (m ).
In all, 287 horses fit inclusion criteria. Incisional complication prevalence was 23.7%. Horses with incisional complications had a higher BMI (median 203.6 kg/m , IQR = 191.5-217.4) compared with those without (median 199.1 kg/m , IQR = 184.7-210.2) (P = .03). Multi-variable analysis of the effects of age, sex, breed and presence of metabolic disease on the association between BMI and risk of incisional complications, identified a tendency towards increased risk with a higher BMI, but statistical significance decreased to P = .07. Breed had an association with BMI (P < .01), but not with incisional complication risk.
BMI as an estimate of body fat has limitations. Retrospective studies with reliance on owners reporting data and complete medical records is imperfect. When the data were subjected to multi-variable analysis, the trend towards an increased incidence of incisional complications in horses with higher BMI persisted but it was not statistically significant.
Higher BMI may increase the risk for the development of incisional complications in horses following emergency ventral midline celiotomy.
肥胖在马群中很常见，它与人类手术发病率和死亡率的增加有关。体重指数（BMI）增加对马发生手术部位感染的影响尚未被研究。
确定通过 BMI 评估体脂增加的马在接受紧急腹中线剖腹手术后是否更容易发生术后并发症，特别是切口并发症。
回顾性、多机构临床研究。
回顾了 2010 年 1 月至 2018 年 9 月期间因腹痛接受腹中线剖腹手术且术后至少随访 30 天的>2 岁马的病历。提取的数据包括特征、手术细节和结果。通过将患者的体重（kg）除以肩高的平方（m）来计算 BMI。
共纳入 287 匹符合条件的马。切口并发症的患病率为 23.7%。有切口并发症的马的 BMI 较高（中位数 203.6kg/m，IQR=191.5-217.4），而没有切口并发症的马的 BMI 较低（中位数 199.1kg/m，IQR=184.7-210.2）（P=0.03）。对年龄、性别、品种和代谢疾病对 BMI 与切口并发症风险之间关联的多变量分析表明，BMI 较高与风险增加呈趋势，但统计学意义下降至 P=0.07。品种与 BMI 有关（P<0.01），但与切口并发症风险无关。
BMI 作为体脂的估计值存在局限性。依靠主人报告数据和完整病历的回顾性研究并不完美。当数据进行多变量分析时，BMI 较高的马发生切口并发症的风险增加的趋势仍然存在，但无统计学意义。
BMI 较高可能会增加马在接受紧急腹中线剖腹手术后发生切口并发症的风险。
