Laurenza Chiara, Ansart Lèa, Portier Karine
Section of Anesthésiologie, Université de Lyon, VetAgro Sup, Marcy l'Étoile, France.
GREAT, Laboratoire Carmen, INSERM U1060, INRA U1235, INSA Lyon, Université Claude Bernard Lyon 1, Villeurbanne, France.
Front Vet Sci. 2020 Jan 22;6:514. doi: 10.3389/fvets.2019.00514. eCollection 2019.
A retrospective analysis was performed to determine mortality and morbidity rates for elective and emergency cases in an equine university teaching hospital. It investigated the effect of horse-, anesthetic-, timing, and clinician experience-related variables on anesthetic complications. In total, 1,161 horses undergoing general anesthesia between January 2012 and December 2016 were included in the study. Patient information and details of the anesthetic, recovery period and immediate complications were retrieved from an archival database. Statistical analysis of qualitative and quantitative factors affecting anesthetic complications was performed using an univariable and multivariable ordinal logistic regression. Odds ratio of variables primarily affecting mortality and complications were calculated. Statistical significance was set at < 0.05. General anesthesia-related global mortality rate was 1.4% (95% CI [7.1-10.4]) but was only 0.96% (95% CI [0.44-1.82]) for non-colic cases. The complication rate was 17.5% ( = 204; 95% CI [15.2-20.0]) of which 46.9% [39.4-54.5] were neuromuscular, 22.6% [16.7-29.5] were respiratory, 15.8% [10.8-22.0] were systemic, 13.6% [8.9-19.5] were cardiovascular, 1.1% [0.1-4.0] were other complications. Ninety two percent of complications occurred during recovery. Major risk factors for mortality and complications included high weight, surgeon experience, increasing age, high ASA score, long duration of anesthesia, quality of induction, lateral recumbency, orthopedic surgery, and hypotension. In these models, colic surgery did not influence the rate of any complications.
进行了一项回顾性分析,以确定一所马科大学教学医院择期和急诊病例的死亡率和发病率。该分析调查了马匹、麻醉、时间以及临床医生经验相关变量对麻醉并发症的影响。该研究共纳入了2012年1月至2016年12月期间接受全身麻醉的1161匹马。从档案数据库中检索了患者信息以及麻醉、恢复期和即刻并发症的详细情况。使用单变量和多变量有序逻辑回归对影响麻醉并发症的定性和定量因素进行了统计分析。计算了主要影响死亡率和并发症的变量的比值比。设定统计学显著性为<0.05。全身麻醉相关的总体死亡率为1.4%(95%可信区间[7.1-10.4]),但非急腹症病例仅为0.96%(95%可信区间[0.44-1.82])。并发症发生率为17.5%(n=204;95%可信区间[15.2-20.0]),其中46.9%[39.4-54.5]为神经肌肉性并发症,22.6%[16.7-29.5]为呼吸性并发症,15.8%[10.8-22.0]为全身性并发症,13.6%[8.9-19.5]为心血管性并发症,1.1%[0.1-4.0]为其他并发症。92%的并发症发生在恢复期。死亡率和并发症的主要危险因素包括体重过高、外科医生经验、年龄增加、美国麻醉医师协会(ASA)评分高、麻醉时间长、诱导质量、侧卧、骨科手术和低血压。在这些模型中,急腹症手术并未影响任何并发症的发生率。