Sharp Claire R, Rozanski Elizabeth A, Finn Emily, Borrego E J
Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA.
J Vet Emerg Crit Care (San Antonio). 2020 Mar;30(2):232-238. doi: 10.1111/vec.12932. Epub 2020 Feb 19.
The primary study objective was to characterize the pattern of in-hospital mortality in dogs with gastric dilatation and volvulus (GDV), with a focus on preoperative nonsurvival.
A retrospective review of medical records from a 10-year period was undertaken at a university teaching hospital. Data collected included signalment, physical examination parameters at hospital presentation, blood lactate concentration, and outcome.
A total of 498 dogs were included. Overall, 319 (64.1%) survived to discharge and 179 (35.9%) were nonsurvivors. Of the nonsurvivors, 149 (31.3% of all dogs) were euthanized and 30 (6%) died. Of those dogs euthanized, the majority (n = 116) were euthanized at the time of hospital presentation prior to surgery (ie, without intent to treat). When dogs that were euthanized prior to surgery were excluded, 83.5% of dogs survived to discharge. Median group age was higher in those euthanized than in the group of dogs that survived to discharge.
Preoperative euthanasia and hence nonsurvival without intent to treat accounted for the majority of GDV mortality in this study. Given the high rate of nonsurvival without intent to treat it is likely that efforts focused at disease prevention will ultimately affect a much greater improvement in overall disease mortality than those focused on improving treatment.
主要研究目的是描述胃扩张扭转（GDV）犬的院内死亡模式，重点关注术前死亡情况。
在一所大学教学医院对10年期间的病历进行回顾性研究。收集的数据包括信号、入院时的体格检查参数、血乳酸浓度和转归。
共纳入498只犬。总体而言，319只（64.1%）存活出院，179只（35.9%）死亡。在死亡犬中，149只（占所有犬的31.3%）实施安乐死，30只（6%）死亡。在实施安乐死的犬中，大多数（n = 116）在入院时手术前即被安乐死（即无意治疗）。排除术前实施安乐死的犬后，83.5%的犬存活出院。安乐死组的中位年龄高于存活出院组。
在本研究中，术前安乐死以及因此而导致的无意治疗死亡占GDV死亡的大多数。鉴于无意治疗的高死亡率，与专注于改善治疗相比，致力于疾病预防的努力最终可能会对整体疾病死亡率产生更大的改善。
