North Downs Specialist Referrals, Friesian Buildings 3&4, The Brewerstreet Dairy Buisiness Park, Brewer Street, Bletchingley, RH1 4QP, UK.
Department of Cardiology, Langford Vets Langford House, Langford, Bristol, BS40 5DU, UK.
J Small Anim Pract. 2021 Jan;62(1):4-11. doi: 10.1111/jsap.13226. Epub 2020 Sep 14.
To report the complications and factors affecting outcome for cats following placement of a subcutaneous ureteral bypass (SUB™).
In this retrospective study, complications, the presence of a urinary tract infection and survival time were recorded following subctutaneous ureteral bypass placement. Factors affecting survival time were assessed using a Kaplan Meier curve and log rank test.
Ninety-five cats had 130 subcutaneous ureteral bypasses placed. Ten cats did not survive to discharge. Forty cats died or were euthanised after discharge (42%); the median survival time of these cats was 530 days (range 7 to 1915). Minor complications occurred in 18 cats (19%) and major complications occurred in 46 cats (48%), the majority of which were after hospital discharge. Twenty-seven cats were diagnosed with a urinary tract infection (UTI) post-operatively. A significant association between long-term survival and creatinine at presentation was identified. The median survival time for cats presenting with creatinine concentration ≥440 μmol/L (International Renal Interest Society stage acute kidney injury (AKI) 4 and 5) was 530 days (95% CI 273-787 days), compared to a median survival time of 949 days (95% CI 655-1243 days; Log Rank P=0.024) for those cats presenting with creatinine <440 μmol/L (International Renal Interest Society stage AKI 1-3).
In this population of cats, subcutaneous ureteral bypass placement was associated with an approximately 10% in-hospital mortality and a high complication rate. Most complications were manageable, resulting in an overall median survival time of over 2 years.
报告猫皮下输尿管旁路（SUB™）置管术后的并发症及影响预后的因素。
在这项回顾性研究中，记录了皮下输尿管旁路置管术后的并发症、尿路感染的存在和存活时间。使用 Kaplan-Meier 曲线和对数秩检验评估影响存活时间的因素。
95 只猫共进行了 130 例 SUB 手术。10 只猫未存活至出院。40 只猫在出院后死亡或安乐死（42%）；这些猫的中位存活时间为 530 天（范围 7 至 1915 天）。18 只猫（19%）出现轻微并发症，46 只猫（48%）出现严重并发症，其中大多数发生在出院后。27 只猫术后被诊断为尿路感染（UTI）。发现长期生存与就诊时肌酐之间存在显著关联。就诊时肌酐浓度≥440 μmol/L（国际肾脏协会急性肾损伤（AKI）4 期和 5 期）的猫中位存活时间为 530 天（95%CI 273-787 天），而就诊时肌酐<440 μmol/L（国际肾脏协会 AKI 1-3 期）的猫中位存活时间为 949 天（95%CI 655-1243 天；Log Rank P=0.024）。
在本猫群中，皮下输尿管旁路置管术与约 10%的住院死亡率和高并发症发生率相关。大多数并发症是可管理的，总体中位存活时间超过 2 年。
