Department of Clinical Sciences & Advanced Medicine, University of Pennsylvania, School of Veterinary Medicine, Philadelphia, PA, USA.
J Feline Med Surg. 2021 Dec;23(12):1098-1108. doi: 10.1177/1098612X21996145. Epub 2021 Mar 1.
The objective of the study was to identify whether venous blood gas (VBG) variables may serve as a predictor of inflammatory lower airway disease (ILAD) in cats presenting with respiratory distress. A secondary objective of this study was to compare the diagnostic utility of patient signalment, history and physical examination findings, as compared with VBG variables.
The medical records of cats presenting with respiratory distress secondary to ILAD (54 cases) and non-ILAD (121 controls) were retrospectively reviewed.
No admission VBG variables were predictive of a final diagnosis of ILAD. Comparatively, multivariable analysis identified a history of a cough ( <0.001), increased respiratory rate ( = 0.001), the presence of an abdominal component to respiration ( = 0.007) and the absence of pleural effusion ( <0.01) to be independently associated with a final diagnosis of ILAD. Cats with a history of a cough and an abdominal component to respiration had 7.86 and 5.81 greater odds of being diagnosed with ILAD, respectively. Cats with pleural effusion had 7.43 lower odds of having this final diagnosis. For every 10 breaths/min increase in respiratory rate, cats had 1.48 greater odds of being diagnosed with ILAD. Cats diagnosed with ILAD had a survival rate of 94% (95% CI 84-99%) vs 61% (95% CI 51-70%) for non-ILAD controls ( <0.001).
The results of this study found patient history and physical examination findings to be more useful predictors of a final diagnosis of ILAD in comparison with VBG variables at presentation. A history of a cough, an abdominal component to respiration and a lack of pleural effusion were found to be significant predictors of this diagnosis. Further investigation into the role of respiratory rate in ILAD is warranted.
本研究旨在确定静脉血气（VBG）变量是否可作为表现为呼吸窘迫的猫的炎症性下呼吸道疾病（ILAD）的预测因子。本研究的次要目的是比较患者特征、病史和体格检查结果与 VBG 变量的诊断效用。
回顾性分析了因 ILAD（54 例）和非-ILAD（121 例对照）导致呼吸窘迫而就诊的猫的病历。
入院时无 VBG 变量可预测 ILAD 的最终诊断。相比之下，多变量分析确定咳嗽史（<0.001）、呼吸频率增加（=0.001）、呼吸时腹部出现（=0.007）和胸腔积液缺失（<0.01）与 ILAD 的最终诊断独立相关。有咳嗽史和呼吸时腹部出现的猫被诊断为 ILAD 的可能性分别增加了 7.86 倍和 5.81 倍。有胸腔积液的猫被诊断为 ILAD 的可能性降低了 7.43 倍。呼吸频率每增加 10 次/分钟，猫被诊断为 ILAD 的可能性增加 1.48 倍。被诊断为 ILAD 的猫的存活率为 94%（95%CI 84-99%），而非-ILAD 对照组为 61%（95%CI 51-70%）（<0.001）。
本研究结果发现，与入院时的 VBG 变量相比，患者病史和体格检查结果是 ILAD 最终诊断更有用的预测指标。咳嗽史、呼吸时腹部出现和无胸腔积液是该诊断的重要预测指标。需要进一步研究呼吸频率在 ILAD 中的作用。
