Büttner Jasmin, Brehm Walter, Gittel Claudia
Klinik für Pferde, Veterinärmedizinische Fakultät der Universität Leipzig.
The Queen's Veterinary School Hospital, Department für Veterinärmedizin, Universität Cambridge.
Tierarztl Prax Ausg G Grosstiere Nutztiere. 2021 Oct;49(5):310-319. doi: 10.1055/a-1584-9150. Epub 2021 Oct 19.
In horses, colic is associated with relatively high mortality rates. Identification of parameters associated with poor outcome may aid in providing a more accurate prognosis. This study aimed to assess the early prognostic value towards survival of the horse based on parameters of the clinical examination.
In a retrospective study (2013-2017), results of the clinical examination of horses with colic were analyzed. Obtained parameters were categorized from physiologic up to different pathophysiologic manifestations. The risk of death was calculated as odds ratios in comparison to normal values of these parameters. Individual score points were obtained and related to the respective outcome. Cut-off values for prognosis and treatment were calculated to distinguish between outcome and treatment group.
A total of 492 colic horses were analyzed, presenting 433 survivors (88 %). Overall, medical treatment was selected in 346 (70.3 %) horses (with 96 % survivors) and surgical treatment (laparotomy) was performed in 146 (29.7 %) horses (69.2 % survivors). An increased likelihood of the outcome "death" was found in horses aged over 20 years (OR = 5.498, p < 0.0005), with colic signs of > 6 hours duration (OR = 3.590, p = 0.035) and, also, for breeds of draft horses (OR = 8.364, p < 0.0005). Horses with significant increases in heart and respiratory rates (OR = 24.294, p < 0.0005 and OR = 20.375, p < 0.0005, respectively) and increased blood lactate concentrations (> 90 mg/dl: OR = 26.390, p < 0.0005) were more likely to succumb to the disease. However, a scoring system failed to show an association between high score points and poor prognosis.
Parameters of the clinical examination as well as the history of the patient may be indicative for the patient's outcome. However, no clear-cut distinction of the evaluated parameters towards survival and treatment options was obtained. A careful investigation of the patient remains mandatory for selection of treatment and a proper assessment of prognosis.
在马匹中，急腹症的死亡率相对较高。识别与不良预后相关的参数可能有助于提供更准确的预后评估。本研究旨在基于临床检查参数评估马匹生存的早期预后价值。
在一项回顾性研究（2013 - 2017年）中，分析了患有急腹症马匹的临床检查结果。将获得的参数从生理状态分类到不同的病理生理表现。计算死亡风险，并以这些参数的正常值为对照计算比值比。获得个体得分点并将其与各自的结局相关联。计算预后和治疗的临界值以区分结局组和治疗组。
共分析了492匹患急腹症的马匹，其中433匹存活（88%）。总体而言，346匹（70.3%）马匹选择了药物治疗（96%存活），146匹（29.7%）马匹接受了手术治疗（剖腹术）（69.2%存活）。发现20岁以上的马匹（OR = 5.498，p < 0.0005）、急腹症症状持续超过6小时的马匹（OR = 3.590，p = 0.035）以及挽马品种（OR = 8.364，p < 0.0005）出现“死亡”结局的可能性增加。心率和呼吸率显著升高的马匹（分别为OR = 24.294，p < 0.0005和OR = 20.375，p < 0.0005）以及血乳酸浓度升高（> 90 mg/dl：OR = 26.390，p < 0.0005）的马匹更易死于该病。然而，评分系统未能显示高分与不良预后之间的关联。
临床检查参数以及患者病史可能提示患者的结局。然而，对于评估参数在生存和治疗选择方面未获得明确区分。对于治疗选择和预后的恰当评估，对患者进行仔细检查仍然是必不可少的。
