Farrell Alanna, Kersh Kevin, Liepman Rachel, Dembek Katarzyna A
Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA, United States.
Chaparral Veterinary Medical Center, Cave Creek, AZ, United States.
Front Vet Sci. 2021 Oct 8;8:697589. doi: 10.3389/fvets.2021.697589. eCollection 2021.
Acute abdominal pain in the horse is a common emergency presenting to equine practices. The wide variety of etiologies makes prognosticating survival a challenge. A retrospective, multi-institutional clinical study was performed to determine clinical parameters associated with survival of horses with colic, and to use them to develop a colic survival scoring system. The scoring system was then validated using clinical data in the prospective portion of the study. Medical records from 67 horses presenting for acute abdominal pain were evaluated to develop the colic assessment score. Twenty eight variables were compared between survivors and non-survivors and entered into logistic regression models for survival. Of these, six variables were included in the colic assessment score. A total colic assessment score range was from 0 to 12, with the highest score representing the lowest probability of survival. The optimal cutoff value to predict survival was seven resulting in an 86% sensitivity and 64% specificity with a positive predictive value of 88% and a negative predictive value of 57%. Data from 95 horses presenting for abdominal pain to two equine hospitals was then collected prospectively to validate the colic assessment score. Horses from the prospective portion of the study that received a score >7 were classified as predicted to die and those with a score ≤7 were predicted to survive. The classification was compared to the actual outcome, of which the sensitivity, specificity, positive and negative predictive values of the colic assessment score were 84, 62, 88, and 52%, respectively.
马的急性腹痛是马匹医疗中常见的急症。病因种类繁多，使得预测存活率成为一项挑战。开展了一项回顾性、多机构临床研究，以确定与患绞痛马匹存活相关的临床参数，并利用这些参数建立绞痛存活评分系统。然后在研究的前瞻性部分使用临床数据对该评分系统进行验证。对67匹因急性腹痛就诊的马的病历进行评估，以制定绞痛评估评分。比较了存活者和非存活者之间的28个变量，并将其纳入存活的逻辑回归模型。其中，6个变量被纳入绞痛评估评分。绞痛评估总分范围为0至12分，分数越高表示存活概率越低。预测存活的最佳临界值为7分，敏感性为86%，特异性为64%，阳性预测值为88%，阴性预测值为57%。然后前瞻性收集了95匹到两家马匹医院因腹痛就诊的马的数据，以验证绞痛评估评分。研究前瞻性部分中得分>7分的马被归类为预测死亡，得分≤7分的马被预测存活。将该分类结果与实际结果进行比较，绞痛评估评分的敏感性、特异性、阳性和阴性预测值分别为84%、62%、88%和52%。
