Sydney School of Veterinary Science, Faculty of Science, The University of Sydney, Camperdown 2006, Australia.
Sydney School of Veterinary Science, Faculty of Science, The University of Sydney, Camperdown 2006, Australia.
Vet J. 2021 Dec;278:105765. doi: 10.1016/j.tvjl.2021.105765. Epub 2021 Oct 29.
A greater understanding of the prognostic variables that affect the timing of death for cats with trauma may help clinicians select treatments and monitoring plans. This study investigated the mortality rate and its distribution pattern in a large population of cats to identify variables associated with the timing of trauma-related deaths. Clinical data was retrieved from the Veterinary Committee on Trauma database to determine mortality rates and timing of deaths, defined as early death (ED; <1 day post-presentation) or delayed death (DD; ≥1 day post-presentation). Multivariable logistic regression analyses were performed to identify characteristics and interventions that best predicted timing of death. Overall mortality rate for 6703 feline trauma patients with complete records was 17.2%, with 7.6% due to natural death and 92.3% due to euthanasia. Among the subset of 543 cats with trauma that died after presentation or required euthanasia due to a grave prognosis (representing an 8.1% mortality rate), EDs were more common (71.7%) than DD and the cause of death was not significantly associated with the timing of death. Clinical pathology parameters were unable to identify animals more likely to die or to require euthanasia due to a poor prognosis during hospitalisation. Factors that were significantly different for cats with ED vs. DD included the median cumulative results for the Modified Glasgow Coma Scale (MGCS) score and the Animal Trauma Triage (ATT) score, the presence of spinal trauma, administration of blood products and undertaking surgical procedures. An increased likelihood of DD rather than ED was associated with the administration of blood products (odds ratio [OR], 3.959; P = 0.019) vs. not, performing a surgical procedure (OR, 6.055; P < 0.001) vs. not, and a cumulative MGCS of 15-17 or 18 (OR, 1.947 and 3.115; P = 0.031 and P = 0.01, respectively) vs. a cumulative MGCS ≤ 11.
对于创伤性猫科动物死亡时间有影响的预后变量有了更深入的了解，可能有助于临床医生选择治疗和监测方案。本研究调查了一个大型猫科动物群体的死亡率及其分布模式，以确定与创伤相关死亡时间相关的变量。从兽医创伤委员会数据库中检索临床数据，以确定死亡率和死亡时间，定义为早期死亡（ED；就诊后 <1 天）或延迟死亡（DD；就诊后≥1 天）。进行多变量逻辑回归分析，以确定预测死亡时间的最佳特征和干预措施。6703 例有完整记录的创伤性猫科动物的总体死亡率为 17.2%，其中 7.6%为自然死亡，92.3%为安乐死。在就诊后死亡或因预后不良而需要安乐死的 543 只创伤性猫亚组中，ED 更为常见（71.7%），而非 DD，且死因与死亡时间无显著相关性。临床病理参数无法识别更有可能因预后不良而死亡或需要安乐死的动物。ED 与 DD 猫之间有显著差异的因素包括改良格拉斯哥昏迷评分（MGCS）和动物创伤分诊（ATT）评分的中位数累计结果、脊柱创伤的存在、血液制品的使用以及手术程序的进行。与 ED 相比，DD 的可能性增加与血液制品的使用（比值比[OR]，3.959；P = 0.019）而非不使用、手术程序（OR，6.055；P < 0.001）而非不使用、以及 MGCS 累计评分为 15-17 或 18（OR，1.947 和 3.115；P = 0.031 和 P = 0.01）而非 MGCS 累计评分为≤11 相关。
