Runge Kira Elisabeth, Bak Maj, Vestergaard Amalie, Staerk-Østergaard Jacob, Jacobsen Stine, Pihl Tina Holberg
Department of Veterinary Clinical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Taastrup, Denmark.
Department of Veterinary and Animal Sciences, Animal Welfare and Disease Control, University of Copenhagen, Copenhagen, Denmark.
Vet Rec. 2023 Apr;192(7):e2644. doi: 10.1002/vetr.2644. Epub 2023 Feb 13.
Predicting non-survival in horses with acute colitis improves early decision making. Therefore, this study aimed to determine the prognostic value of serum amyloid A (SAA) and other clinicopathological and clinical variables in adult horses with acute colitis.
Clinical variables, SAA and other blood biomarkers, including plasma L-lactate (lactate), were assessed in 176 horses with acute colitis. A multivariate model for the prediction of non-survival was constructed. Icelandic horses were analysed separately.
Admission SAA was similar in survivors (median 548 mg/L; range 0-5453 mg/L) and non-survivors (396 mg/L; 0-5294) (p = 0.43). A model for non-survival included year of admission, lactate, heart rate, age and colic duration of more than 24 hours. Icelandic horses had a relative risk of 2.9 (95% confidence interval = 2.2-3.8) for acute colitis compared to other breeds. Lactate in Icelandic horses was higher than that in other breeds in both survivors (4.0 mmol/L, range 1.0-12.7 vs. 2.0, 0.7-12.5) and non-survivors (10.0, 1.5-26 vs. 5.4, 0.8-22) (p < 0.001).
The prognostic value of repeated measurements of SAA could not be assessed in this study, as 71% of the non-surviving horses died within a day of admission.
Admission SAA did not predict non-survival. Breed needs consideration when lactate is evaluated as a predictor for non-survival in horses with colitis.
预测患有急性结肠炎马匹的死亡情况有助于改善早期决策。因此,本研究旨在确定血清淀粉样蛋白A(SAA)以及其他临床病理和临床变量对成年急性结肠炎马匹的预后价值。
对176匹患有急性结肠炎的马匹评估了临床变量、SAA及其他血液生物标志物,包括血浆L-乳酸(乳酸)。构建了一个预测死亡的多变量模型。对冰岛马进行了单独分析。
存活马匹(中位数548mg/L;范围0 - 5453mg/L)和死亡马匹(396mg/L;0 - 5294)入院时的SAA水平相似(p = 0.43)。一个预测死亡的模型纳入了入院年份、乳酸、心率、年龄以及腹痛持续时间超过24小时。与其他品种相比,冰岛马患急性结肠炎的相对风险为2.9(95%置信区间 = 2.2 - 3.8)。在存活马匹(4.0mmol/L,范围1.0 - 12.7 vs. 2.0,0.7 - 12.5)和死亡马匹(10.0,1.5 - 26 vs. 5.4,0.8 - 22)中,冰岛马的乳酸水平均高于其他品种(p < 0.001)。
本研究无法评估重复测量SAA的预后价值,因为71%的死亡马匹在入院一天内死亡。
入院时的SAA不能预测死亡。在将乳酸作为结肠炎马匹死亡预测指标进行评估时,需要考虑品种因素。