Emergency & Critical Care Service, BluePearl Specialty + Emergency Pet Hospital, Lafayette, Colorado, USA.
Emergency & Critical Care Service, BluePearl Specialty + Emergency Pet Hospital, Tampa, Florida, USA.
J Vet Emerg Crit Care (San Antonio). 2023 Sep-Oct;33(5):587-597. doi: 10.1111/vec.13325. Epub 2023 Aug 12.
To determine if RBC distribution width (RDW), neutrophil-to-lymphocyte ratio (NLR), and other hematological parameters are associated with increased odds of in-hospital mortality, increased length of hospitalization (LOH), or disease severity as measured by the Canine Acute Pancreatitis Severity (CAPS) score in dogs with acute pancreatitis (AP).
Retrospective, multicenter study from January 2016 to August 2020.
Four private emergency and specialty referral centers.
On initial case search, 118 client-owned dogs were identified with a clinical diagnosis of AP. Out of these cases, 114 dogs met inclusion criteria, defined as sudden onset of ≥2 compatible clinic signs (lethargy, anorexia, vomiting, or abdominal pain), a specific canine pancreatic lipase concentration >400 μg/L, hospital admission, as well as CBC and serum biochemistry run within 48 hours of initial hospitalization. Disease severity was calculated and measured using the CAPS score, in addition to LOH and in-hospital mortality.
None.
Clinical endpoints were in-hospital mortality, LOH, and disease severity, as evaluated by the CAPS score. Overall in-hospital mortality was 36.8%. NLR was significantly associated with survival, with a higher percentage being associated with an increased likelihood of nonsurvival (odds ratio: 1.1, 95% confidence interval: 1.0-1.2; P = 0.006, adjusted P = 0.04). Increased NLR was found to be significantly associated with a longer LOH based on the unadjusted P-value (P = 0.02) but was not statistically significant based on a P-value adjusted for multiple comparisons (P = 0.12). No significant associations were noted when RDW, platelet-to-lymphocyte ratio, WBC count, mean platelet volume, RDW-to-platelet ratio, or RDW-to-total serum calcium ratio was evaluated against outcome measures.
This study retrospectively evaluated the prognostic utility of several readily available hematological parameters in dogs hospitalized for AP. Dogs with an increased NLR may have a higher risk of in-hospital mortality and increased LOH, although future prospective studies are necessary to confirm these findings.
确定红细胞分布宽度（RDW）、中性粒细胞与淋巴细胞比值（NLR）和其他血液学参数是否与住院死亡率增加、住院时间延长（LOH）或犬急性胰腺炎（AP）的犬病严重程度（通过犬急性胰腺炎严重程度评分（CAPS）测量）相关。
2016 年 1 月至 2020 年 8 月的回顾性、多中心研究。
四个私人急诊和专科转诊中心。
在最初的病例搜索中，确定了 118 只患有临床诊断为 AP 的患犬。在这些病例中，114 只犬符合纳入标准，定义为突然出现≥2 种符合的临床体征（嗜睡、厌食、呕吐或腹痛）、特定的犬胰脂肪酶浓度>400μg/L、住院以及在初次住院后 48 小时内进行的全血细胞计数和血清生化检查。使用 CAPS 评分计算和测量疾病严重程度，此外还测量 LOH 和住院死亡率。
无。
临床终点是住院死亡率、LOH 和疾病严重程度，通过 CAPS 评分进行评估。总的住院死亡率为 36.8%。NLR 与存活率显著相关，百分比越高，存活的可能性越低（比值比：1.1，95%置信区间：1.0-1.2；P=0.006，调整后 P=0.04）。未调整 P 值显示 NLR 升高与 LOH 延长显著相关（P=0.02），但基于多重比较调整的 P 值无统计学意义（P=0.12）。在评估红细胞分布宽度、血小板与淋巴细胞比值、白细胞计数、平均血小板体积、红细胞分布宽度与血小板比值或红细胞分布宽度与总血清钙比值与结果指标时，未发现显著相关性。
本研究回顾性评估了几种易于获得的血液学参数在犬急性胰腺炎住院患者中的预后价值。NLR 升高的犬可能有更高的住院死亡率和 LOH 风险，尽管需要进一步的前瞻性研究来证实这些发现。
