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前瞻性病例研究:对转诊治疗腹痛的马进行关键决策。

Prospective case study of critical decision making for horses referred for treatment of colic.

机构信息

School of Veterinary Medicine and Science, University of Nottingham, Sutton Bonington, UK.

出版信息

Vet Rec. 2024 Jun 15;194(12):e3615. doi: 10.1002/vetr.3615. Epub 2023 Nov 21.

DOI:10.1002/vetr.3615
PMID:37990604
Abstract

BACKGROUND

There is limited evidence on factors affecting critical decision making for horses with colic. This study's aim was to describe the assessment and decision making involved in horses referred for management of colic.

METHODS

An in-depth case analysis was used to document case presentation, decision making and outcomes for horses referred for colic to two UK equine veterinary practices over a 12-month period. The data recorded included previous history, presenting signs, response to treatment, case outcome and factors affecting decisions for further treatment or euthanasia.

RESULTS

Data were available for 60 cases: 55 were hospitalised for medical or surgical treatment and five horses were euthanased following initial assessment. The main factors affecting treatment decisions were severity of clinical signs (80%, 47/59), financial concerns (10%, 6/59) and ongoing health issues or previous history of colic (5%, 3/59). Factors associated with euthanasia decisions were postoperative complications (5/18), poor prognosis (4/18), deteriorating clinical signs (3/18) and financial concerns (3/18).

LIMITATION

The limited study population may affect the extent to which the findings can be generalised.

CONCLUSION

The severity of clinical signs was the key factor in treatment decision making. The main factors affecting euthanasia decisions were clinical deterioration, poor prognosis and financial constraints. These findings should be incorporated into clinical case recording to capture the multifactorial nature of decision making.

摘要

背景

关于影响疝痛马关键决策的因素,目前相关证据有限。本研究旨在描述转诊治疗疝痛马的评估和决策过程。

方法

采用深入的病例分析,记录了在英国两家兽医诊所转诊治疗疝痛的 60 例马的病例介绍、决策和结果。记录的数据包括既往史、就诊症状、治疗反应、病例结局以及影响进一步治疗或安乐死决策的因素。

结果

55 例因医疗或手术治疗而住院,5 例在初步评估后安乐死。影响治疗决策的主要因素是临床症状的严重程度(80%,47/59)、经济因素(10%,6/59)和持续的健康问题或既往疝痛史(5%,3/59)。与安乐死决策相关的因素包括术后并发症(5/18)、预后不良(4/18)、临床症状恶化(3/18)和经济因素(3/18)。

局限性

有限的研究人群可能会影响研究结果的推广程度。

结论

临床症状的严重程度是治疗决策的关键因素。影响安乐死决策的主要因素是临床恶化、预后不良和经济限制。这些发现应纳入临床病例记录中,以捕捉决策的多因素性质。

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