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241例牛肠套叠的长期存活情况及与死亡率相关的因素

Long-Term Survival in 241 Cases of Intussusception in Cattle and Factors Associated with Mortality.

作者信息

Chantillon Laurens, Pas Mathilde Laetitia, Vlaminck Lieven, Pardon Bart

机构信息

Department of Internal Medicine, Reproduction and Population Medicine, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium.

Department of Surgery and Anaesthesiology of Domestic Animals, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium.

出版信息

Animals (Basel). 2024 Feb 21;14(5):676. doi: 10.3390/ani14050676.

Abstract

Intussusception is a frequent cause of mechanical ileus in cattle. Long-term survival has never been described and risk factors for mortality are scarcely documented. A retrospective cohort study on 241 cattle was conducted to determine survival of intussusception and identify risk factors for mortality. Clinical records were matched with the national cattle identification database. Information on possible predictors including clinical examination, ultrasonography, blood-gas analysis and surgery were collected. Survival analysis and decision tree analysis were used. Overall survival was 44.8% until discharge. Of all animals, 39.0% could complete their life cycle and were eligible for slaughter. Male animals and cattle < 226 days old experienced a significantly higher mortality risk (hazard ratio [HR] = 2.1; 95% confidence interval [CI] = 1.4-3.0 and HR = 2.4; 95% CI = 1.7-3.4, respectively). The final model consisted of heart rate (>95 beats per minute) and packed cell volume (<36.5%) with sensitivity and specificity of 60.4% and 49.4%, respectively. A second model consisted of sex (male) and time to referral (>4.5 days) with sensitivity and specificity of 88.0% and 65.6%, respectively. The long-term prognosis for intussusception in cattle appears to be fair. Factors identified in this study may aid in the decision-making process in cases with presumed intussusception to perform the surgery or opt for euthanasia.

摘要

肠套叠是牛机械性肠梗阻的常见病因。此前从未有过长期存活的报道,关于死亡率的风险因素也鲜有记录。我们对241头牛进行了一项回顾性队列研究,以确定肠套叠的存活率并识别死亡风险因素。临床记录与国家牛只识别数据库进行了匹配。收集了包括临床检查、超声检查、血气分析和手术等可能预测因素的信息。采用了生存分析和决策树分析。总体存活率直至出院时为44.8%。在所有动物中,39.0%能够完成其生命周期并符合屠宰条件。雄性动物和年龄小于226天的牛死亡率风险显著更高(风险比[HR]=2.1;95%置信区间[CI]=1.4 - 3.0;HR = 2.4;95%CI = 1.7 - 3.4)。最终模型由心率(>95次/分钟)和血细胞比容(<36.5%)组成,敏感性和特异性分别为60.4%和49.4%。第二个模型由性别(雄性)和转诊时间(>4.5天)组成,敏感性和特异性分别为88.0%和65.6%。牛肠套叠的长期预后似乎尚可。本研究中确定的因素可能有助于在疑似肠套叠病例的决策过程中决定是否进行手术或选择安乐死。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5d63/10931378/5bebde678f14/animals-14-00676-g001.jpg

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