Loomes Kate, de Grauw Janny, Gozalo-Marcilla Miguel, Redondo José I, Bettschart-Wolfensberger Regula
Rainbow Equine Hospital, Malton, North Yorkshire, UK.
Royal Veterinary College, Department of Clinical Sciences and Services, University of London, Hatfield, UK.
Equine Vet J. 2025 Jul;57(4):827-861. doi: 10.1111/evj.14416. Epub 2024 Oct 24.
Equine post-operative morbidity represents a significant concern for both veterinary surgeons and horse owners.
To estimate the prevalence of post-operative complications in horses after elective/non-abdominal surgery or colic surgery.
Systematic review.
A database search identified eligible studies which reported the prevalence of equine post-operative complications published as a full paper in English in a peer-reviewed journal between 2000 and 2023. Studies were evaluated using the JBI Critical Appraisal Checklist for Prevalence Studies and GRADE (Grading of Recommendations, Assessment, Development and Evaluations) framework. Data for the most commonly reported complications were analysed using Chi-squared analysis of weighted means to answer 13 PICO (Population, Intervention, Comparator and Outcomes) questions.
Sixty-seven studies met inclusion criteria. Data for eight post-operative morbidities (colic, surgical site complications, myopathy/neuropathy, laminitis, diarrhoea/colitis, fever/pyrexia, jugular thrombophlebitis/thrombosis, respiratory complications) were sufficient to allow statistical analyses. The weighted mean of the overall proportion of post-operative complications after elective/non-abdominal surgery is 17.48% (95% confidence interval [95% CI]: 13.20-22.92), significantly increasing to 55.62% (95% CI: 45.79-65.03) after colic surgery (odds ratio [OR] 6.63; 95% CI: 5.83-7.56; p < 0.001). The most commonly reported morbidity was post-operative colic, with a weighted mean prevalence of 7.45% (95% CI: 4.83-11.76) after elective/non-abdominal surgery, significantly rising to 26.46% (95% CI: 19.11-35.97) after colic surgery (OR 4.11; 95% CI: 3.60-4.71; p < 0.001). The weighted mean prevalence of surgical site complications, laminitis, diarrhoea/colitis, fever/pyrexia, jugular thrombophlebitis/thrombosis and respiratory complications were significantly higher after colic surgery compared with elective/non-abdominal surgery. Myopathy/neuropathy was the only morbidity where prevalence was not different between groups (OR 1.86; 95% CI: 0.86-4.16; p = 0.16).
The majority of studies were retrospective. Morbidity definitions, data collection periods, follow-up time and methods varied between studies.
Based on current evidence, the prevalence of post-operative colic, surgical site complications, laminitis, diarrhoea/colitis, fever/pyrexia, jugular thrombophlebitis/thrombosis and respiratory complications is significantly higher after colic surgery compared with elective/non-abdominal surgery under general anaesthesia.
马术后发病是兽医和马主都非常关注的问题。
估计择期/非腹部手术或绞痛手术后马术后并发症的发生率。
系统评价。
通过数据库检索，确定了符合条件的研究，这些研究报告了2000年至2023年间在同行评审期刊上以英文全文发表的马术后并发症发生率。使用JBI患病率研究批判性评价清单和GRADE（推荐分级、评估、发展和评价）框架对研究进行评估。对最常报告的并发症数据进行加权均值的卡方分析，以回答13个PICO（人群、干预措施、对照和结局）问题。
67项研究符合纳入标准。八项术后发病情况（绞痛、手术部位并发症、肌病/神经病、蹄叶炎、腹泻/结肠炎、发热/高热、颈静脉血栓性静脉炎/血栓形成、呼吸道并发症）的数据足以进行统计分析。择期/非腹部手术后术后并发症总体比例的加权均值为17.48%（95%置信区间[95%CI]：13.20 - 22.92），绞痛手术后显著增加至55.62%（95%CI：45.79 - 65.03）（优势比[OR]6.63；95%CI：5.83 - 7.56；p < 0.001）。最常报告的发病情况是术后绞痛，择期/非腹部手术后加权平均患病率为7.45%（95%CI：4.83 - 11.76），绞痛手术后显著升至26.46%（95%CI：19.11 - 35.97）（OR 4.11；95%CI：3.60 - 4.71；p < 0.001）。与择期/非腹部手术相比，绞痛手术后手术部位并发症、蹄叶炎、腹泻/结肠炎、发热/高热、颈静脉血栓性静脉炎/血栓形成和呼吸道并发症的加权平均患病率显著更高。肌病/神经病是唯一两组患病率无差异的发病情况（OR 1.86；95%CI：0.86 - 4.16；p = 0.16）。
大多数研究是回顾性的。各研究之间发病率定义、数据收集期、随访时间和方法各不相同。
根据现有证据，与全身麻醉下的择期/非腹部手术相比，绞痛手术后术后绞痛、手术部位并发症、蹄叶炎、腹泻/结肠炎、发热/高热、颈静脉血栓性静脉炎/血栓形成和呼吸道并发症的发生率显著更高。
