Mainar-Jaime R C, House J K, Smith B P, Hird D W, House A M, Kamiya D Y
Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis 95616-8737, USA.
J Am Vet Med Assoc. 1998 Oct 15;213(8):1162-6.
To predict mortality of horses by use of clinical data from the first day of hospitalization, to determine whether fecal shedding of Salmonella organisms is related to severity of clinical disease, and to determine the impact of fecal shedding of Salmonella organisms on mortality.
Prospective study.
1,446 hospitalized horses.
Medical information was obtained from horses hospitalized in an intensive care unit or isolation facility during a 4.5-year period. A model was created to predict mortality, using covariates determined on the day of admission. Predicted mortality provided a measure of clinical condition. Predicted mortality was compared between horses that were and were not shedding Salmonella organisms in their feces to determine whether shedding was associated with severity of disease. Predicted and observed mortality between horses were also compared to evaluate the association between fecal shedding of Salmonella organisms and mortality.
92 horses were identified as shedding Salmonella organisms. In a multivariable model, 4 variables (heart rate, respiratory rate, rectal temperature, and clinical management) were associated with mortality. A higher predicted probability of death was observed in horses that shed Salmonella krefeld or more than 1 serotype. Relative risk (RR) of mortality was high for horses shedding S typhimurium (RR, 1.94; 95% confidence interval, 1.04 to 3.59) and multiple serotypes (RR, 4.75; 95% confidence interval, 2.29 to 9.84). When the clinical condition (i.e., prior predicted probability of death) was taken into consideration, fecal shedding of Salmonella organisms was not significantly associated with mortality.
In this horse population, fecal shedding of S krefeld was associated with more severe clinical conditions at the time of admission; however, fecal shedding of Salmonella organisms during hospitalization did not alter predicted mortality.
利用马匹住院首日的临床数据预测其死亡率，确定沙门氏菌属微生物的粪便排菌情况是否与临床疾病严重程度相关，以及确定沙门氏菌属微生物的粪便排菌情况对死亡率的影响。
前瞻性研究。
1446匹住院马匹。
获取在4.5年期间入住重症监护病房或隔离设施的马匹的医疗信息。创建一个模型来预测死亡率，使用入院当天确定的协变量。预测死亡率提供了临床状况的一种衡量指标。比较粪便中排菌和未排菌的马匹的预测死亡率，以确定排菌是否与疾病严重程度相关。还比较了马匹的预测死亡率和观察到的死亡率，以评估沙门氏菌属微生物的粪便排菌情况与死亡率之间的关联。
92匹马被确定为排菌。在多变量模型中，4个变量（心率、呼吸频率、直肠温度和临床管理）与死亡率相关。排克雷费尔德沙门氏菌或多种血清型的马匹观察到更高的预测死亡概率。排鼠伤寒沙门氏菌的马匹（相对危险度[RR]，1.94；95%置信区间，1.04至3.59）和排多种血清型的马匹（RR，4.75；95%置信区间，2.29至9.84）的死亡相对危险度较高。当考虑临床状况（即先前的预测死亡概率）时，沙门氏菌属微生物的粪便排菌情况与死亡率无显著关联。
在这群马匹中，排克雷费尔德沙门氏菌与入院时更严重的临床状况相关；然而，住院期间沙门氏菌属微生物的粪便排菌情况并未改变预测死亡率。
