EQUINE | Abstracts
Serum amyloid A and plasma fibrinogen concentrations
in horses following emergency exploratory celiotomy
M. De Cozar, C. Sherlock, E. Knowles, T. Mair
Background
Acute‐phase proteins may help assess the nature and
severity of lesions and outcome in horses undergoing
colic surgery.
Objectives
To compare serum amyloid A and plasma fibrinogen
concentrations ([SAA] and [fibrinogen]) in the
immediate post‐operative period after exploratory
celiotomy and determine their value in assessment of
post‐operative complications and survival to discharge.
Study design
Main limitations
Observational study.
Methods
This study included horses over 1 year of age undergoing
exploratory celiotomy. Surgical procedures, lesions,
post‐operative care, complications and survival to
discharge were recorded. [SAA] and [fibrinogen] were
measured prior to surgery and 5 days post‐operatively.
Statistical analyses included Yate's Chi‐square test,
linear mixed effects model, Mann–Whitney U test and
logistic regression.
Results
different between horses that did and did not develop
post‐operative complications (P<0.05). Median [SAA]
at days 1, 4 and 5 were significantly different between
horses that did and did not survive to discharge
(P<0.05). Logistic regression revealed post‐operative
complications to be associated with strangulating
lesions (OR 2.35, 95% confidence interval [CI] 1.41–
3.91, P≤0.001) and higher [fibrinogen] at admission
(OR 1.21, 95% CI 1.00–1.45, P<0.05), and survival
to discharge to be associated with lower [SAA] at 5
days post‐operatively (OR 0.965, 95% CI 0.94–0.99,
P = 0.002).
A large variety of lesions and complications prevented
detailed analysis of associations between inflammatory
markers, lesions and complications.
Conclusions
Horses that develop post‐operative complications
have acute‐phase responses of greater magnitudes
and durations compared with those that do not
develop complications. This is also seen in horses that
do not survive to discharge. Measuring [SAA] daily
and [fibrinogen] at admission, may help predict the
development of post‐operative complications.
Of 300 horses, 52.0% developed post‐operative
complications and 83.7% survived to discharge, with
significantly reduced chance of survival in horses that
developed post‐operative complications (P<0.01).
Median [SAA] at days 1, 2, 3, 4 and 5 and median
[fibrinogen] at days 3, 4 and 5 were significantly
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