Development of a Colic Scoring System to Predict Outcome in Horses.

Alanna Farrell,Katarzyna A Dembek,Kevin Kersh,Rachel Liepman

doi:10.3389/fvets.2021.697589

Alanna Farrell, Katarzyna A Dembek + Show 2 more

Open Access

https://doi.org/10.3389/fvets.2021.697589

Copy DOI

Abstract

Acute abdominal pain in the horse is a common emergency presenting to equine practices. The wide variety of etiologies makes prognosticating survival a challenge. A retrospective, multi-institutional clinical study was performed to determine clinical parameters associated with survival of horses with colic, and to use them to develop a colic survival scoring system. The scoring system was then validated using clinical data in the prospective portion of the study. Medical records from 67 horses presenting for acute abdominal pain were evaluated to develop the colic assessment score. Twenty eight variables were compared between survivors and non-survivors and entered into logistic regression models for survival. Of these, six variables were included in the colic assessment score. A total colic assessment score range was from 0 to 12, with the highest score representing the lowest probability of survival. The optimal cutoff value to predict survival was seven resulting in an 86% sensitivity and 64% specificity with a positive predictive value of 88% and a negative predictive value of 57%. Data from 95 horses presenting for abdominal pain to two equine hospitals was then collected prospectively to validate the colic assessment score. Horses from the prospective portion of the study that received a score >7 were classified as predicted to die and those with a score ≤7 were predicted to survive. The classification was compared to the actual outcome, of which the sensitivity, specificity, positive and negative predictive values of the colic assessment score were 84, 62, 88, and 52%, respectively.

Highlights

Acute abdominal pain from gastrointestinal disorders can be successfully treated medically or surgically [1,2,3,4]
After the 28 variables were compared between survivors and nonsurvivors and entered into univariate logistic regression analyses for survival (Table 1), data for each of the six selected variables were plotted as histograms with the proportion of survivors and non-survivors at each increment of measurement identified
This study developed a colic assessment scoring system for use in horses that can help prognosticate survival in horses presenting for evaluation of colic

Summary

Introduction

Acute abdominal pain from gastrointestinal disorders can be successfully treated medically or surgically [1,2,3,4]. The prediction of whether or not a horse is likely to survive a colic episode is oftentimes based on the veterinarian’s clinical impression of the animal. This typically depends on the horse’s comfort level at initial evaluation, clinical history, physical exam parameters, rectal examination, peritoneal fluid evaluation, abdominal ultrasound findings, and clinical pathology [5, 6]. Together, these clinical findings provide useful information that is essential for prognostication

Objectives

Methods

Results

Conclusion