Predictors of outcome in dogs undergoing thoracic surgery (2002–2011)

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ObjectiveTo evaluate mortality in a canine population undergoing thoracic surgery and identify factors which may be associated with outcome. Study designRetrospective cohort study. Animals286 dogs anaesthetized for thoracic surgery at the Royal Veterinary College between June 2002 – June 2011. MethodsVariables examined included: signalment; ASA status; nature of disease; presence of co-morbidities; pre-anaesthetic oxygen requirement; surgical approach; anaesthesia management [anaesthetic agents; requirement for thoracocentesis; central venous pressure measurement; duration of surgery and anaesthesia; use of colloids, blood products, inotropes or neuromuscular blocking agents (NMBA)]. Outcome was defined as either non-survival to 24 hours after surgery or (having survived to 24 hours) to discharge. Univariate and multivariable logistic regressions were performed to identify risk factors associated with non-survival. ResultsOverall non-survival (excluding those euthanased) to discharge was 5.9%. Non-survival was 2.2% at 24 hours and 3.6% at time of discharge. Non-survival to 24 hours was associated with pre-anaesthetic oxygen requirement (odds ratio (OR) 12.2 [95% CI 1.8–84.5]) and NMBA use (OR 9.6 [95% CI 1.6–57.9]). Non-survival to discharge was associated with surgical duration, with surgeries >180 minutes having OR 16.9 [95% CI 2.0–144.0] compared to surgeries ≤90 minutes and blood product use (OR 4.6 [95% CI 1.3–14.6]). No association was found between ASA category and non-survival at 24 hours (OR 1.4 [95% CI 0.2–11.7]) or discharge (OR 4.4 [95% CI 0.6–34.3]). Significant associations were found between NMBA use and ASA category (p = 0.046), surgical duration (p = 0.002), use of colloids (p = 0.011), blood products (p = 0.001) and inotropes and/or vasopressors (p < 0.001). Conclusions and clinical relevanceVariables significantly associated with non-survival from canine thoracic surgery at 24 hours include NMBA use and pre-anaesthetic oxygen requirement. Blood product use and increasing surgical duration were associated with non-survival to hospital discharge. The associations may relate to the need for such products in the most complicated cases.