Abstract
BackgroundTo determine associations between perioperative mortality after surgery for traumatic diaphragmatic hernia, medical records of 17 cats and 79 dogs that underwent diaphragmatic herniorrhaphy were reviewed.ResultsThe combined perioperative survival rate was 81.3% (88.2% in cats and 79.8% in dogs). Data from acute and chronic cases was assessed separately. Of the acute cases (12 cats and 48 dogs), 10 cats (83.3%) and 38 dogs (79.2%) survived to discharge. Of the chronic cases (5 cats and 31 dogs), 5 cats (100%) and 25 dogs (80.6%) survived to discharge. The time between trauma and surgery, trauma and admission, and admission and surgery were not associated with survival. For cats and dogs, increased duration of anesthesia and surgical procedure were associated with increased mortality (P = 0.0013 and 0.004, respectively). Animals with concurrent soft tissue injuries had a 4.3 times greater odds of mortality than those without soft tissue injury (P = 0.01). Animals with concurrent soft tissue and orthopedic injuries had a 7.3 times greater odds of mortality than those without soft tissue and orthopedic injuries (P = 0.004). Animals that were oxygen dependent had a 5.0 times greater odds of mortality than those that were not (P = 0.02). No other variables were significantly associated with survival.ConclusionsFor cats and dogs that underwent surgery for traumatic diaphragmatic hernia, increased anesthetic duration, increased duration of surgical procedure, concurrent soft tissue injuries, concurrent soft tissue and orthopedic injuries, and perioperative oxygen dependence were associated with increased mortality.
Highlights
To determine associations between perioperative mortality after surgery for traumatic diaphragmatic hernia, medical records of 17 cats and 79 dogs that underwent diaphragmatic herniorrhaphy were reviewed
The authors of this study report that the 62.5% chronic herniation mortality rate was falsely increased by including dogs that died of unrelated medical problems [1]
In animals with acute herniation, this study found no associations between perioperative survival and time from trauma to admission, time between admission and surgery, or time from trauma to surgery [8]
Summary
To determine associations between perioperative mortality after surgery for traumatic diaphragmatic hernia, medical records of 17 cats and 79 dogs that underwent diaphragmatic herniorrhaphy were reviewed. Multiple factors have been reported to influence the rate of survival, including the timing of surgical intervention [1, 2, 6,7,8, 10, 11]. Surgical intervention within 24 h of trauma, or more than 1 year after trauma resulted in significantly higher mortality rates in dogs [1]. The authors of this study report that the 62.5% chronic herniation mortality rate was falsely increased by including dogs that died of unrelated medical problems [1]. Only 8 dogs underwent surgery over a year following trauma for chronic hernia repair. As a result of this previously published study, some investigators recommend delaying surgical intervention for a minimum of 24 h to permit stabilization of the patient prior to surgery [1, 7]. Stabilizing animals prior to anesthesia and surgery may reduce the mortality rates due to complications from dehydration, hypovolemic
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