Veterinary anaesthesia and analgesia · 2025
The Confidential Enquiry into Perioperative Equine Fatalities: phase 4 (CEPEF4) - a worldwide observational, prospective, multicentre cohort study in 2025.
СтатьяМногоцентровое исследованиеObservational Study, VeterinaryНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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История · было → стало
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Gozalo-Marcilla Miguel, Redondo José I, Bettschart-Wolfensberger Regula, Domenech Luis, Doménech Javier, Johnston G Mark, Taylor Polly M
Аннотация
OBJECTIVE: To report on the Confidential Enquiry into Perioperative Equine Fatalities 4 (CEPEF4).
STUDY DESIGN: Confidential, observational, prospective, multicentre, cohort study.
ANIMALS: 47,396 horses/ponies undergoing general anaesthesia (GA).
METHODS: Characteristics of each GA (249 variables) were collected. Outcomes after seven days were ALIVE (or discharged), EUTHANASIA or DEAD. Logistic regression analysed patient demographics and the anaesthetic drugs (p < 0.05).
RESULTS: Data were collected from 47,396 GAs in 93 centres in 28 countries. Death rates were 1.2% overall, 0.6% for cases classified as NON-COLIC and 4.2% for COLIC. For NON-COLICs (227 deaths from 39,798 NON-COLICs), the main three causes of death were fractures (35.7%), abdominal complications (18.1%) and central nervous system problems (13.2%). Logistic regression analyses revealed an increase in the odds of death for pregnant mares, geriatrics, thin horses, those with a higher American Society of Anesthesiologists grade, urgent procedures and those lasting < 1 hour or > 2 hours. Ketamine infusions and plasma lactate measurement during maintenance were associated with elevated risk. By contrast, monitoring invasive arterial pressure, end-tidal CO2, blood gases and body temperature were each associated with reduced odds of death. Premedication with agonist-antagonist/partial-agonist opioids with non-steroidal anti-inflammatory drugs and administration of α2-adrenoceptor agonists during recovery, alone or with acepromazine, were associated with reduced odds of death.
CONCLUSIONS AND CLINICAL RELEVANCE: CEPEF4 reports a reduction in the death rate compared with CEPEF2 in 2002: overall 1.2% versus 1.9%, colic death rate 4.2% versus 7.8% and non-colic death rate 0.6% versus 0.9%. Healthy horses still die, the majority because of fractures during recovery. We identified factors that may influence clinical decision-making and enhance patient safety. The CEPEF4 database will continue to provide clinically applicable information, with potential for further insights and improvements in equine anaesthesia.
STUDY DESIGN: Confidential, observational, prospective, multicentre, cohort study.
ANIMALS: 47,396 horses/ponies undergoing general anaesthesia (GA).
METHODS: Characteristics of each GA (249 variables) were collected. Outcomes after seven days were ALIVE (or discharged), EUTHANASIA or DEAD. Logistic regression analysed patient demographics and the anaesthetic drugs (p < 0.05).
RESULTS: Data were collected from 47,396 GAs in 93 centres in 28 countries. Death rates were 1.2% overall, 0.6% for cases classified as NON-COLIC and 4.2% for COLIC. For NON-COLICs (227 deaths from 39,798 NON-COLICs), the main three causes of death were fractures (35.7%), abdominal complications (18.1%) and central nervous system problems (13.2%). Logistic regression analyses revealed an increase in the odds of death for pregnant mares, geriatrics, thin horses, those with a higher American Society of Anesthesiologists grade, urgent procedures and those lasting < 1 hour or > 2 hours. Ketamine infusions and plasma lactate measurement during maintenance were associated with elevated risk. By contrast, monitoring invasive arterial pressure, end-tidal CO2, blood gases and body temperature were each associated with reduced odds of death. Premedication with agonist-antagonist/partial-agonist opioids with non-steroidal anti-inflammatory drugs and administration of α2-adrenoceptor agonists during recovery, alone or with acepromazine, were associated with reduced odds of death.
CONCLUSIONS AND CLINICAL RELEVANCE: CEPEF4 reports a reduction in the death rate compared with CEPEF2 in 2002: overall 1.2% versus 1.9%, colic death rate 4.2% versus 7.8% and non-colic death rate 0.6% versus 0.9%. Healthy horses still die, the majority because of fractures during recovery. We identified factors that may influence clinical decision-making and enhance patient safety. The CEPEF4 database will continue to provide clinically applicable information, with potential for further insights and improvements in equine anaesthesia.