Veterinary medicine and science · 2025
Can Arterial Blood Gas, Electrolyte and Acid-Base Analysis at Admission be Used to Predict Survival to Hospital Discharge for Different Causes of Colic?
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Milner Peter I, Bardell David
Аннотация
BACKGROUND: Predicting outcome in horses presenting with colic remains challenging.
OBJECTIVES: To test whether arterial blood samples in horses admitted for colic predict outcome to hospital discharge for different colic types.
METHODS: Arterial blood samples collected on admission from 358 horses undergoing medical or surgical management of colic were evaluated for pH, PaO2, PaCO2, Na+, K+, iCa2+, Cl-, HCO3 - (P), HCO3 - (P, set), Base (B), Base (ecf) and anion gap. Categories were small intestinal non-strangulating (SINS) or strangulating (SIS) lesions, large colon non-volvulus (LCNV) or volvulus (LCV), small colon non-strangulating (SCNS) or strangulating (SCS) lesions, viscus rupture or other. Multivariable logistic regression models were developed based on survival, or not, to hospital discharge. Odd ratios (ORs) with 95% confidence intervals (95%CI) and area under the curve receiver operator characteristics (AUROC), sensitivity, specificity and positive and negative predictive values were calculated at a cut-off value of p = 0.5.
RESULTS: A total of 295/358 (82.4%) horses survived to hospital discharge. Variables retained as significantly associated with survival were PaO2 for SINS (OR 1.15, 95%CI 1.04-1.27), PaO2 (OR 1.06, 95% CI 1.01-1.11) and Na+ (OR 1.24, 95% CI 1.02-1.52) for SIS, Ca2+ (OR 175.1, 95% CI 2.20-13958) and HCO3 - (P) (OR 1.18, 95% CI 1.01-1.37) for LCNV and PaCO2 (OR 1.47, 95% CI 1.05-2.06) for LCV. AUROCs showed acceptable-excellent discrimination (range: 0.7-0.9), excellent sensitivity (range: 91%-100%) but poor-fair specificity (range: 8%-50%).
CONCLUSIONS: Arterial blood is good at predicting survival based on colic type but less accurate at predicting those horses which do not survive to hospital discharge.
OBJECTIVES: To test whether arterial blood samples in horses admitted for colic predict outcome to hospital discharge for different colic types.
METHODS: Arterial blood samples collected on admission from 358 horses undergoing medical or surgical management of colic were evaluated for pH, PaO2, PaCO2, Na+, K+, iCa2+, Cl-, HCO3 - (P), HCO3 - (P, set), Base (B), Base (ecf) and anion gap. Categories were small intestinal non-strangulating (SINS) or strangulating (SIS) lesions, large colon non-volvulus (LCNV) or volvulus (LCV), small colon non-strangulating (SCNS) or strangulating (SCS) lesions, viscus rupture or other. Multivariable logistic regression models were developed based on survival, or not, to hospital discharge. Odd ratios (ORs) with 95% confidence intervals (95%CI) and area under the curve receiver operator characteristics (AUROC), sensitivity, specificity and positive and negative predictive values were calculated at a cut-off value of p = 0.5.
RESULTS: A total of 295/358 (82.4%) horses survived to hospital discharge. Variables retained as significantly associated with survival were PaO2 for SINS (OR 1.15, 95%CI 1.04-1.27), PaO2 (OR 1.06, 95% CI 1.01-1.11) and Na+ (OR 1.24, 95% CI 1.02-1.52) for SIS, Ca2+ (OR 175.1, 95% CI 2.20-13958) and HCO3 - (P) (OR 1.18, 95% CI 1.01-1.37) for LCNV and PaCO2 (OR 1.47, 95% CI 1.05-2.06) for LCV. AUROCs showed acceptable-excellent discrimination (range: 0.7-0.9), excellent sensitivity (range: 91%-100%) but poor-fair specificity (range: 8%-50%).
CONCLUSIONS: Arterial blood is good at predicting survival based on colic type but less accurate at predicting those horses which do not survive to hospital discharge.