Veterinary surgery : VS · 2009
Prevalence of and risk factors for postoperative ileus after small intestinal surgery in two hundred and thirty-three horses.
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Holcombe Susan J, Rodriguez Katie M, Haupt Jennifer L, Campbell James O, Chaney Kristin P, Sparks Holly D, Hauptman Joe G
Аннотация
OBJECTIVES: To determine the incidence of postoperative ileus (POI) in a population of horses after small intestinal surgery and the effect of multiple variables on development of POI.
STUDY DESIGN: Case series.
ANIMALS: Horses (n=233) aged > or =1 year that had exploratory celiotomy for small intestinal disease that recovered from surgery from 1995 to 2005.
METHODS: Sixty-eight variables were collected from medical records (1995-2005) for each horse. POI was defined as nasogastric reflux volume >20 L over 24 hours or >8 L at any single time after surgery.
RESULTS: Twenty-seven percent (64/233) of horses developed POI; 29 of 64 (46%) horses with POI had duodenitis proximal jejunitis (DPJ). When no intestinal resection was required at surgery, excluding horses with DPJ, 15% of horses had POI; 30% horses had POI after intestinal resection. Ten percent of horses had POI for >24 hours. When horses with DPJ were excluded, factors associated with increased risk of POI included high packed cell volume at hospital admission (P=.024), increasing age (P=.0004), and length of intestinal resection (P=.05).
CONCLUSIONS: Risk factors for POI in this study were nonspecific although horses with intestinal resection are at higher risk compared with horses without intestinal resection.
CLINICAL RELEVANCE: Predicting with certainty which cases will develop POI remains elusive.
STUDY DESIGN: Case series.
ANIMALS: Horses (n=233) aged > or =1 year that had exploratory celiotomy for small intestinal disease that recovered from surgery from 1995 to 2005.
METHODS: Sixty-eight variables were collected from medical records (1995-2005) for each horse. POI was defined as nasogastric reflux volume >20 L over 24 hours or >8 L at any single time after surgery.
RESULTS: Twenty-seven percent (64/233) of horses developed POI; 29 of 64 (46%) horses with POI had duodenitis proximal jejunitis (DPJ). When no intestinal resection was required at surgery, excluding horses with DPJ, 15% of horses had POI; 30% horses had POI after intestinal resection. Ten percent of horses had POI for >24 hours. When horses with DPJ were excluded, factors associated with increased risk of POI included high packed cell volume at hospital admission (P=.024), increasing age (P=.0004), and length of intestinal resection (P=.05).
CONCLUSIONS: Risk factors for POI in this study were nonspecific although horses with intestinal resection are at higher risk compared with horses without intestinal resection.
CLINICAL RELEVANCE: Predicting with certainty which cases will develop POI remains elusive.