Veterinary surgery : VS · 2019
Clinical findings associated with development of postoperative reflux and short-term survival after small intestinal surgery in geriatric and mature nongeriatric horses.
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Boorman Sophie, Stefanovski Darko, Southwood Louise L
Аннотация
OBJECTIVE: To determine risk factors, especially age, associated with postoperative reflux (POR; >2 L of reflux present upon intubation), high-volume POR (≥20 L in 24 hours), and short-term outcome after small intestinal (SI) surgery.
STUDY DESIGN: Retrospective case-control study.
SAMPLE POPULATION: Horses aged ≥16 years (geriatric; range, 16-30; n = 44) and <16 years (mature; range, 2-15; n = 39) with an SI surgical lesion that survived general anesthesia and did not have a second exploratory celiotomy during the same visit.
METHODS: Medical records (2009-2015) were reviewed; perioperative variables were evaluated for associations with outcomes by using multivariable logistic regression.
RESULTS: Postoperative reflux was associated with an increasing packed cell volume at admission (odds ratio [OR], 1.08; 95% CI, 1.00-1.16; P = .042) and presence of nasogastric reflux at admission (OR, 4.61; 95% CI, 1.3-15.69; P = .014). High-volume POR was associated with an increasing glycemia at admission (OR, 1.19; 95% CI, 1.01-1.40; P = .041), presence of nasogastric reflux at admission (OR, 10.05; 95% CI, 2.21-45.74; P = .003), and SI resection (OR, 10.52; 95% CI, 1.81-61.25; P = .009). Increasing surgical time (OR, 2.50; 95% CI, 1.16-5.29; P = .019) and high-volume POR (OR, 6.37; 95% CI, 2.12-19.12; P = .001) were associated with nonsurvival.
CONCLUSION: Age, considered as both a continuous variable and a categorical variable, was not associated with the development of POR, high-volume POR, or nonsurvival.
CLINICAL SIGNIFICANCE: Age does not influence the occurrence of POR and should not negatively impact an owner's decision to pursue surgery in aged horses.
STUDY DESIGN: Retrospective case-control study.
SAMPLE POPULATION: Horses aged ≥16 years (geriatric; range, 16-30; n = 44) and <16 years (mature; range, 2-15; n = 39) with an SI surgical lesion that survived general anesthesia and did not have a second exploratory celiotomy during the same visit.
METHODS: Medical records (2009-2015) were reviewed; perioperative variables were evaluated for associations with outcomes by using multivariable logistic regression.
RESULTS: Postoperative reflux was associated with an increasing packed cell volume at admission (odds ratio [OR], 1.08; 95% CI, 1.00-1.16; P = .042) and presence of nasogastric reflux at admission (OR, 4.61; 95% CI, 1.3-15.69; P = .014). High-volume POR was associated with an increasing glycemia at admission (OR, 1.19; 95% CI, 1.01-1.40; P = .041), presence of nasogastric reflux at admission (OR, 10.05; 95% CI, 2.21-45.74; P = .003), and SI resection (OR, 10.52; 95% CI, 1.81-61.25; P = .009). Increasing surgical time (OR, 2.50; 95% CI, 1.16-5.29; P = .019) and high-volume POR (OR, 6.37; 95% CI, 2.12-19.12; P = .001) were associated with nonsurvival.
CONCLUSION: Age, considered as both a continuous variable and a categorical variable, was not associated with the development of POR, high-volume POR, or nonsurvival.
CLINICAL SIGNIFICANCE: Age does not influence the occurrence of POR and should not negatively impact an owner's decision to pursue surgery in aged horses.