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Operative factors associated with short‐term outcome in horses with large colon volvulus: 47 cases from 2006 to 2013
Author(s) -
Gonzalez L. M.,
Fogle C. A.,
Baker W. T.,
Hughes F. E.,
Law J. M.,
MotsingerReif A. A.,
Blikslager A. T.
Publication year - 2015
Publication title -
equine veterinary journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.82
H-Index - 87
eISSN - 2042-3306
pISSN - 0425-1644
DOI - 10.1111/evj.12273
Subject(s) - medicine , volvulus , logistic regression , univariate analysis , crypt , stepwise regression , retrospective cohort study , gastroenterology , surgery , multivariate analysis
Summary Reasons for performing study There is an important need for objective parameters that accurately predict the outcome of horses with large colon volvulus. Objectives To evaluate the predictive value of a series of histomorphometric parameters on short‐term outcome, as well as the impact of colonic resection on horses with large colon volvulus. Study design Retrospective cohort study. Methods Adult horses admitted to the E quine and F arm A nimal V eterinary C enter at N orth C arolina S tate U niversity, P eterson and S mith and C hino V alley E quine H ospitals between 2006 and 2013 that underwent an exploratory coeliotomy, diagnosed with large colon volvulus of ≥360 degrees, where a pelvic flexure biopsy was obtained, and that recovered from general anaesthesia, were selected for inclusion in the study. Logistic regression was used to determine associations between signalment, histomorphometric measurements of interstitium‐to‐crypt ratio, degree of haemorrhage, percentage loss of luminal and glandular epithelium, as well as colonic resection with short‐term outcome (discharge from the hospital). Results Pelvic flexure biopsies from 47 horses with large colon volvulus were evaluated. Factors that were significantly associated with short‐term outcome on univariate logistic regression were Thoroughbred breed (P = 0.04), interstitium‐to‐crypt ratio >1 (P = 0.02) and haemorrhage score ≥3 (P = 0.005). Resection (P = 0.92) was not found to be associated significantly with short‐term outcome. No combined factors increased the likelihood of death in forward stepwise logistic regression modelling. A digitally quantified measurement of haemorrhage area strengthened the association of haemorrhage with nonsurvival in cases of large colon volvulus. Conclusions Histomorphometric measurements of interstitium‐to‐crypt ratio and degree of haemorrhage predict short‐term outcome in cases of large colon volvulus. Resection was not associated with short‐term outcome in horses selected for this study. Accurate quantification of mucosal haemorrhage at the time of surgery may improve veterinary surgeons’ prognostic capabilities in horses with large colon volvulus.