Factors associated with survival of horses following relaparotomy

Findley, JA, Salem, S ORCID: 0000-0001-5315-8934, Burgess, R and Archer, DC
(2017) Factors associated with survival of horses following relaparotomy. Equine veterinary journal, 49 (4). pp. 448-453.

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Relaparotomy may be required to investigate and manage complications that occur following surgical management of colic.To report factors associated with survival following relaparotomy.Retrospective cohort study.Records of horses that had undergone exploratory laparotomy for treatment of colic over a 10-year period (2002 - 2012) and had undergone relaparotomy <8 weeks following the initial surgery were reviewed. Descriptive data were generated and association with survival time was modelled using Cox proportional hazards models.Relaparotomy was performed in 96 horses at <8 weeks following initial surgery at a median of 4 days. This represented 6.3% of horses that underwent laparotomy during the study period (n = 1,531). Relaparotomy was most frequently undertaken based on signs of persistent postoperative colic (76%; n = 73). Short-term survival for horses undergoing relaparotomy due to persistent colic was 53%, incisional dehiscence 50% postoperative reflux 37%, haemoperitoneum 17% and septic peritonitis 0%. Median survival was 6 days for all horses undergoing relaparotomy and 778 days for those that recovered following anaesthesia. Non-survival was associated with increased packed cell volume at 24 h following initial laparotomy (HR 1.06, 95% CI 1.04-1.10, P = 0.009), peritonitis as a reason for undertaking relaparotomy (HR 4.41, 95% CI 1.43-13.6, P = 0.01) and adhesions found at relaparotomy (HR 1.77, 95% CI 1.03-3.04, P = 0.04). Increased likelihood of survival was associated with colic signs being the reason for performing relaparotomy (HR 0.48, 95% CI 0.26-0.88, P = 0.02) and small intestinal distension found at relaparotomy (HR 0.53, 95% CI 0.29-0.96, P = 0.04).This study has provided information about survival rates and risk factors for survival in horses undergoing relaparotomy that can assist clinicians and owners when determining whether to perform relaparotomy and in predicting the likely surgical outcome. This article is protected by copyright. All rights reserved.

Item Type: Article
Uncontrolled Keywords: horse, repeat laparotomy, relaparotomy, colic, survival
Depositing User: Symplectic Admin
Date Deposited: 22 Sep 2016 10:24
Last Modified: 19 Jan 2023 07:30
DOI: 10.1111/evj.12635
Related URLs:
URI: https://livrepository.liverpool.ac.uk/id/eprint/3003203