Isgren, CM, Salem, SE 
ORCID: 0000-0001-5315-8934, Singer, ER, Wylie, CE, Lipreri, G ORCID: 0000-0002-2510-6085, Graham, RJTY, Bladon, B, Boswell, JC, Fiske-Jackson, AR, Mair, TS et al (show 1 more authors)
(2020)
A multi-centre cohort study investigating the outcome of synovial contamination or sepsis of the calcaneal bursae in horses treated by endoscopic lavage and debridement.
EQUINE VETERINARY JOURNAL, 52 (3).
pp. 404-410.
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Calcanela bursa edndoscopic lavage paper.pdf - Author Accepted Manuscript Download (1MB) | Preview |
Abstract
<h4>Background</h4>Previous studies investigating factors associated with survival following endoscopic treatment of contamination/sepsis of the calcaneal bursa are limited.<h4>Objectives</h4>To investigate the factors associated with survival in horses with contamination/sepsis of the calcaneal bursae treated endoscopically and to describe the bacterial isolates involved in the synovial infections.<h4>Study design</h4>Retrospective analysis of clinical records.<h4>Methods</h4>Medical records from 128 horses with contamination/sepsis of the calcaneal bursae treated by endoscopic lavage at seven equine hospitals were reviewed. A follow-up questionnaire was used to determine survival and return to athletic performance. Descriptive statistics and Cox proportional hazards survival models were used to determine factors associated with survival.<h4>Results</h4>Horses underwent one (n = 107), two (n = 19), or three (n = 2) surgeries. Survival to hospital discharge was 84.4%. Univariable survival analysis revealed that administration of systemic antimicrobials prior to referral was associated with reduced mortality (hazard ratio, [HR] 0.41, 95% CI 0.18-0.91, P = 0.03). Increased mortality was associated with bone fracture/osteomyelitis (HR 2.43, 95% CI 1.12-5.26, P = 0.03), tendon involvement (≥30% cross sectional area) (HR 3.78 95% CI 1.78-8.04, P = 0.001), duration of general anaesthesia (HR 1.01, 95% CI 1.00-1.02, P = 0.04), post-operative synoviocentesis (HR 3.18, 95% CI 1.36-7.43, P = 0.006) and post-operative wound dehiscence (HR 2.5, 95% CI 1.08-5.65, P = 0.04). Multivariable Cox proportional hazards model revealed reduced mortality after systemic antimicrobial administration prior to referral (HR 0.25, 95% CI 0.11-0.60, P = 0.002) and increased mortality with tendinous involvement (≥30% cross-sectional area) (HR 7.92, 95% CI 3.31-19.92, P<0.001). At follow-up (median 30 months, range 0.25-13 years, n = 70) 87.1% horses were alive, 7.1% had been euthanised due to the calcaneal injury and 5.7% had been euthanised for unrelated reasons. From 57 horses with athletic performance follow-up, 91.2% returned to the same/higher level of exercise, 5.3% to a lower level and 3.5% were retired due to persistent lameness of the affected limb.<h4>Main limitations</h4>Retrospective study and incomplete follow-up.<h4>Conclusion</h4>Endoscopic treatment of contamination/sepsis of the calcaneal bursae has an 84% survival rate to hospital discharge. Tendinous involvement reduced survival whilst systemic antimicrobials administration prior to referral improved survival.
| Item Type: | Article |
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| Uncontrolled Keywords: | horse, infection, tendon injury, bursoscopy, bacterial isolates, antimicrobials |
| Depositing User: | Symplectic Admin |
| Date Deposited: | 13 Sep 2019 07:24 |
| Last Modified: | 19 Jan 2023 00:26 |
| DOI: | 10.1111/evj.13180 |
| Related URLs: | |
| URI: | https://livrepository.liverpool.ac.uk/id/eprint/3054414 |
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