Factors associated with development of post-operative reflux in horses with large colon volvulus and association with complications and outcomes
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Factors associated with development of post-operative reflux in horses with large colon volvulus and association with complications and outcomes. / Watrobska, Natalia; Gough, Rachel; Hallowell, Gayle; Haugaard, Simon; McGovern, Kate F.
In: Equine Veterinary Journal, 2024.Research output: Contribution to journal › Journal article › Research › peer-review
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T1 - Factors associated with development of post-operative reflux in horses with large colon volvulus and association with complications and outcomes
AU - Watrobska, Natalia
AU - Gough, Rachel
AU - Hallowell, Gayle
AU - Haugaard, Simon
AU - McGovern, Kate F.
N1 - © 2024 EVJ Ltd.
PY - 2024
Y1 - 2024
N2 - BACKGROUND: Post-operative reflux (POR) is rare following large colon volvulus (LCV) but does occur despite the absence of a small intestinal lesion. The prevalence, risk factors and association with survival of POR after LCV are currently unknown.OBJECTIVES: To determine the prevalence of POR in horses with an LCV and its association with survival. A further objective was to assess factors which may predict POR. The hypothesis was that horses with POR following LCV surgery have a worse outcome for survival compared to those without POR.STUDY DESIGN: A retrospective cross-sectional study.METHODS: Clinical data of client owned horses which underwent colic surgery at a single UK referral hospital between 2008 and 2021, where LCV was the primary finding, were retrieved from hospital records. Statistical analyses included chi-squared, t-tests and odds ratios (ORs). Horses with concurrent lesions, and those that did not survive past anaesthetic recovery, were excluded from analysis. POR was defined as ≥2 L of gastric reflux on at least one occasion.RESULTS: A total of 128 horses were included in the study, 23 of which had POR (18%). Overall survival to hospital discharge was 86%, 95% in the non-POR and 44% in the POR group. Horses with POR were less likely to survive to discharge than those without (OR = 26, 95% confidence interval [CI] [7.68-88.0], p < 0.001), and less likely to be alive 3 years after surgery (OR = 13.4, 95% CI [2.78-64.8], p < 0.001).MAIN LIMITATIONS: Due to the retrospective study design, full data sets were not available for every case because clinical records were incomplete or, at that time, certain tests were not performed or clinical variables were not measured.CONCLUSIONS: POR in LCV cases is a negative prognostic indicator for survival.
AB - BACKGROUND: Post-operative reflux (POR) is rare following large colon volvulus (LCV) but does occur despite the absence of a small intestinal lesion. The prevalence, risk factors and association with survival of POR after LCV are currently unknown.OBJECTIVES: To determine the prevalence of POR in horses with an LCV and its association with survival. A further objective was to assess factors which may predict POR. The hypothesis was that horses with POR following LCV surgery have a worse outcome for survival compared to those without POR.STUDY DESIGN: A retrospective cross-sectional study.METHODS: Clinical data of client owned horses which underwent colic surgery at a single UK referral hospital between 2008 and 2021, where LCV was the primary finding, were retrieved from hospital records. Statistical analyses included chi-squared, t-tests and odds ratios (ORs). Horses with concurrent lesions, and those that did not survive past anaesthetic recovery, were excluded from analysis. POR was defined as ≥2 L of gastric reflux on at least one occasion.RESULTS: A total of 128 horses were included in the study, 23 of which had POR (18%). Overall survival to hospital discharge was 86%, 95% in the non-POR and 44% in the POR group. Horses with POR were less likely to survive to discharge than those without (OR = 26, 95% confidence interval [CI] [7.68-88.0], p < 0.001), and less likely to be alive 3 years after surgery (OR = 13.4, 95% CI [2.78-64.8], p < 0.001).MAIN LIMITATIONS: Due to the retrospective study design, full data sets were not available for every case because clinical records were incomplete or, at that time, certain tests were not performed or clinical variables were not measured.CONCLUSIONS: POR in LCV cases is a negative prognostic indicator for survival.
U2 - 10.1111/evj.14095
DO - 10.1111/evj.14095
M3 - Journal article
C2 - 38613156
JO - Equine Veterinary Journal
JF - Equine Veterinary Journal
SN - 0425-1644
ER -
ID: 389404642