Retrospective cohort study on diseases and risk factors associated with death in hospitalized neonatal foals
Abstract Background The care of sick neonatal foals is labor‐intensive and costly. Prediction of risk of death upon admission is often difficult but might support decision‐making. Objectives To determine diseases and risk factors associated with death in neonatal hospitalized foals. Animals Two hund...
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| Format: | Article |
| Language: | English |
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Wiley
2025-01-01
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| Series: | Journal of Veterinary Internal Medicine |
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| Online Access: | https://doi.org/10.1111/jvim.17269 |
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| author | Donatienne L. Castelain Alexander Dufourni Mathilde L. Pas Jade Bokma Eva deBruijn Ellen Paulussen Laurence Lefère Gunther vanLoon Bart Pardon |
| author_facet | Donatienne L. Castelain Alexander Dufourni Mathilde L. Pas Jade Bokma Eva deBruijn Ellen Paulussen Laurence Lefère Gunther vanLoon Bart Pardon |
| author_sort | Donatienne L. Castelain |
| collection | DOAJ |
| description | Abstract Background The care of sick neonatal foals is labor‐intensive and costly. Prediction of risk of death upon admission is often difficult but might support decision‐making. Objectives To determine diseases and risk factors associated with death in neonatal hospitalized foals. Animals Two hundred twenty‐two hospitalized foals, ≤7 days old. Methods Retrospective cohort study. Clinical and laboratory variables were evaluated for their association with death by means of Cox survival analysis and by classification and regression tree (CART) analysis. Results Most prevalent diseases were sepsis (43.9%), enteritis (14.0%), and omphalitis (9.0%). Case fatality rate was 33.3%. Neonatal sepsis significantly increased the risk of death (hazard ratio [HR] = 1.9; 95% confidence interval [CI] = 1.2‐3.0; P = .009). Multivariable Cox regression in foals ≤7 days old revealed comatose mental state (HR = 2.9; 95% CI = 1.1‐8.1; P = .04), L‐lactatemia (≥373.8 mg/L [4.2 mmol/L]; HR = 4.4; 95% CI = 1.7‐11.7; P = .003) and increased serum amyloid A (SAA; ≥2054 μg/mL; HR = 3.9; 95% CI = 1.2‐12.7; P = .02) as risk factors for death, with a sensitivity and specificity of 7.5% and 95.7%, respectively. The CART analysis highlighted L‐lactatemia, comatose mental state, and hypercapnia as risk factors for death, with a sensitivity of 38.1% and specificity of 86.1% after validation. Conclusions and Clinical Importance In this study sample, sepsis was associated with the highest risk of death. Identified risk factors such as SAA, L‐lactate, and comatose mental state might guide veterinarians and owners in better decision‐making for economic or welfare reasons. Frequently measured laboratory variables, such as blood glucose concentration and Immunoglobulin G, were not sensitive and specific enough to provide reliable decision support for survival estimation. |
| format | Article |
| id | doaj-art-bce783a3ded24a3f8e657f18d203961b |
| institution | Kabale University |
| issn | 0891-6640 1939-1676 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Veterinary Internal Medicine |
| spelling | doaj-art-bce783a3ded24a3f8e657f18d203961b2025-01-27T15:22:41ZengWileyJournal of Veterinary Internal Medicine0891-66401939-16762025-01-01391n/an/a10.1111/jvim.17269Retrospective cohort study on diseases and risk factors associated with death in hospitalized neonatal foalsDonatienne L. Castelain0Alexander Dufourni1Mathilde L. Pas2Jade Bokma3Eva deBruijn4Ellen Paulussen5Laurence Lefère6Gunther vanLoon7Bart Pardon8Department of Internal Medicine, Reproduction and Population Medicine Ghent University, Salisburylaan 133 Merelbeke 9820 BelgiumDepartment of Internal Medicine, Reproduction and Population Medicine Ghent University, Salisburylaan 133 Merelbeke 9820 BelgiumDepartment of Internal Medicine, Reproduction and Population Medicine Ghent University, Salisburylaan 133 Merelbeke 9820 BelgiumDepartment of Internal Medicine, Reproduction and Population Medicine Ghent University, Salisburylaan 133 Merelbeke 9820 BelgiumDepartment of Internal Medicine, Reproduction and Population Medicine Ghent University, Salisburylaan 133 Merelbeke 9820 BelgiumDepartment of Internal Medicine, Reproduction and Population Medicine Ghent University, Salisburylaan 133 Merelbeke 9820 BelgiumDepartment of Internal Medicine, Reproduction and Population Medicine Ghent University, Salisburylaan 133 Merelbeke 9820 BelgiumDepartment of Internal Medicine, Reproduction and Population Medicine Ghent University, Salisburylaan 133 Merelbeke 9820 BelgiumDepartment of Internal Medicine, Reproduction and Population Medicine Ghent University, Salisburylaan 133 Merelbeke 9820 BelgiumAbstract Background The care of sick neonatal foals is labor‐intensive and costly. Prediction of risk of death upon admission is often difficult but might support decision‐making. Objectives To determine diseases and risk factors associated with death in neonatal hospitalized foals. Animals Two hundred twenty‐two hospitalized foals, ≤7 days old. Methods Retrospective cohort study. Clinical and laboratory variables were evaluated for their association with death by means of Cox survival analysis and by classification and regression tree (CART) analysis. Results Most prevalent diseases were sepsis (43.9%), enteritis (14.0%), and omphalitis (9.0%). Case fatality rate was 33.3%. Neonatal sepsis significantly increased the risk of death (hazard ratio [HR] = 1.9; 95% confidence interval [CI] = 1.2‐3.0; P = .009). Multivariable Cox regression in foals ≤7 days old revealed comatose mental state (HR = 2.9; 95% CI = 1.1‐8.1; P = .04), L‐lactatemia (≥373.8 mg/L [4.2 mmol/L]; HR = 4.4; 95% CI = 1.7‐11.7; P = .003) and increased serum amyloid A (SAA; ≥2054 μg/mL; HR = 3.9; 95% CI = 1.2‐12.7; P = .02) as risk factors for death, with a sensitivity and specificity of 7.5% and 95.7%, respectively. The CART analysis highlighted L‐lactatemia, comatose mental state, and hypercapnia as risk factors for death, with a sensitivity of 38.1% and specificity of 86.1% after validation. Conclusions and Clinical Importance In this study sample, sepsis was associated with the highest risk of death. Identified risk factors such as SAA, L‐lactate, and comatose mental state might guide veterinarians and owners in better decision‐making for economic or welfare reasons. Frequently measured laboratory variables, such as blood glucose concentration and Immunoglobulin G, were not sensitive and specific enough to provide reliable decision support for survival estimation.https://doi.org/10.1111/jvim.17269blood cultureprognosissepsissepticemiasurvival analysis |
| spellingShingle | Donatienne L. Castelain Alexander Dufourni Mathilde L. Pas Jade Bokma Eva deBruijn Ellen Paulussen Laurence Lefère Gunther vanLoon Bart Pardon Retrospective cohort study on diseases and risk factors associated with death in hospitalized neonatal foals Journal of Veterinary Internal Medicine blood culture prognosis sepsis septicemia survival analysis |
| title | Retrospective cohort study on diseases and risk factors associated with death in hospitalized neonatal foals |
| title_full | Retrospective cohort study on diseases and risk factors associated with death in hospitalized neonatal foals |
| title_fullStr | Retrospective cohort study on diseases and risk factors associated with death in hospitalized neonatal foals |
| title_full_unstemmed | Retrospective cohort study on diseases and risk factors associated with death in hospitalized neonatal foals |
| title_short | Retrospective cohort study on diseases and risk factors associated with death in hospitalized neonatal foals |
| title_sort | retrospective cohort study on diseases and risk factors associated with death in hospitalized neonatal foals |
| topic | blood culture prognosis sepsis septicemia survival analysis |
| url | https://doi.org/10.1111/jvim.17269 |
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