title: Factors associated with survival in 148 recumbent horses.
abstract: BACKGROUND
  There are currently few data available on the prognosis and outcome of recumbent horses.
  
  
  OBJECTIVE
  To investigate the outcome of hospitalised horses that had been recumbent in the field or hospital and factors affecting their survival within the first 3 days of hospitalisation and survival after 3 days to hospital discharge.
  
  
  METHODS
  Retrospective analysis of clinical records.
  
  
  METHODS
  Records of 148 horses admitted to the William R. Pritchard Veterinary Medical Teaching Hospital, University of California Davis from January 1995 to December 2010 with a history of recumbency or horses that became recumbent while hospitalised were evaluated. Exact logistic regression was used to assess the association between clinical parameters and survival within the first 3 days of hospitalisation and survival to hospital discharge after 3 days.
  
  
  RESULTS
  There were 109 nonsurvivors and 39 survivors. Multivariate analysis showed variables associated with an increased odds of death within the first 3 days of hospitalisation included duration of clinical signs prior to presentation, with horses showing clinical signs for over 24 h having increased odds of death (P = 0.043, odds ratio [OR] 4.16, 95% confidence interval [95% CI] 1.04-16.59), the presence of band neutrophils (P = 0.02, OR 7.94, 95% CI 1.39-45.46), the horse not using the sling (P = 0.031, OR 4.22, 95% confidence interval 1.14-15.68) and horses that were unable to stand after treatment (P<0.0001, OR 231.15, 95% CI 22.82-2341.33). Increasing cost was associated with lower odds of death (P = 0.017, OR 0.96, for each additional $100 billed, 95% CI 0.93-0.99).
  
  
  CONCLUSIONS
  This study demonstrates that the duration of clinical signs, response to treatment and the ability of horses to use a sling are associated with survival to hospital discharge for recumbent horses.
authors.affiliation: William R. Prichard Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California Davis, USA.
authors.forename: L S
authors.initials: LS
authors.lastname: Winfield
authors.forename: P H
authors.initials: PH
authors.lastname: Kass
authors.forename: K G
authors.initials: KG
authors.lastname: Magdesian
authors.forename: J E
authors.initials: JE
authors.lastname: Madigan
authors.forename: M
authors.initials: M
authors.lastname: Aleman
authors.forename: N
authors.initials: N
authors.lastname: Pusterla
mesh_terms: D000375:Aging; D000818:Animals; D005260:Female; D006734:Horse Diseases / Q000191:economics / Q000401:mortality*; D006736:Horses; D016015:Logistic Models; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis
keywords: down horse; horse; recumbent horse; sling