title: The Association of Fibrinous Pleural Effusion with Survival and Complications in Horses with Pleuropneumonia (2002-2012): 74 Cases.
abstract: BACKGROUND
  Fibrinous parapneumonic pleural effusions are associated with decreased efficacy of pleural fluid drainage and increased risk of medical treatment failure in people, but similar associations have not been established in horses.
  
  
  OBJECTIVE
  We hypothesized that fibrin deposition in the pleural cavity of horses with parapneumonic effusions increases the risk of poor outcome.
  
  
  METHODS
  Seventy four horses with bacterial pleuropneumonia diagnosed by culture and cytology of tracheal aspirates, pleural fluid, or both, and pleural effusion diagnosed by ultrasonographic examination.
  
  
  METHODS
  Retrospective study of cases was from 2002 to 2012. Information obtained from the medical records included signalment, history, sonographic findings, treatments, and outcome. The primary outcome investigated was survival and secondary outcomes were development of complications and surgical intervention. Fisher's exact test and logistic regression were applied for categorical variables. A t-test was used to find differences in continuous variables between groups.
  
  
  RESULTS
  Seventy four horses met study criteria and 50 (68%) survived. Fibrinous pleural effusion was associated with higher respiratory rate and pleural fluid height at admission, necrotizing pneumonia, increased number of indwelling thoracic drains required for treatment, and decreased survival.
  
  
  CONCLUSIONS
  Fibrin accumulation in parapneumonic effusions is associated with increased mortality. Direct fibrinolytic treatment might be indicated in affected horses.
authors.affiliation: Department of Clinical Studies, New Bolton Center, University of Pennsylvania School of Veterinary Medicine, Kennett Square, PA.
authors.forename: J E
authors.initials: JE
authors.lastname: Tomlinson
authors.affiliation: Department of Clinical Studies, New Bolton Center, University of Pennsylvania School of Veterinary Medicine, Kennett Square, PA.
authors.forename: V B
authors.initials: VB
authors.lastname: Reef
authors.affiliation: Department of Clinical Studies, New Bolton Center, University of Pennsylvania School of Veterinary Medicine, Kennett Square, PA.
authors.forename: R C
authors.initials: RC
authors.lastname: Boston
authors.affiliation: Department of Clinical Studies, New Bolton Center, University of Pennsylvania School of Veterinary Medicine, Kennett Square, PA.
authors.forename: A L
authors.initials: AL
authors.lastname: Johnson
mesh_terms: D000818:Animals; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D005260:Female; D006734:Horse Diseases / Q000188:drug therapy / Q000401:mortality / Q000473:pathology*; D006736:Horses; D008297:Male; D010996:Pleural Effusion / Q000150:complications / Q000401:mortality / Q000473:pathology / Q000662:veterinary*; D011002:Pleuropneumonia, Contagious / Q000188:drug therapy / Q000401:mortality / Q000473:pathology*; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis
chemical_list: D000900:Anti-Bacterial Agents
keywords: Equine; Fibrin; Pleuritis; Pneumonia