title: Predicting Outcome in dogs with Primary Immune-Mediated Hemolytic Anemia: Results of a Multicenter Case Registry.
abstract: BACKGROUND
  Outcome prediction in dogs with immune-mediated hemolytic anemia (IMHA) is challenging and few prognostic indicators have been consistently identified.
  
  
  OBJECTIVE
  An online case registry was initiated to: prospectively survey canine IMHA presentation and management in the British Isles; evaluate 2 previously reported illness severity scores, Canine Hemolytic Anemia Score (CHAOS) and Tokyo and to identify independent prognostic markers.
  
  
  METHODS
  Data from 276 dogs with primary IMHA across 10 referral centers were collected between 2008 and 2012.
  
  
  METHODS
  Outcome prediction by previously reported illness-severity scores was tested using univariate logistic regression. Independent predictors of death in hospital or by 30-days after admission were identified using multivariable logistic regression.
  
  
  RESULTS
  Purebreds represented 89.1% dogs (n = 246). Immunosuppressive medications were administered to 88.4% dogs (n = 244), 76.1% (n = 210) received antithrombotics and 74.3% (n = 205) received packed red blood cells. Seventy-four per cent of dogs (n = 205) were discharged from hospital and 67.7% (n = 187) were alive 30-days after admission. Two dogs were lost to follow-up at 30-days. In univariate analyses CHAOS was associated with death in hospital and death within 30-days. Tokyo score was not associated with either outcome measure. A model containing SIRS-classification, ASA classification, ALT, bilirubin, urea and creatinine predicting outcome at discharge was accurate in 82% of cases. ASA classification, bilirubin, urea and creatinine were independently associated with death in hospital or by 30-days.
  
  
  CONCLUSIONS
  Markers of kidney function, bilirubin concentration and ASA classification are independently associated with outcome in dogs with IMHA. Validation of this score in an unrelated population is now warranted.
authors.affiliation: School of Physiology and Pharmacology, University of Bristol, Bristol, UK.
authors.forename: R
authors.initials: R
authors.lastname: Goggs
authors.affiliation: Department of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA.
authors.forename: S G
authors.initials: SG
authors.lastname: Dennis
authors.affiliation: Vets Now Referrals Kent, Blue Bell Hill, UK.
authors.forename: A
authors.initials: A
authors.lastname: Di Bella
authors.affiliation: Department of Clinical Sciences and Services, RVC, North Mymms, UK.
authors.forename: K R
authors.initials: KR
authors.lastname: Humm
authors.affiliation: University of Glasgow, Glasgow, UK.
authors.forename: G
authors.initials: G
authors.lastname: McLauchlan
authors.affiliation: University College Dublin, Dublin, Ireland.
authors.forename: C
authors.initials: C
authors.lastname: Mooney
authors.affiliation: University of Edinburgh, Edinburgh, UK.
authors.forename: A
authors.initials: A
authors.lastname: Ridyard
authors.affiliation: Dick White Referrals, Six Mile Bottom, UK.
authors.forename: S
authors.initials: S
authors.lastname: Tappin
authors.affiliation: Anderson Moores Veterinary Specialists, Winchester, UK.
authors.forename: D
authors.initials: D
authors.lastname: Walker
authors.affiliation: Companion Animal Studies, University of Bristol, Langford, UK.
authors.forename: S
authors.initials: S
authors.lastname: Warman
authors.affiliation: Davies Veterinary Specialists, Higham Gobion, UK.
authors.forename: N T
authors.initials: NT
authors.lastname: Whitley
authors.affiliation: Production and Population Health, Royal Veterinary College, North Mymms, UK.
authors.forename: D C
authors.initials: DC
authors.lastname: Brodbelt
authors.affiliation: Department of Clinical Sciences and Services, RVC, North Mymms, UK.
authors.forename: D L
authors.initials: DL
authors.lastname: Chan
mesh_terms: D000744:Anemia, Hemolytic, Autoimmune / Q000628:therapy / Q000662:veterinary*; D000818:Animals; D004283:Dog Diseases / Q000628:therapy*; D004285:Dogs; D005260:Female; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008297:Male; D015999:Multivariate Analysis; D012042:Registries; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents
keywords: Canine hemolytic anemia objective score; Immune-mediated hemolytic anemia; Survival; Thromboembolism