Scoring System for Multiple Organ Dysfunction in Adult Horses with Acute Surgical Gastrointestinal Disease.
BACKGROUND
The prevalence of multiple organ dysfunction syndrome (MODS) in horses with acute surgical gastrointestinal (GI) disease is unknown. Currently, there are no validated criteria to confirm MODS in adult horses.


OBJECTIVE
To develop criteria for a MODS score for horses with acute surgical colic (MODS SGI) and evaluate the association with 6-month survival. To compare the MODS SGI score with a MODS score extrapolated from criteria used in people (MODS EQ).


METHODS
Adult horses that required exploratory laparotomy (n = 62) for colic. Healthy adult horses undergoing elective surgical procedures (n = 12) established the reference range of some variables.


METHODS
Prospectively, a MODS SGI score was developed based on organ-specific criteria established from a literature review, data collection, and clinical judgment. Data for scoring each horse were collected on Days 1 and 2 postoperatively. Horses were scored retrospectively using both scoring criteria. The prognostic performance of the MODS SGI score and its overall performance compared with the MODS EQ score were assessed with receiver operating characteristic (ROC) curve analysis.


RESULTS
The MODS SGI score had excellent performance for predicting 6-month survival with an area under the ROC curve (AUC) of 0.95 (95% CI: 0.87-0.99). The AUC for the MODS SGI score was significantly higher than the MODS EQ (AUC: 0.76; 0.63-0.86).


CONCLUSIONS
The MODS SGI score predicts 6-month survival from discharge in horses with acute surgical colic. The MODS SGI score performed better than a score extrapolated from human scoring systems.
Department of Large Animal Medicine, College of Veterinary Medicine, University of Georgia, Athens, GA.
E
E
McConachie
Department of Large Animal Medicine, College of Veterinary Medicine, University of Georgia, Athens, GA.
S
S
Giguère
Department of Large Animal Medicine, College of Veterinary Medicine, University of Georgia, Athens, GA.
M H
MH
Barton
D000818:Animals; D019540:Area Under Curve; D003085:Colic / Q000601:surgery / Q000662:veterinary*; D006734:Horse Diseases / Q000145:classification* / Q000473:pathology / Q000601:surgery; D006736:Horses; D063305:Organ Dysfunction Scores; D018746:Systemic Inflammatory Response Syndrome / Q000473:pathology / Q000662:veterinary*
Colic; Equine; MODS; Systemic inflammatory response syndrome