Additive prognostic value of preoperative plasma glucose concentrations in calves undergoing abdominal surgery

Lausch, Corinna; Lorch, A.; Giertzuch, S.; Rieger, Anna; Trefz, F.M.

doi:10.3168/jdsc.2021-0133

Cited by 2 publications

(6 citation statements)

References 26 publications

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“…Stepwise linear regression analysis indicated that plasma L‐lactate concentration was the most important predictor of venous blood pH. This was an expected finding based on the high prevalence of hyper‐L‐lactatemia in this study sample 4 , 12 that was most likely caused by inadequate oxygen delivery to ischemic gastrointestinal tissues secondary to volvulus, torsion, or luminal distention. The concurrent presence of hyperlactatemia and low venous pO 2 suggested that global hypoperfusion existed in a number of calves, because of hypovolemic or maldistributive shock secondary to sepsis.…”

Section: Discussionsupporting

confidence: 66%

“…[53][54][55][56] Although this study provided valuable information in respect to derangement of acid-base variables and associated biochemical analytes, there were some limitations that were also considered relevant in our previous analyses. 3,4,12 These limitations include the selection bias of cases that are referred to veterinary teaching hospitals, the potential impact of euthanasia on the outcome, interindividual treatment variations, and documentation issues related to the retrospective part of the study. As there are age-dependent changes on acidbase and electrolyte variables, 57 the use of age-invariant reference ranges might be considered as another limitation.…”

Section: Discussionmentioning

confidence: 99%

“…The primary analysis used a subset of calves in a dataset (dataset 1; DS1) that had been used in 2 retrospective studies focusing on the prognostic relevance of preoperative plasma L‐lactate and glucose concentrations. 4 , 12 Data from a subsequent prospective investigation (dataset 2; DS2) was analyzed to validate the predictive utility of a developed prognosis model from DS1 in terms of short‐ and midterm outcome to treatment. 3 …”

Section: Methodsmentioning

confidence: 99%

“…For multivariable modeling of prognostic factors, data were analyzed using classification tree analysis to identify additional cut‐points as potential mortality predictors for subsequent evaluation using binary logistic regression analysis. 4 , 12 , 13 Because of our previous finding that survival rates of affected calves <3 weeks of age are considerably low, 4 , 12 age was additionally included in this analysis. Variables identified as statistically significant predictors during classification tree analysis were subsequently entered as categorized outcome variables into multivariable regression models using a stepwise backward procedure with Wald P < .05 as selection criterion.…”

Section: Methodsmentioning

confidence: 99%

“…For this analysis, the level of significance was also adjusted using the Bonferroni method (total of 9 comparisons, providing an experiment‐wise comparison P < .006). For multivariable modeling of prognostic factors, data were analyzed using classification tree analysis to identify additional cut‐points as potential mortality predictors for subsequent evaluation using binary logistic regression analysis 4,12,13 . Because of our previous finding that survival rates of affected calves <3 weeks of age are considerably low, 4,12 age was additionally included in this analysis.…”

Section: Methodsmentioning

confidence: 99%

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Acid‐base imbalances and the association of blood‐gas variables, electrolytes, and biochemical analytes with outcome in hospitalized calves undergoing abdominal surgery

Trefz

Lausch

Rieger

et al. 2023

Veterinary Internal Medicne

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Background Surgical abdominal emergencies in calves are associated with a guarded prognosis and have the potential for complex metabolic derangements including acid‐base imbalances. Objectives To perform a comprehensive analysis of acid‐base status and to assess the prognostic relevance of preoperative clinicopathologic variables in calves undergoing abdominal surgery. Animals Hospital‐based study samples of 535 (dataset 1; DS1) and 83 calves (dataset 2; DS2). Methods Retrospective (DS1) and prospective (DS2) case series. Results In DS1, acidemia (pH <7.33) was present in 49.9%, whereas alkalemia (pH >7.37) was present in 30.7% of calves. Plasma L‐lactate, chloride, and serum inorganic phosphorus concentration accounted for 51.9%, 11.6% and 9.4% of the variation of venous blood pH, respectively. Classification tree analysis indicated that a negative outcome (death or euthanasia during hospitalization) was associated with venous pO 2 ≤33.6 mm Hg, anion gap >18.3 and >22.9 mEq/L, serum albumin concentration ≤36.5 and ≤29.4 g/L, serum urea concentration >4.4 mmol/L, and plasma ionized calcium concentration ≤1.26 mmol/L. The area under the receiver operating characteristic curve of this model was 0.85 (95% CI: 0.82‐0.89, P < .001) and the resulting sensitivity and specificity for the prediction of nonsurvival at the optimal probability cut‐point of 0.5 was 89.8% and 65.7%, respectively. In DS2 the model had a similar sensitivity and specificity of 90.5% and 70%, respectively. Conclusions and Clinical Importance Clinicopathologic imbalances and associated changes of acid‐base status are common in calves with surgical abdominal emergencies and have clinical utility for the prediction of a negative postoperative outcome.

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Section: Discussionsupporting

confidence: 66%