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Lipreri G, ER S, Rubio ML, Van 'T RH. How Does Race-Training Influence the Ultrastructural Characteristic of the Equine Proximal Phalangeal Sagittal Groove? Vet Comp Orthop Traumatol 2020. [DOI: 10.1055/s-0040-1712875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- G Lipreri
- Institute of Aging and Chronic Disease, University of Liverpool, Liverpool, United Kingdom
| | - Singer ER
- E Singer Equine Orthopaedics and Surgery, Neston, United Kingdom
| | | | - R Hof Van 'T
- Institute of Aging and Chronic Disease, University of Liverpool, Liverpool, United Kingdom
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Isgren CM, Salem SE, Singer ER, Wylie CE, Lipreri G, Graham RJTY, Bladon B, Boswell JC, Fiske-Jackson AR, Mair TS, Rubio-Martínez LM. A multi-centre cohort study investigating the outcome of synovial contamination or sepsis of the calcaneal bursae in horses treated by endoscopic lavage and debridement. Equine Vet J 2019; 52:404-410. [PMID: 31502700 PMCID: PMC7186813 DOI: 10.1111/evj.13180] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Accepted: 08/29/2019] [Indexed: 11/27/2022]
Abstract
Background Previous studies investigating factors associated with survival following endoscopic treatment of contamination/sepsis of the calcaneal bursa are limited. Objectives To investigate the factors associated with survival in horses with contamination/sepsis of the calcaneal bursae treated endoscopically and to describe the bacterial isolates involved in the synovial infections. Study design Retrospective analysis of clinical records. Methods Medical records from 128 horses with contamination/sepsis of the calcaneal bursae treated by endoscopic lavage at seven equine hospitals were reviewed. A follow‐up questionnaire was used to determine survival and return to athletic performance. Descriptive statistics and Cox proportional hazards survival models were used to determine factors associated with survival. Results Horses underwent one (n = 107), two (n = 19), or three (n = 2) surgeries. Survival to hospital discharge was 84.4%. Univariable survival analysis revealed that administration of systemic antimicrobials prior to referral was associated with reduced mortality (hazard ratio, [HR] 0.41, 95% CI 0.18–0.91, P = 0.03). Increased mortality was associated with bone fracture/osteomyelitis (HR 2.43, 95% CI 1.12–5.26, P = 0.03), tendon involvement (≥30% cross sectional area) (HR 3.78 95% CI 1.78–8.04, P = 0.001), duration of general anaesthesia (HR 1.01, 95% CI 1.00–1.02, P = 0.04), post‐operative synoviocentesis (HR 3.18, 95% CI 1.36–7.43, P = 0.006) and post‐operative wound dehiscence (HR 2.5, 95% CI 1.08–5.65, P = 0.04). Multivariable Cox proportional hazards model revealed reduced mortality after systemic antimicrobial administration prior to referral (HR 0.25, 95% CI 0.11–0.60, P = 0.002) and increased mortality with tendinous involvement (≥30% cross‐sectional area) (HR 7.92, 95% CI 3.31–19.92, P<0.001). At follow‐up (median 30 months, range 0.25–13 years, n = 70) 87.1% horses were alive, 7.1% had been euthanised due to the calcaneal injury and 5.7% had been euthanised for unrelated reasons. From 57 horses with athletic performance follow‐up, 91.2% returned to the same/higher level of exercise, 5.3% to a lower level and 3.5% were retired due to persistent lameness of the affected limb. Main limitations Retrospective study and incomplete follow‐up. Conclusion Endoscopic treatment of contamination/sepsis of the calcaneal bursae has an 84% survival rate to hospital discharge. Tendinous involvement reduced survival whilst systemic antimicrobials administration prior to referral improved survival.
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Affiliation(s)
- C M Isgren
- Department of Equine Clinical Science, Institute of Veterinary Science, University of Liverpool, Wirral, UK.,Department of Epidemiology and Population Health, Institute of Infection and Global Health, University of Liverpool, Wirral, UK
| | - S E Salem
- Department of Epidemiology and Population Health, Institute of Infection and Global Health, University of Liverpool, Wirral, UK.,Department of Surgery, Faculty of Veterinary Medicine, Zagazig University, Zagazig, Egypt
| | - E R Singer
- Department of Equine Clinical Science, Institute of Veterinary Science, University of Liverpool, Wirral, UK
| | - C E Wylie
- Rossdales Equine Hospital, Exning, Newmarket, Suffolk, UK
| | - G Lipreri
- Department of Equine Clinical Science, Institute of Veterinary Science, University of Liverpool, Wirral, UK
| | - R J T Y Graham
- The Royal (Dick) School of Veterinary Studies and Roslin Institute, The University of Edinburgh, Midlothian, UK
| | - B Bladon
- Donnington Grove Veterinary Group, Newbury, Oxfordshire, UK
| | - J C Boswell
- The Liphook Equine Hospital, Forest Mere, Liphook, Hampshire, UK
| | - A R Fiske-Jackson
- Equine Referral Hospital, Royal Veterinary College, North Mymms, Hertfordshire, UK
| | - T S Mair
- Bell Equine Veterinary Clinic, Mereworth, Maidstone, Kent, UK
| | - L M Rubio-Martínez
- Department of Equine Clinical Science, Institute of Veterinary Science, University of Liverpool, Wirral, UK.,Sussex Equine Hospital, West Sussex, UK
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