Serum amyloid A concentration in postoperative colic horses and its association with postoperative complications.
Authors: Aitken Maia R, Stefanovski Darko, Southwood Louise L
Journal: Veterinary surgery : VS
Summary
# Editorial Summary Following colic surgery, distinguishing between inflammatory responses and genuine infection remains clinically challenging; this prospective study tracked serum amyloid A (SAA), fibrinogen, and neutrophil counts across 51 postoperative horses to evaluate whether SAA could serve as an early infection marker. Researchers collected blood samples at days 0, 1, 2, and 4–6 postoperatively and at discharge, correlating acute phase protein concentrations with the 35 complications that emerged (69% complication rate), including postoperative colic (25%), reflux (22%), and surgical site infection (18%). Whilst day 2 and day 4–6 SAA showed associations with postoperative colic, diarrhea, intravenous catheter complications, and reflux (all P <0.05), and discharge SAA correlated with surgical site infection (P=0.001), SAA levels failed to distinguish between infection-related and non-infection-related complications—a critical limitation reflecting the substantial inflammatory burden inherent to colic surgery itself. Clinicians should recognise that SAA elevation in the early postoperative period reflects both surgical trauma and infection equally, though measuring SAA at discharge may offer diagnostic value for late-presenting surgical site infections; fibrinogen concentration appears similarly useful for predicting non-infectious complications and offers no advantage over SAA as an early infection indicator.
Read the full abstract on PubMed
Practical Takeaways
- •SAA point-of-care testing in the early postoperative period cannot reliably distinguish surgical site infection from other complications due to high baseline inflammation from colic surgery itself
- •Elevated SAA at hospital discharge may be a useful marker to monitor for delayed surgical site infections in colic recovery cases
- •Fibrinogen appears to track similarly with postoperative complications as SAA and may be equally useful clinically while being more cost-effective
Key Findings
- •Serum amyloid A (SAA) was markedly elevated in all postoperative colic horses but did not differentiate between infection and non-infection complications
- •Day 2 SAA was associated with postoperative colic (P=0.004), diarrhea (P=0.042), catheter complications (P=0.008), and reflux (P=0.008)
- •Discharge SAA concentration was associated with surgical site infection (P=0.001), making it potentially useful for late postoperative infection detection
- •Fibrinogen at days 4-6 and discharge was associated with postoperative colic (P=0.003), diarrhea (P=0.004), catheter complications (P=0.002), and reflux (P=0.023)