Factors associated with outcome and gradual improvement in survival over time in 1065 equine neonates admitted to an intensive care unit.
Authors: Giguère S, Weber E J, Sanchez L C
Journal: Equine veterinary journal
Summary
# Editorial Summary This 26-year retrospective analysis of 1065 neonatal foals admitted to intensive care examined which disorders and clinical parameters predict survival, revealing that 72.8% were discharged whilst 27.2% did not survive. Using multivariable logistic regression, researchers identified several critical indicators of poor prognosis: positive blood cultures, neutrophil counts below 2.28 × 10⁹/l, hypothermia (≤37.6°C), abnormal blood gas values (bicarbonate and PCO₂), infectious orthopaedic conditions, and elevated sepsis scores. Most encouragingly, the adjusted odds of survival improved markedly over the study period, with foals admitted in the 2000s having approximately 3.4 times greater odds of survival compared with those admitted in the 1980s—a testament to advances in neonatal management protocols. For practitioners, these findings underscore the critical importance of prompt haematological and microbial assessment in sick neonates, rigorous temperature regulation, and aggressive management of sepsis and acid-base disturbances; the temporal improvement in outcomes also suggests that contemporary evidence-based approaches to neonatal intensive care yield measurable clinical benefits. Understanding which parameters most strongly associate with poor outcomes enables more informed prognostication and risk stratification when counselling owners of critically ill foals.
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Practical Takeaways
- •Monitor for sepsis indicators (positive blood cultures, hypothermia ≤37.6°C, neutropenia <2.28 × 10⁹/l) as these are strong predictors of poor outcome in neonatal foals requiring ICU care
- •Infectious orthopaedic complications significantly worsen prognosis and should be screened for aggressively in at-risk neonates
- •Modern neonatal ICU management has dramatically improved survival rates over recent decades; early referral and comprehensive supportive care of sick neonates is justified based on substantially better outcomes than historical data
Key Findings
- •72.8% of 1065 neonatal foals admitted to ICU survived to discharge, with 27.2% nonsurvival rate
- •Positive blood culture, neutrophils <2.28 × 10⁹/l, temperature ≤37.6°C, and infectious orthopaedic disorders were independent factors associated with nonsurvival
- •Foals admitted in the 2000s had 3.4 times higher adjusted odds of survival compared to those admitted in the 1980s, indicating substantial improvement in neonatal intensive care over 26 years
- •Sepsis score, bicarbonate levels, and PCO₂ were significant variables retained in the multivariable model for predicting outcome