Sensitivity and specificity of blood leukocyte counts as an indicator of mortality in horses after colic surgery.
Authors: Salciccia A, Sandersen C, Grulke S, de la Rebière de Pouyade G, Caudron I, Serteyn D, Detilleux J
Journal: The Veterinary record
Summary
# Leukocyte counts as a postoperative prognostic indicator following equine colic surgery Following surgical colic, clinicians urgently need reliable prognostic markers to identify horses at high risk of mortality and guide management decisions. Researchers analysed perioperative blood leukocyte kinetics in 103 horses undergoing colic surgery (53 in the descriptive cohort, 50 for validation) by measuring total white cell counts before, during, and serially after surgery, then using receiver operating characteristic analysis to establish a clinically useful cut-off threshold. Survivor horses demonstrated significantly higher leukocyte elevation kinetics in the early postoperative period compared to non-survivors; critically, horses with at least one blood leukocyte count of ≤3.9 × 10³/mm³ between 28–60 hours post-surgery were substantially more likely to die, and this cut-off proved valid when tested on the second population. Since leukocyte enumeration is a routine, inexpensive laboratory procedure available to most practitioners, incorporating this specific threshold into your postoperative monitoring protocol—particularly during the critical 28–60 hour window—provides an objective, evidence-based tool to strengthen prognostication alongside traditional clinical and laboratory assessments. This approach may help identify horses requiring escalated intervention or intensive supportive care during the high-risk early recovery phase.
Read the full abstract on PubMed
Practical Takeaways
- •Monitor postoperative leukocyte counts between 28-60 hours post-colic surgery; counts ≤3.9×10³/mm³ suggest increased mortality risk and warrant closer observation or intervention
- •Use leukocyte trends as a supplementary prognostic tool in combination with existing clinical indicators to improve outcome prediction
- •Early detection of abnormally low leukocyte counts may help identify high-risk horses for more intensive postoperative management
Key Findings
- •Blood leukocyte kinetics in survivor horses were higher than non-survivors during the first postoperative days
- •Non-survivor horses were significantly more likely to have leukocyte counts ≤3.9×10³/mm³ between 28-60 hours post-surgery compared to survivors
- •A cut-off value of 3.9×10³/mm³ was validated in a second population of 50 colic surgery horses
- •Routine blood leukocyte counts can serve as an additional prognostic indicator alongside other outcome predictors after colic surgery