Association between hyperglycemia and survival in 228 horses with acute gastrointestinal disease.
Authors: Hassel D M, Hill A E, Rorabeck R A
Journal: Journal of veterinary internal medicine
Summary
# Editorial Summary Elevated blood glucose concentrations are recognised markers of critical illness in humans and correlate with poor outcomes, yet their prognostic significance in equine colic has been less thoroughly characterised. Hassel and colleagues conducted a retrospective analysis of 228 adult horses presenting with acute gastrointestinal disease, collecting admission data including plasma glucose, vital parameters, acid–base status and clinical findings, then using logistic regression to identify independent risk factors for non-survival to discharge. Mean glucose concentration was 155 mg/dL (8.5 mM) across the cohort, with 45% exceeding the reference range and 16.7% classified as severely hyperglycaemic (>195 mg/dL); glucose emerged as a significant predictor of mortality alongside diagnosis and age, with the combined model accurately predicting outcome in 92.5% of cases. Beyond glucose itself, severity of pain at admission, tachycardia, elevated packed cell volume and increased anion gap all independently associated with worse survival odds. Clinicians managing equine colic cases should recognise that hyperglycaemia at presentation—particularly when severe—represents a meaningful prognostic indicator of reduced survival likelihood and warrants aggressive management; the finding that glucose concentration independently predicted outcome distinct from diagnosis suggests it captures valuable information about systemic stress severity that may guide clinical decision-making and client counselling regarding hospitalisation, surgical intervention and expected prognosis.
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Practical Takeaways
- •Blood glucose measurement at admission to horses with acute colic provides prognostic information; elevated glucose (especially >195 mg/dL) indicates worse survival odds independent of diagnosis
- •Hyperglycemia in colic cases should be viewed as a negative prognostic indicator and may help guide decisions about treatment intensity and client communication regarding prognosis
- •Glucose testing is a simple, cost-effective diagnostic aid in acute gastrointestinal disease that should be incorporated into initial assessment protocols
Key Findings
- •Mean blood glucose was 155 mg/dL with 45% of horses exceeding the reference range, and 16.7% presenting with severe hyperglycemia (>195 mg/dL)
- •Hyperglycemia was independently associated with increased odds of failure to survive to hospital discharge, alongside diagnosis and age
- •A multivariable model including glucose and diagnosis correctly classified outcome in 92.5% of cases
- •Factors associated with nonsurvival included glucose level, pain severity, heart rate, PCV, anion gap, and diagnosis