Initial investigation of mortality rates and prognostic indicators in horses with colic in Israel: a retrospective study.
Authors: Sutton G A, Ertzman-Ginsburg R, Steinman A, Milgram J
Journal: Equine veterinary journal
Summary
# Colic Mortality and Prognostic Indicators: A Retrospective Analysis from Israel Retrospective analysis of 208 colic cases at an Israeli referral hospital identified overall mortality at 25%, with marked variation by lesion type: medical management showed 7% mortality versus 34% for surgical cases, whilst strangulating lesions carried substantially worse prognosis (60%) than non-strangulating lesions (18%), and small intestinal involvement proved more fatal (63%) than large intestinal disease (26%). Using logistic regression modelling, capillary refill time (CRT) and mucous membrane colour emerged as robust prognostic indicators across all colic presentations, with CRT and lesion severity most predictive in surgical cases specifically. Though outcomes aligned with most international data, the authors noted that UK and USA centres reported superior results for small intestinal surgery, suggesting that variations in euthanasia decision-making between regions may substantially influence reported mortality statistics. These findings provide equine clinicians with evidence-based parameters for early prognostication at presentation and reinforce the importance of standardised outcome reporting across geographical populations to identify practice-level improvements in colic management.
Read the full abstract on PubMed
Practical Takeaways
- •Perform rapid clinical assessment of CRT and mucous membrane colour at presentation to provide immediate prognostic guidance to horse owners regarding likelihood of survival
- •Strangulating intestinal lesions carry significantly higher mortality (60%) than nonstrangulating (18%), and small intestinal lesions are worse than large intestinal; use these facts when counselling clients on treatment options and likely outcomes
- •Medical management alone achieves 93% survival rate but surgical cases average 34% mortality; help clients understand these baseline expectations differ substantially between treatment approaches
Key Findings
- •Overall mortality rate was 25% (51/208), with 7% in medically treated cases versus 34% in surgical cases
- •Strangulating lesions had 60% mortality compared to 18% in nonstrangulating lesions, and small intestinal lesions had 63% mortality versus 26% in large intestinal lesions
- •Capillary refill time and mucous membrane colour were independent prognostic indicators in multivariate analysis for all colic cases
- •In surgical cases only, capillary refill time and lesion severity remained as independent prognostic indicators of mortality