Short-term outcome of equine emergency admissions at a university referral hospital.
Authors: Southwood L L, Dolente B A, Lindborg S, Russell G, Boston R
Journal: Equine veterinary journal
Summary
# Editorial Summary: Short-term Outcomes in Equine Emergency Admissions Between 2009 and 2010, Southwood and colleagues reviewed 918 emergency admissions to a university referral hospital over 12 months, stratifying survival-to-discharge data by age, presenting complaint, pathological findings, and therapeutic interventions to identify prognostic factors and opportunities for improved case management. The overall mortality rate was 24%, but this figure masked substantial variation: foals experienced 34% mortality, geriatric horses 40%, whilst mature horses averaged 21%, with seasonal variation peaking at 37% in March. Presenting complaint proved highly predictive—neurological conditions carried 46% mortality and neonatal presentations 41%, compared with just 5% for ophthalmological cases and 13% for trauma/skin conditions—whilst critical laboratory abnormalities including abnormal peritoneal fluid (71%), coagulopathy (63%), and acid-base disturbances (52%) signalled substantially worse prognosis. Interestingly, admission timing and duration of pre-presentation clinical signs did not affect outcomes, though certain interventions correlated with higher mortality (intranasal oxygen 57%, plasma administration 34%), likely reflecting disease severity rather than treatment failure. These findings underscore that age and critical illness fundamentally determine prognosis in equine emergencies, highlighting the need for targeted research into neonatal, geriatric and critically ill populations to refine management strategies for these highest-risk groups.
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Practical Takeaways
- •Age and severity of clinical pathology abnormalities are critical prognostic indicators when counseling owners on emergency admission outcomes; foals and geriatric horses require particularly guarded prognosis discussions
- •Abnormal peritoneal fluid and coagulopathy findings warrant very poor prognostic estimates (71% and 63% mortality), while straightforward orthopedic injuries carry excellent survival prospects, aiding case triage and client communication
- •The high mortality associated with intranasal oxygen therapy likely reflects underlying severe respiratory compromise rather than iatrogenic harm, emphasizing the importance of addressing underlying disease pathology rather than relying on supportive care alone
Key Findings
- •Overall death rate in equine emergency admissions was 24%, with foals (34%) and geriatric horses (40%) having significantly higher mortality than mature horses (21%)
- •Neurological (46%) and neonatal (41%) presentations had the highest death rates, while ophthalmological (5%) and trauma/skin (13%) cases had the lowest
- •Critical pathology abnormalities including abnormal peritoneal fluid (71%), coagulopathy (63%), acid-base abnormalities (52%), and hypoxia/hypercapnia (48%) were strongly associated with poor outcomes
- •Procedural interventions showed variable outcomes: intranasal oxygen therapy (57% death rate) and plasma transfusion (34%) were associated with high mortality, while joint lavage (4%) and laceration repair (0%) had excellent survival rates