Clinical features and prognostic variables in 109 horses with esophageal obstruction (1992-2009)

• Published in: Journal of veterinary internal medicine 2010-09, Vol.24 (5), p.1147-1152
• Main Authors: Chiavaccini, L, Hassel, D.M
• Format: Article
• Language: English
• Subjects: Acepromazine - therapeutic use; Adrenergic alpha-Agonists - therapeutic use; anesthesia; Animals; Anti-Bacterial Agents - therapeutic use; Anti-Inflammatory Agents, Non-Steroidal - therapeutic use; Cross-Sectional Studies; Dopamine Antagonists - therapeutic use; Equine; Esophageal Diseases - drug therapy; Esophageal Diseases - veterinary; Esophagitis; Esophagus; Female; Horse Diseases - drug therapy; Horse Diseases - pathology; Horses; Male; males; medicine; multivariate analysis; pneumonia; Prognosis; regression analysis; respiratory rate; Retrospective Studies; risk; risk factors
• ISSN: 0891-6640; 1939-1676
• DOI: 10.1111/j.1939-1676.2010.0573.x

Background: Esophageal obstruction is common in horses and can result in life-threatening complications. Previous studies have described clinical findings in horses with esophageal obstruction, but there are no reports that attempt to make correlations of clinical findings with outcome. Hypothesis: Specific clinical features of horses with esophageal obstruction are associated with increased likelihood of complications. Animals: One hundred and nine horses with esophageal obstruction. Methods: Retrospective cross-sectional study. All clinical records of horses admitted between April 1992 and February 2009 for esophageal obstruction were reviewed. The association among 24 clinical, hematological, biochemical, therapeutic variables and the likelihood of complications was investigated by a univariable logistic regression model, followed by multivariable analysis. Results: Multiple logistic regression analysis revealed that intact males (P= .02), age >15 years (P < .01), and a need for general anesthesia (P < .01) were associated with the development of complications after an episode of esophageal obstruction. Increased respiratory rate (>22 breaths/min) and moderate or severe tracheal contamination, although not associated with complications as a whole, significantly increased the risk of developing aspiration pneumonia (P less than .01). Conclusions and Clinical Importance: Signalment, clinical variables, and endoscopic findings were confirmed as important tools in assessing the severity of the esophageal lesion and pulmonary involvement. Knowledge of risk factors for the development of complications will aid in making informed decisions to optimize treatment and assist in the assessment of prognosis.