Professor Equine Internal Medicine University of Illinois Champaign-Urbana Urbana, Illinois, United States
Abstract:
Background: The clinical utility of SIRS or its individual components to predict infection and mortality in critically ill neonatal foals aged 4-14 days is currently unknown.
Objective: To identify association of SIRS criteria with critically ill neonatal foals. Study
Design: Retrospective, multicenter, cross-sectional study. Animals: Convenience sample of 199 critically ill neonatal foals from 16 veterinary referral hospitals in four countries.
Methods: Data were retrieved from the medical records. A patient was considered positive for SIRS if two or more of the following six criteria were abnormal at admission (age range 4-14 days): leukocyte count/band neutrophils, rectal temperature, heart rate, respiratory rate, venous L-lactate and glucose concentration; at least one of the abnormal criteria must be rectal temperature or leukocyte/band count. Univariate data were analyzed using Chi-square and Mann Whitney U-tests, with P< 0.05 considered significant. Binomial logistic regression and classification tree methods were used to characterize associations between various factors and identified infection on admission and in-hospital mortality.
Results: Infection was identified in 51 (26%) foals while mortality was 23%. SIRS was not predictive of infection, whereas increased serum amyloid A (P=0.028) and band neutrophil (P=0.049) were predictive of infection. Cold extremities, mucous membrane hyperemia, increased heart rate, L-lactate and fibrinogen, and decreased glucose, were predictors of mortality.
Conclusion: SIRS was not predictive of infection. Cardiovascular dysfunction appears to be the predominant cause of mortality in neonatal foals 4-14 days of age, similar to reported findings of the 2025 study of 1,068 newborn foals ≤3 days of age.
Learning Objectives:
Upon completion, participant will have gained an understanding of the origin of SIRS.
Upon completion, participant will be able know the most common components of SIRS criteria used in various studies.
Upon completion, participant will understand how post-gestation age afftects determination of SIRS and infection.
Upon completion, participant will be able to recognize that SIRS criteria used in foals applied to distinct age groups, differ in the determination of infection or risk of mortality..
