Acute phase proteins as diagnostic markers in horses with colic
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Acute phase proteins as diagnostic markers in horses with colic. / Pihl, Tina; Scheepers, Elrien; Sanz, Macarena; Goddard, Amelia; Page, Patrick; Toft, Nils; Kjelgaard-Hansen, Mads; Andersen, Pia Haubro; Jacobsen, Stine.
In: Journal of Veterinary Emergency and Critical Care, Vol. 26, No. 5, 2016, p. 664–674.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Acute phase proteins as diagnostic markers in horses with colic
AU - Pihl, Tina
AU - Scheepers, Elrien
AU - Sanz, Macarena
AU - Goddard, Amelia
AU - Page, Patrick
AU - Toft, Nils
AU - Kjelgaard-Hansen, Mads
AU - Andersen, Pia Haubro
AU - Jacobsen, Stine
PY - 2016
Y1 - 2016
N2 - Objective – To investigate the diagnostic potential of the concentrations of acute-phase proteins serum amyloid A (SAA), haptoglobin (Hp), and fibrinogen in blood and peritoneal fluid (PF) for differentiating horses within flammatory colic (entero-colitis and peritonitis) from those with surgical colic.Design – Prospective observational multicenter study.Setting – Two university referral hospitals.Animals – Horses referred for severe acute abdominal pain to Hospital 1 (n = 148) or Hospital 2 (n = 78).Intervention – Blood and PF samples collected at admission were used for acute-phase protein concentration measurement.Measurements and Main Results – A multivariable logistic model including clinical parameters (lethargy, rectal temperature >38°C [100.4°F], normal rectal examination findings, and gastric reflux of 5–10 L) recorded atadmission was constructed from Hospital 1 data. The ability of the model to correctly differentiate inflammatory from surgical colic was 86% determined as area under the receiver operating characteristic curve. Adding blood parameters (WBC, PCV, total plasma protein, lactate, SAA, Hp, and fibrinogen concentrations) to the logistic model based on clinical parameters revealed that only WBC and SAA and fibrinogen concentrations improved the model. With SAA included in the model no additional blood parameters improved the model, and the final model had an area under the curve of 90%. Addition of PF parameters (hemolysis, total protein concentration, WBC, SAA, or Hp concentrations) did not improve the model. When validated in Hospital 2 data, the models had good integrity and diagnostic performance.Conclusions – Evaluation of SAA in serum improved the ability to differentiate horses with acute inflammatory colic requiring medical treatment from horses with colic requiring surgery, as it allowed an additional 4% of horses to be correctly classified into medical and surgical cases. Improved differentiation of these 2 groups of horses with colic may minimize the risk of unnecessary or delayed surgery.
AB - Objective – To investigate the diagnostic potential of the concentrations of acute-phase proteins serum amyloid A (SAA), haptoglobin (Hp), and fibrinogen in blood and peritoneal fluid (PF) for differentiating horses within flammatory colic (entero-colitis and peritonitis) from those with surgical colic.Design – Prospective observational multicenter study.Setting – Two university referral hospitals.Animals – Horses referred for severe acute abdominal pain to Hospital 1 (n = 148) or Hospital 2 (n = 78).Intervention – Blood and PF samples collected at admission were used for acute-phase protein concentration measurement.Measurements and Main Results – A multivariable logistic model including clinical parameters (lethargy, rectal temperature >38°C [100.4°F], normal rectal examination findings, and gastric reflux of 5–10 L) recorded atadmission was constructed from Hospital 1 data. The ability of the model to correctly differentiate inflammatory from surgical colic was 86% determined as area under the receiver operating characteristic curve. Adding blood parameters (WBC, PCV, total plasma protein, lactate, SAA, Hp, and fibrinogen concentrations) to the logistic model based on clinical parameters revealed that only WBC and SAA and fibrinogen concentrations improved the model. With SAA included in the model no additional blood parameters improved the model, and the final model had an area under the curve of 90%. Addition of PF parameters (hemolysis, total protein concentration, WBC, SAA, or Hp concentrations) did not improve the model. When validated in Hospital 2 data, the models had good integrity and diagnostic performance.Conclusions – Evaluation of SAA in serum improved the ability to differentiate horses with acute inflammatory colic requiring medical treatment from horses with colic requiring surgery, as it allowed an additional 4% of horses to be correctly classified into medical and surgical cases. Improved differentiation of these 2 groups of horses with colic may minimize the risk of unnecessary or delayed surgery.
KW - Faculty of Health and Medical Sciences
KW - Acute phase proteins
KW - surgery
KW - diagnostic accuracy
KW - horse
KW - colic
KW - white blood cell count
KW - lactate
KW - peritoneal fluid
KW - fibrinogen
KW - haptoglobin
KW - serum amyloid A
U2 - 10.1111/vec.12504
DO - 10.1111/vec.12504
M3 - Journal article
C2 - 27384962
VL - 26
SP - 664
EP - 674
JO - Journal of Veterinary Emergency and Critical Care
JF - Journal of Veterinary Emergency and Critical Care
SN - 1479-3261
IS - 5
ER -
ID: 140713367