The Systemic Inflammatory Response Syndrome and Predictors of Infection and Mortality in 1068 Critically Ill Newborn Foals
ABSTRACT Background Sepsis has been defined in humans as the concurrent proven or suspected presence of microbial infection and the systemic inflammatory response syndrome (SIRS). Sepsis is the leading cause of morbidity and mortality in neonatal foals. The clinical utility of using SIRS or its indi...
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Wiley
2025-03-01
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| Series: | Journal of Veterinary Internal Medicine |
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| Online Access: | https://doi.org/10.1111/jvim.70004 |
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| author | Pamela A. Wilkins David Wong Nathan M. Slovis Niamh Collins Bonnie S. Barr Catriona MacKenzie Cristobal Navas De Solis Carolina Castagnetti Jole Mariella Teresa Burns Gillian Perkins Barbara Delvescovo L. Chris Sanchez Ann M. Kemper K. Gary Magdesian Daniela Bedenice Sandra D. Taylor Jenifer Gold Bettina Dunkel Gene Pranzo Peter D. Constable |
| author_facet | Pamela A. Wilkins David Wong Nathan M. Slovis Niamh Collins Bonnie S. Barr Catriona MacKenzie Cristobal Navas De Solis Carolina Castagnetti Jole Mariella Teresa Burns Gillian Perkins Barbara Delvescovo L. Chris Sanchez Ann M. Kemper K. Gary Magdesian Daniela Bedenice Sandra D. Taylor Jenifer Gold Bettina Dunkel Gene Pranzo Peter D. Constable |
| author_sort | Pamela A. Wilkins |
| collection | DOAJ |
| description | ABSTRACT Background Sepsis has been defined in humans as the concurrent proven or suspected presence of microbial infection and the systemic inflammatory response syndrome (SIRS). Sepsis is the leading cause of morbidity and mortality in neonatal foals. The clinical utility of using SIRS or its individual components to predict infection and mortality in critically ill foals is currently unknown. Objectives Assess the ability of history and signalment, clinical findings, laboratory results, and SIRS‐related indices to predict infection and mortality in critically ill foals. Animals Retrospective, multi‐center, cross‐sectional study using a convenience sample of 1068 critically ill foals < 3 days of age admitted to 16 veterinary referral hospitals in 4 countries. Methods Data were retrieved from medical records. Infection was defined as the presence of bacteremia (positive blood culture) or clinical identification of an infected focus on admission. Univariate non‐parametric and categorical methods, multivariate logistic regression, and classification tree methods were used for statistical analysis. Results Foal age at admission and presence of toxic neutrophils were independent predictors of infection, whereas SIRS‐related indices were not predictive of infection. In‐hospital mortality was 24%. Independent predictors for mortality were hypokinetic pulses, cold extremities, presence of seizures, blood L‐lactate concentration > 6.0 mmol/L, and increased serum potassium and total bilirubin concentrations. Conclusions and Clinical Importance The presence of infection in critically ill newborn foals was not predicted by SIRS indices. Cardiovascular dysfunction was strongly associated with mortality, suggesting that maintaining adequate perfusion and pulse pressure should be important treatment goals. |
| format | Article |
| id | doaj-art-e7bf9e67e39948899e325a964ff9acc3 |
| institution | DOAJ |
| issn | 0891-6640 1939-1676 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Veterinary Internal Medicine |
| spelling | doaj-art-e7bf9e67e39948899e325a964ff9acc32025-08-20T02:58:00ZengWileyJournal of Veterinary Internal Medicine0891-66401939-16762025-03-01392n/an/a10.1111/jvim.70004The Systemic Inflammatory Response Syndrome and Predictors of Infection and Mortality in 1068 Critically Ill Newborn FoalsPamela A. Wilkins0David Wong1Nathan M. Slovis2Niamh Collins3Bonnie S. Barr4Catriona MacKenzie5Cristobal Navas De Solis6Carolina Castagnetti7Jole Mariella8Teresa Burns9Gillian Perkins10Barbara Delvescovo11L. Chris Sanchez12Ann M. Kemper13K. Gary Magdesian14Daniela Bedenice15Sandra D. Taylor16Jenifer Gold17Bettina Dunkel18Gene Pranzo19Peter D. Constable20College of Veterinary Medicine University of Illinois at Urbana‐Champaign Ubana Illinois USAVeterinary Clinical Sciences, Lloyd Veterinary Medical Center Iowa State University Ames Iowa USAHagyard Equine Medical Institute Lexington Kentucky USAScone Equine Hospital Scone New South Wales United Kingdom of Great Britain and Northern IrelandRood and Riddle Equine Hospital Lexington Kentucky USARossdales Equine Hospital Newmarket United Kingdom of Great Britain and Northern IrelandTexas A&M College Station Texas USADepartment of Veterinary Medical Sciences University of Bologna Bologna ItalyDepartment of Veterinary Medical Sciences University of Bologna Bologna ItalyVeterinary Clinical Sciences The Ohio State University Columbus Ohio USADepartment of Clinical Sciences Cornell University Ithaca New York USADepartment of Clinical Sciences Cornell University Ithaca New York USALarge Animal Clinical Sciences University of Florida Gainesville Florida USACollege of Veterinary Medicine University of Illinois at Urbana‐Champaign Ubana Illinois USADepartment of Medicine and Epidemiology, School of Veterinary Medicine University of California, Davis Davis California USACummings School of Veterinary Medicine Tufts University North Grafton Massachusetts USADepartment of Veterinary Clinical Sciences Purdue University West Lafayette Indiana USAWashington State University Pullman Washington USAVeterinary Basic Sciences Royal Veterinary College North Mymms Hertsfordshire United Kingdom of Great Britain and Northern IrelandDorothy Russell Havemeyer Foundation New York USACollege of Veterinary Medicine University of Illinois at Urbana‐Champaign Ubana Illinois USAABSTRACT Background Sepsis has been defined in humans as the concurrent proven or suspected presence of microbial infection and the systemic inflammatory response syndrome (SIRS). Sepsis is the leading cause of morbidity and mortality in neonatal foals. The clinical utility of using SIRS or its individual components to predict infection and mortality in critically ill foals is currently unknown. Objectives Assess the ability of history and signalment, clinical findings, laboratory results, and SIRS‐related indices to predict infection and mortality in critically ill foals. Animals Retrospective, multi‐center, cross‐sectional study using a convenience sample of 1068 critically ill foals < 3 days of age admitted to 16 veterinary referral hospitals in 4 countries. Methods Data were retrieved from medical records. Infection was defined as the presence of bacteremia (positive blood culture) or clinical identification of an infected focus on admission. Univariate non‐parametric and categorical methods, multivariate logistic regression, and classification tree methods were used for statistical analysis. Results Foal age at admission and presence of toxic neutrophils were independent predictors of infection, whereas SIRS‐related indices were not predictive of infection. In‐hospital mortality was 24%. Independent predictors for mortality were hypokinetic pulses, cold extremities, presence of seizures, blood L‐lactate concentration > 6.0 mmol/L, and increased serum potassium and total bilirubin concentrations. Conclusions and Clinical Importance The presence of infection in critically ill newborn foals was not predicted by SIRS indices. Cardiovascular dysfunction was strongly associated with mortality, suggesting that maintaining adequate perfusion and pulse pressure should be important treatment goals.https://doi.org/10.1111/jvim.70004bacteremiahyperlactatemiasepsisshock |
| spellingShingle | Pamela A. Wilkins David Wong Nathan M. Slovis Niamh Collins Bonnie S. Barr Catriona MacKenzie Cristobal Navas De Solis Carolina Castagnetti Jole Mariella Teresa Burns Gillian Perkins Barbara Delvescovo L. Chris Sanchez Ann M. Kemper K. Gary Magdesian Daniela Bedenice Sandra D. Taylor Jenifer Gold Bettina Dunkel Gene Pranzo Peter D. Constable The Systemic Inflammatory Response Syndrome and Predictors of Infection and Mortality in 1068 Critically Ill Newborn Foals Journal of Veterinary Internal Medicine bacteremia hyperlactatemia sepsis shock |
| title | The Systemic Inflammatory Response Syndrome and Predictors of Infection and Mortality in 1068 Critically Ill Newborn Foals |
| title_full | The Systemic Inflammatory Response Syndrome and Predictors of Infection and Mortality in 1068 Critically Ill Newborn Foals |
| title_fullStr | The Systemic Inflammatory Response Syndrome and Predictors of Infection and Mortality in 1068 Critically Ill Newborn Foals |
| title_full_unstemmed | The Systemic Inflammatory Response Syndrome and Predictors of Infection and Mortality in 1068 Critically Ill Newborn Foals |
| title_short | The Systemic Inflammatory Response Syndrome and Predictors of Infection and Mortality in 1068 Critically Ill Newborn Foals |
| title_sort | systemic inflammatory response syndrome and predictors of infection and mortality in 1068 critically ill newborn foals |
| topic | bacteremia hyperlactatemia sepsis shock |
| url | https://doi.org/10.1111/jvim.70004 |
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