A comparison of the Sepsis-2 and Sepsis-3 definitions for assessment of mortality risk in dogs with parvovirus.

Abstract

OBJECTIVE: To evaluate the use of a modified Sepsis-3 (mSepsis-3) definition compared to the currently used modified Sepsis-2 (mSepsis-2) definition to determine whether the mSepsis-2 or mSepsis-3 stratifications were able to identify populations of dogs ultimately more likely to die from canine parvovirus (CPV) infection. DESIGN: Retrospective, January 2009 to March 2020. SETTING: A private, small animal, urban, referral emergency and specialty hospital. ANIMALS: Fifty-nine client-owned dogs hospitalized for treatment of CPV. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Dogs were divided into mSepsis-2 and mSepsis-3 categories based on the highest level of illness severity reached during hospitalization. Greater illness severity based on mSepsis-2 criteria (ie, sepsis, severe sepsis, septic shock) was associated with an increase in average length of stay (P&#xa0;<&#xa0;0.001), increase in average cost of stay (P&#xa0;<&#xa0;0.01), and presence of leukopenia (P&#xa0;<&#xa0;0.05). An increase in illness severity within the mSepsis-2 criteria was not associated with hyperlactatemia (P&#xa0;=&#xa0;0.29), presence of neutropenia (P&#xa0;=&#xa0;0.12), or mortality (P&#xa0;=&#xa0;0.35). Greater illness severity based on mSepsis-3 criteria (ie, infection only, sepsis, septic shock) was associated with an increase in mortality (P&#xa0;<&#xa0;0.05), increase in average length of stay (P&#xa0;<&#xa0;0.001), increase in average cost of stay (P&#xa0;<&#xa0;0.01), presence of leukopenia (P&#xa0;<&#xa0;0.01), and presence of neutropenia (P&#xa0;<&#xa0;0.05). The mSepsis-3 criteria were not associated with the presence of hyperlactatemia (P&#xa0;=&#xa0;0.68). There was no significant difference between survivors and nonsurvivors in the presence of leukopenia (P&#xa0;=&#xa0;0.19), neutropenia (P&#xa0;=&#xa0;0.67), or hyperlactatemia (P&#xa0;=&#xa0;0.58). CONCLUSIONS: The mSepsis-3 diagnostic criteria appear to better identify dogs with CPV at higher risk for mortality compared to the mSepsis-2 criteria.