Clinical findings associated with development of postoperative reflux and short-term survival after small intestinal surgery in geriatric and mature nongeriatric horses.

Abstract

OBJECTIVE: To determine risk factors, especially age, associated with postoperative reflux (POR; >2&#x2009;L of reflux present upon intubation), high-volume POR (&#x2265;20&#x2009;L in 24&#x2009;hours), and short-term outcome after small intestinal (SI) surgery. STUDY DESIGN: Retrospective case-control study. SAMPLE POPULATION: Horses aged &#x2265;16&#x2009;years (geriatric; range, 16-30; n&#x2009;=&#x2009;44) and&#x2009;<16&#x2009;years (mature; range, 2-15; n&#x2009;=&#x2009;39) with an SI surgical lesion that survived general anesthesia and did not have a second exploratory celiotomy during the same visit. METHODS: Medical records (2009-2015) were reviewed; perioperative variables were evaluated for associations with outcomes by using multivariable logistic regression. RESULTS: Postoperative reflux was associated with an increasing packed cell volume at admission (odds ratio [OR], 1.08; 95% CI, 1.00-1.16; P&#x2009;=&#x2009;.042) and presence of nasogastric reflux at admission (OR, 4.61; 95% CI, 1.3-15.69; P&#x2009;=&#x2009;.014). High-volume POR was associated with an increasing glycemia at admission (OR, 1.19; 95% CI, 1.01-1.40; P&#x2009;=&#x2009;.041), presence of nasogastric reflux at admission (OR, 10.05; 95% CI, 2.21-45.74; P&#x2009;=&#x2009;.003), and SI resection (OR, 10.52; 95% CI, 1.81-61.25; P&#x2009;=&#x2009;.009). Increasing surgical time (OR, 2.50; 95% CI, 1.16-5.29; P&#x2009;=&#x2009;.019) and high-volume POR (OR, 6.37; 95% CI, 2.12-19.12; P&#x2009;=&#x2009;.001) were associated with nonsurvival. CONCLUSION: Age, considered as both a continuous variable and a categorical variable, was not associated with the development of POR, high-volume POR, or nonsurvival. CLINICAL SIGNIFICANCE: Age does not influence the occurrence of POR and should not negatively impact an owner's decision to pursue surgery in aged horses.