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D-Dimer Improves the Prognostic Value of Combined Clinical and Laboratory Data in Equine Gastrointestinal Colic
Authors:M Sandholm  A Vidovic  A Puotunen-Reinert  S Sankari  K Nyholm  H Rita
Institution:19.Department of Clinical Sciences, College of Veterinary Medicine, Hämeentie 57, SF-00580 Helsinki, Finland ;29.Hochmoor Tierklinik, Gescher-Hochmoor, Germany ;39.Department of Forest Resource Management/Statistics, University of Helsinki, Finland
Abstract:The discriminating ability of 15 parameters alone or in combinations, including results from analysis of plasma endotoxin, the Nycomed plasma D-Dimer test and phospholipase A2, were analyzed to predict morbidity and mortality in equine gastrointestinal colic. Endotoxaemia was a characteristic feature of the colic horses. The problem of adequately predicting non-survivors among colic horses required several parameters to be included in the logistic model: if the “classical parameters”, (heart rate, respiratory rate, PCV, anion gap) were included in the model, addition of plasma D-dimer, phospholipase A2, and Cl- significantly improved the predictive value of the logistic model. Increasing heart rate and D-dimer together with decreasing chloride was a risk factor for nonsurvival. The sensitivity of this three-parameter logistic model to predict nonsurvival was 78% and specificity 77%. The Nycomed D-Dimer test is recommended as a horse-site test to predict disseminated intravascular coagulation and nonsurvival in equine colic.
Keywords:horse  diagnosis  acute phase  mortality  inflammation  enzymes  sorbitol dehydrogenase  phospholipase  glutamate dehydrogenase  endotoxin  acid-base  thrombosis  fibrinolysis  DIC
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