Retrospective investigation of prognostic indicators for adult horses with infection of a synovial structure

Objective To investigate predictors of survival and athletic function in adult horses with infection of a synovial structure. Hypotheses Increasing duration from contamination to referral, bone or tendon involvement and positive microbial culture decreases short‐term survival. Synovitis and/or sepsis at 5 days post‐admission and involvement of Staphylococcus spp. decreases long‐term athletic function. Design Retrospective study. Methods Records over 4 years of adult horses with synovial sepsis were reviewed. A two‐tailed Fisher's exact test, Mann‐Whitney U test or t‐test was used to examine whether variables were predictive of short‐term survival and long‐term athletic function. Results During the study period 75 horses underwent treatment for infection of 93 synovial structures. Short‐term survival was 84% (63/75) and 54% (30/56) of horses returned to athletic function. Of the variables measured at admission, duration from contamination to referral did not affect survival, whereas evidence of bone or tendon involvement decreased survival and athletic function. Of the variables available during treatment, abnormal synovial fluid at 4–6 days post‐admission and positive microbial culture reduced athletic function. Staphylococcal infection was associated with persistent sepsis. Conclusions Of the variables available at presentation, only evidence of bone or tendon involvement negatively affected survival and athletic function. During treatment of synovial sepsis, analysis of synovial fluid at 4–6 days and bacterial culture results have prognostic value.