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J Vet Intern Med ; 33(2): 499-507, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30770578

RESUMO

BACKGROUND: Acute pancreatitis (AP) is associated with a high death rate in dogs, but accurate predictors of early death are still lacking. OBJECTIVES: To develop a scoring system for prediction of short-term case fatality in dogs with AP. ANIMALS: One hundred sixty-nine dogs with AP including 138 dogs in the training cohort and 31 dogs in the validation cohort. METHODS: Multicenter, retrospective cohort study. Survival analysis was used to assess the associations with short-term death (within 30 days after admission). Independent predictors of death were identified by a stepwise selection method and used for the score calculation. RESULTS: Death rate within 30 days after admission was 33% in the training cohort. Four independent risk factors for short-term death were identified in the training cohort: presence of systemic inflammatory response syndrome, coagulation disorders, increased creatinine and ionized hypocalcemia. Canine Acute Pancreatitis Severity (CAPS) score was developed to predict short-term death, integrating these 4 factors in a weighted way. A simplified version of CAPS score (sCAPS) including respiratory rate instead of SIRS was also assessed. The area under the receiver-operating characteristic curve (AUC) of CAPS and sCAPS scores was 0.92 in the training cohort with an optimal cutoff of 11 (sensitivity, 89%; specificity, 90%) and 6 (sensitivity, 96%; specificity, 77%), respectively. CAPS and sCAPS score were validated in the validation cohort with respective AUC of 0.91 and 0.96. CONCLUSIONS AND CLINICAL IMPORTANCE: We propose 2 scoring systems that allow early and accurate prediction of short-term death in dogs with AP.


Assuntos
Doenças do Cão/mortalidade , Pancreatite/veterinária , Doença Aguda , Animais , Estudos de Coortes , Cães , Feminino , Frequência Cardíaca , Hipocalcemia/veterinária , Masculino , Pancreatite/mortalidade , Valor Preditivo dos Testes , Curva ROC , Taxa Respiratória , Estudos Retrospectivos , Fatores de Risco , Sensibilidade e Especificidade , Análise de Sobrevida , Síndrome de Resposta Inflamatória Sistêmica/veterinária
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