# In-Depth Analysis of the Prognostic Factors Associated with Short-Term Outcome in Equine Colic Patients: Multicentric Retrospective Study

## TL;DR

This study identifies age and strangulating colic as key predictors of poor outcomes in horses with colic, using data from multiple clinics.

## Contribution

The study provides a multicenter, multivariable analysis confirming age and colic type as significant mortality predictors in equine colic.

## Key findings

- Strangulating lesions and older age are primary predictors of mortality in equine colic patients.
- Cardiovascular instability, SIRS escalation, and lactate surges are linked to poor outcomes.
- Multicenter data collection improves robustness despite limitations from site heterogeneity.

## Abstract

Numerous studies have investigated risk factors for equine colic and prognostic indicators, yet consensus remains elusive due to methodological variations. This retrospective analysis reviewed medical records from 236 colic cases across three equine clinics, collecting data on signalment (age, breed, sex), history, clinical exams, hematology, SIRS status and 0–6 point-scale SIRS score, lesion types (obstruction vs. strangulating), treatments (medical vs. surgical), and survival outcomes. Multivariate regression confirmed strangulating lesions and older age as primary predictors of mortality, reflecting ischemia, necrosis, and comorbidities. Multifactorial etiology of colic complicates management. Geriatric horses and vascular compromises heighten risks, amplified by cardiovascular instability, SIRS escalation (26–60% fatality), and lactate surges signaling hypoperfusion. These findings underscore serial monitoring for triage, though retrospective biases necessitate prospective validation.

Several studies investigated risk and prognostic parameters for horses with colic; however, the consensus is still debated. The present work aimed to investigate colic outcomes and to identify risk factors in horses referred for colic. In this multicenter retrospective study, 236 clinical records of equids referred for colic at three different equine centers were reviewed. The following data were collected: history, signalment, physical examination at the time of admission, hematological and biochemical analysis, diagnosis, SIRS status and 0–6 point-scale SIRS score, colic type, treatment attempted, and outcome. Descriptive statistics were performed, and distribution of continuous variables was reported as median and percentile. A multivariable logistic regression model was applied to assess parameters associated with colic outcomes in horses (p < 0.05). A total of 138/236 horses were included in the study. The univariate analysis identified as potentially associated with the outcome: sex (p = 0.046), colic type (p < 0.001), treatment type (p < 0.001), SIRS score (p = 0.049), age (p-value = 0.057), heart rate (p = 0.013), and respiratory rate (p = 0.017). The logistic regression model indicated that colic type (p < 0.001) and age (p = 0.004) were significantly associated with a negative outcome. Equine colic risks are multifactorial; prognosis declines with age and strangulating obstructive non-strangulating colic. Poor outcomes link to cardiovascular signs like elevated heart rate, SIRS status and score, and blood lactate. Heterogeneity from diverse sites limits generalizability, but standardized protocols, binarized data, and a multicenter approach enhance robustness and representativeness while reducing local biases.