Change language to Russian
FECAVA on Facebook
to FECAVA News
View other issues
of EJCAP online
Give your feedback
Summary of multivariable logistic regression models. Variables significantly associated with the outcome variable (P < 0.05) are indicated in bold typeface
The study found that markers of kidney function, bilirubin concentration and American Society of Anesthesiologists (ASA) classification are independently associated with outcome in dogs with IMHA; a multivariate model combining illness severity scores and clinicopathologic data (see table) correctly predicted outcome at discharge in 82% cases.
Calculation of CHAOS and Tokyo illness severity scores.
* 38.9 °C
CHAOS: predictive value
In the study, two previously published illness-severity scores (CHAOS and Tokyo) were prospectively evaluated for their ability to predict outcome in a population separate from that used to generate the score.
Of these two, only CHAOS (canine haemolytic anaemia score) was predictive of outcome in our population.
CHAOS ≥3 was associated with increased odds of death and in particular, a high CHAOS was associated with a risk of death during hospitalization.
Background: Outcome prediction in dogs with immune-mediated haemolytic anaemia (IMHA) is challenging and few prognostic indicators have been consistently identified.
Objectives: An online case registry was initiated to: prospectively survey canine IMHA presentation and management in the British Isles; evaluate two previously reported illness severity scores, Canine Haemolytic Anaemia Score (CHAOS) and Tokyo and to identify independent prognostic markers.
Animals: Data from 276 dogs with primary IMHA across 10 referral centres were collected between 2008 and 2012.
Methods: Outcome prediction by previously reported illness-severity scores was tested using univariate logistic regression. Independent predictors of death in hospital or by 30 days after admission were identified using multivariable logistic regression.
Results: Purebreds represented 89.1% dogs (n = 246). Immunosuppressive medications were administered to 88.4% dogs (n = 244), 76.1% (n = 210) received antithrombotics and 74.3%
(n = 205) received packed red blood cells. Seventy-four per cent of dogs (n = 205) were discharged from hospital and 67.7% (n = 187) were alive 30 days after admission. Two dogs were lost to follow-up at 30 days. In univariate analyses CHAOS was associated with death in hospital and death within 30 days. Tokyo score was not associated with either outcome measure. A model containing SIRS classification, ASA classification, ALT, bilirubin, urea and creatinine predicting outcome at discharge was accurate in 82% of cases. ASA classification, bilirubin, urea and creatinine were independently associated with death in hospital or by 30 days.
Conclusions and clinical importance: Markers of kidney function, bilirubin concentration and ASA classification are independently associated with outcome in dogs with IMHA. Validation of this score in an unrelated population is now warranted.
Key words: Canine haemolytic anaemia objective score; Immune-mediated haemolytic anaemia; Survival; Thromboembolism.
* This paper originally appeared in the Journal of Veterinary Internal Medicine 2015;29:1603–1610 DOI: 10.1111/jvim.13642
Robert A.N. Goggs
BVSc PhD DipACVECC Dip ECVECC
Cornell University College of Veterinary Medicine
930 Campus Road
Ithaca NY 14853
Robert Goggs qualified from the University of Liverpool in 2004. After qualifying, he became a clinical training scholar at the Royal Veterinary College of the University of London, and later Staff clinician in emergency and critical care. In 2008 he became diplomate of the American College of Veterinary Emergency and Critical Care. In 2010 he became the Wellcome Trust Research Training Fellow at School of Physiology and Pharmacology, University of Bristol, where he obtained his PhD (platelet biology) in 2013.
He moved to Cornell University in October 2013 as a Lecturer in Emergency and Critical Care at the College of Veterinary Medicine. In the same year, he became of Cornell University and in 2015, he also obtained his Dip ECVECC. He has authored and co-authored numerous original and review papers in peer-reviewed publications and book chapters. His principal research interests lie in platelet biology, coagulation and IMHA.
Volume 26(2), Summer 2016
Predicting Outcome in dogs with Primary Immune-Mediated Haemolytic Anaemia: Results of a Multicentre Case Registry
by Robert Goggs, Simon G. Dennis, Andrea Di Bella, Karen R. Humm,
Gerard McLauchlan, Carmel Mooney, Alison Ridyard, Simon Tappin, David Walker, Sheena Warman, Nat Whitley, David Brodbelt and Daniel L. Chan
In the study, two previously published illness-severity scores (CHAOS and Tokyo) were prospectively evaluated for their ability to predict outcome in a population separate from that ...
... Read More
The study found that markers of kidney function, bilirubin concentration and American Society of Anesthesiologists (ASA) classification are ...
... Read more
Background: Outcome prediction in dogs with immune-mediated haemolytic anaemia (IMHA) is challenging and few prognostic indicators have been consistently identified. ...
... Read More