Development and validation of a brachycephalic risk (BRisk) score to predict the risk of complications in dogs presenting for surgical treatment of brachycephalic obstructive airway syndrome.

Abstract

OBJECTIVE To develop and validate a preoperative brachycephalic risk (BRisk) score that objectively and accurately predicts the risk of major complications or death in dogs undergoing corrective surgery for brachycephalic obstructive airway syndrome (BOAS). STUDY DESIGN Retrospective multicenter cohort study. SAMPLE POPULATION Score development n = 233 dogs, validation n = 50 dogs. METHODS Data were collected on signalment, medical history, reason for presentation, physical examination, and preoperative diagnostic findings. The primary outcome measures included risk of major complications (requirement for postoperative oxygen support for >48 hours or postoperative temporary/permanent tracheostomy) or death within the hospitalization period. The score was developed by using data from two centers and was validated in a third center. The 10-point BRisk score was modeled on breed, history of previous surgery, concurrent procedures, body condition score, airway status, and admission rectal temperature. RESULTS The score was associated with negative outcome (P < .0001) and discriminated well in both the construction (area under the receiver operator characteristic [AUROC] = 0.83) and validation groups (AUROC = 0.84). Dogs with scores >3 were 9.1 times more likely to have a negative outcome (95% CI = 3.9-21.2) compared with dogs with scores ≤3. CONCLUSION The BRisk score developed from admission data in this study accurately rated the risk of negative outcome of dogs undergoing corrective surgery for BOAS. CLINICAL SIGNIFICANCE Preoperative determination of the BRisk score may assist triage, management of owner expectations, decision making regarding intervention selection, and characterization of populations in clinical research.