Data-driven safety limits for assessing perianesthetic mortality risk in dogs and cats undergoing elective procedures

IF 1.9 2区农林科学 Q2 VETERINARY SCIENCES

Veterinary anaesthesia and analgesia Pub Date : 2025-03-20 DOI:10.1016/j.vaa.2025.03.008

Carina Salt , Jo Ann Morrison , Nate Spofford , Abigail O’Rourke

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引用次数: 0

Abstract

Objective

To create data-driven clinical pathology thresholds for routine blood tests to assess perianesthetic mortality risk in dogs and cats undergoing elective procedures.

Study design

Retrospective analysis.

Animals

Data from dogs and cats visiting Banfield hospitals between January 2019 and March 2023.

Methods

Using routinely collected veterinary data from dogs and cats undergoing elective procedures at primary care veterinary practices, data-driven clinical pathology thresholds were calculated to identify perianesthetic mortality risk. This process involved simulation from a generalized additive model that estimated perianesthetic mortality risk, based on signalment data, procedure type, physical status classification and blood analyte values, with data collected between January 2019 and March 2023. The simulated data was used to test 400 potential thresholds. Optimal thresholds were chosen to maximize sensitivity (proportion of deaths correctly predicted) subject to limits on false positive rate (number of non-deaths incorrectly identified). These optimal limits were evaluated on observed data.

Results

Two levels of data-driven clinical pathology thresholds were determined, ‘stop’ and ‘critical stop’, with the latter more stringent. For the ‘stop’ limits, the overall median sensitivity on observed data was 7.16% (interquartile range 4.29%–9.88%) and 11.80% (11.00%–14.60%) for dogs and cats, respectively, and the overall median false positive rate was 2.65% (2.40%–3.31%) and 8.25% (6.86%–9.66%) for dogs and cats, respectively. Albumin, hematocrit, neutrophils and white blood cells were identified as having strong evidence for their utility in creating thresholds for dogs. Neutrophils showed strong evidence for thresholds for cats. These new data-driven thresholds offer more consistent and quantifiable false positive rates and increased sensitivities compared with existing limits. However, weaker evidence resulted in fewer useful thresholds for cats owing to lower data availability.

Conclusions and clinical relevance

It is possible to use routinely collected data to create data-driven clinical pathology thresholds for blood tests to identify animals at increased risk of perianesthetic mortality.

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数据驱动的安全限制评估围麻醉期狗和猫接受选择性手术的死亡风险。

目的：为常规血液检查创建数据驱动的临床病理阈值，以评估接受选择性手术的狗和猫的围麻醉期死亡风险。研究设计：回顾性分析。动物：2019年1月至2023年3月期间访问班菲尔德医院的狗和猫的数据。方法：使用常规收集的在初级保健兽医诊所接受选择性手术的狗和猫的兽医数据，计算数据驱动的临床病理阈值，以确定围麻醉期死亡风险。该过程涉及从广义相加模型进行模拟，该模型根据信号数据、手术类型、身体状态分类和血液分析物值估计麻醉周围死亡风险，数据收集于2019年1月至2023年3月。模拟数据用于测试400个潜在阈值。选择最佳阈值以最大限度地提高灵敏度（正确预测的死亡比例），同时限制假阳性率（错误识别的非死亡人数）。根据观测数据对这些最佳限度进行了评价。结果：确定了两个级别的数据驱动的临床病理阈值，“停止”和“临界停止”，后者更为严格。对于“停止”限制，狗和猫对观察数据的总体中位数敏感性分别为7.16%（四分位数间为4.29%-9.88%）和11.80%(11.00%-14.60%)，狗和猫的总体中位数假阳性率分别为2.65%（2.40%-3.31%）和8.25%（6.86%-9.66%）。白蛋白、红细胞压积、中性粒细胞和白细胞被认为有强有力的证据证明它们在为狗创造阈值方面的效用。中性粒细胞对猫的阈值有强有力的证据。与现有的限制相比，这些新的数据驱动的阈值提供了更一致和可量化的假阳性率，并提高了灵敏度。然而，由于数据可用性较低，证据较弱导致猫的有用阈值较低。结论和临床意义：有可能使用常规收集的数据来创建数据驱动的临床病理阈值，用于血液检查，以识别麻醉周围死亡风险增加的动物。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Veterinary anaesthesia and analgesia 农林科学-兽医学

CiteScore

3.10

自引率

17.60%

发文量

审稿时长

97 days

期刊介绍： Veterinary Anaesthesia and Analgesia is the official journal of the Association of Veterinary Anaesthetists, the American College of Veterinary Anesthesia and Analgesia and the European College of Veterinary Anaesthesia and Analgesia. Its purpose is the publication of original, peer reviewed articles covering all branches of anaesthesia and the relief of pain in animals. Articles concerned with the following subjects related to anaesthesia and analgesia are also welcome: the basic sciences; pathophysiology of disease as it relates to anaesthetic management equipment intensive care chemical restraint of animals including laboratory animals, wildlife and exotic animals welfare issues associated with pain and distress education in veterinary anaesthesia and analgesia. Review articles, special articles, and historical notes will also be published, along with editorials, case reports in the form of letters to the editor, and book reviews. There is also an active correspondence section.