Outcomes and prognostic factors of surgical treatments for brachycephalic obstructive airway syndrome in 3 breeds. Issue 2 (February 2017)

• Record Type: Journal Article
• Authors: Liu, Nai‐Chieh; Oechtering, Gerhard U.; Adams, Vicki J.; Kalmar, Lajos; Sargan, David R.; Ladlow, Jane F.
• Is Part Of: Veterinary surgery. Volume 46:Issue 2(2017)
• Page Start: 271
• Page End: 280
• Publication Date: 2017-02
• Subjects: Veterinary surgery -- Periodicals; Veterinary Medicine -- Periodicals; Surgery -- Periodicals; Societies, Medical -- Periodicals; 636.0897
• DOI: 10.1111/vsu.12608
• Languages: English
• ISSNs: 0161-3499

Abstract

Abstract: Objective: To determine prognostic indicators for the surgical treatment of brachycephalic obstructive airway syndrome (BOAS) and to compare the prognosis of 2 multilevel surgical procedures. Study Design: Prospective clinical study. Sample Population: Client‐owned pugs, French bulldogs, and bulldogs (n = 50). Methods: Noninvasive whole‐body barometric plethysmography (WBBP) was used to assess respiratory function before, 1 month and 6 months after upper airway corrective surgery. Postoperatively, BOAS indices (ie, ascending severity score generated from WBBP data, 0%‐100%) that equaled to or exceeded the cut‐off values of BOAS in the diagnostic models were considered to have a "poor prognosis." A multivariate logistic regression was used to assess predictors for prognosis. Results: The median BOAS indices decreased after surgery (from 76% to 63%, P < .0001), although dogs with indices in this range would still be considered clinically affected. Age (odds ratios [OR] = 0.96, 95% confidence interval [CI]: 0.93‐0.99, P < .05), body condition (OR = 0.06, 95% CI: 0.01‐0.39, P < .01), laryngeal collapse (OR = 6.1, 95% CI: 1‐37.22, P < .05), and surgical techniques (OR = 7.94, 95% CI: 1.17‐54.01, P < .05) were associated with postoperative prognosis. The multivariate model suggests modified multilevel surgery (MMS) may have a better outcome than traditional multilevel surgery (TMS) ( P = .034). The positive predictive value of the logistic model was 84% (95% CI: 68‐94%) and the area under the receiver operating characteristic (ROC) curve was 89% (95% CI: 78‐99%, P <.0001). Conclusions: Younger age, normal body condition, presence of laryngeal collapse, and treatment with TMS were negative prognostic factors after surgical treatment of BOAS. MMS is recommended, particularly in dogs with a higher probability of poor prognosis.