Distribution of mortality patterns in cats with naturally occurring trauma: A Veterinary Committee on Trauma registry study. (December 2021)

• Record Type: Journal Article
• Authors: Hickey, M.C.; Gray, R.; van Galen, G.; Ward, M.P.
• Is Part Of: Veterinary journal. Volume 278(2021)
• Publication Date: 2021-12
• Subjects: Composite and component Animal Trauma Triage (ATT) score -- Modified Glasgow Coma Scale (MGCS) score; Veterinary medicine -- Periodicals; 636
• DOI: 10.1016/j.tvjl.2021.105765
• Languages: English
• ISSNs: 1090-0233

Abstract

Highlights: The overall post-trauma feline mortality rate (MR) was 17.2%. Most mortalities were due to euthanasia. The MR for natural death or euthanasia due to a grave prognosis was 8.1%. Most mortalities occurred <1 day after presentation, classified as early death (ED). Compared to ED, odds of delayed death increased with higher Modified Glasgow Coma Scale score. Abstract: A greater understanding of the prognostic variables that affect the timing of death for cats with trauma may help clinicians select treatments and monitoring plans. This study investigated the mortality rate and its distribution pattern in a large population of cats to identify variables associated with the timing of trauma-related deaths. Clinical data was retrieved from the Veterinary Committee on Trauma database to determine mortality rates and timing of deaths, defined as early death (ED; <1 day post-presentation) or delayed death (DD; ≥1 day post-presentation). Multivariable logistic regression analyses were performed to identify characteristics and interventions that best predicted timing of death. Overall mortality rate for 6703 feline trauma patients with complete records was 17.2%, with 7.6% due to natural death and 92.3% due to euthanasia. Among the subset of 543 cats with trauma that died after presentation or required euthanasia due to a grave prognosis (representing an 8.1% mortality rate), EDs were more common (71.7%) than DD and the cause of death was not significantly associated with the timing of death. Clinical pathology parameters were unable to identify animals more likely to die or to require euthanasia due to a poor prognosis during hospitalisation. Factors that were significantly different for cats with ED vs. DD included the median cumulative results for the Modified Glasgow Coma Scale (MGCS) score and the Animal Trauma Triage (ATT) score, the presence of spinal trauma, administration of blood products and undertaking surgical procedures. An increased likelihood of DD rather than ED was associated with the administration of blood products (odds ratio [OR], 3.959; P = 0.019) vs. not, performing a surgical procedure (OR, 6.055; P < 0.001) vs. not, and a cumulative MGCS of 15−17 or 18 (OR, 1.947 and 3.115; P = 0.031 and P = 0.01, respectively) vs. a cumulative MGCS ≤ 11.