Risk factors influencing death prior to discharge in 302 dogs undergoing unilateral adrenalectomy for treatment of primary adrenal gland tumours.

IF 2.3 2区 农林科学 Q1 VETERINARY SCIENCES Veterinary and comparative oncology Pub Date : 2023-12-01 Epub Date: 2023-08-31 DOI:10.1111/vco.12931
Hunter J Piegols, Brittany E Abrams, Janis M Lapsley, Megan T Cray, Josephine A Dornbusch, Christina Murphy, Brandan G Wustefeld-Janssens, Carlos H Souza, Marine Traverson, Pierre Amsellem, Elroy Williams, Owen T Skinner, Julius M Liptak, Julie A Stephens, Laura E Selmic
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Abstract

Adrenalectomies for canine adrenal tumours are associated with peri-operative morbidity and mortality. Objectives of this study included assessing the prognostic value of tumour- or surgery-related variables in predicting peri-operative mortality and overall survival in dogs undergoing adrenalectomies for primary adrenal tumours as well as pre-treatment with phenoxybenzamine on survival to discharge with pheochromocytomas specifically. A multi-institutional retrospective cohort study was performed across nine institutions. Electronic medical record searches identified 302 dogs which met the inclusion criteria. Data collected included dog-related, tumour-related, treatment-related, surgery-related, and outcome variables. Univariate and multivariable logistic regression and cox proportional hazards models were used to identify variables associated with death prior to discharge and tumour-related survival. Overall, 87% of dogs survived to discharge with a tumour-related survival time of 3.96 years. Post-operative complications were reported in 25%. Increased surgical time (p = 0.002) and pre-surgical medical treatment other than phenoxybenzamine (p = 0.024) were significantly associated with increased peri-operative mortality while ureteronephrectomy (p = 0.021), post-operative pancreatitis (p = 0.025), and post-operative aspiration pneumonia (p < 0.001) were significantly associated with decreased overall survival. Phenoxybenzamine pretreatment had no effect on peri-operative mortality. Thirty-seven of 45 (82%) dogs with pheochromocytomas not pretreated survived to discharge, and 50 of 59 (85%) dogs with pheochromocytomas pretreated with phenoxybenzamine survived to discharge (p = 0.730). This study provides information on risk factors for death prior to discharge and tumour-related survival that may help guide clinical management and owner expectations. In addition, the study findings challenge the previously reported benefit of phenoxybenzamine for pretreatment of dogs undergoing adrenalectomies for pheochromocytomas.

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302只接受单侧肾上腺切除术治疗原发性肾上腺肿瘤的狗出院前死亡的危险因素
犬肾上腺肿瘤的肾上腺切除术与围手术期发病率和死亡率有关。本研究的目的包括评估肿瘤或手术相关变量在预测因原发性肾上腺肿瘤接受肾上腺切除术的狗的围手术期死亡率和总生存率方面的预后价值,以及苯氧苄胺预处理对嗜铬细胞瘤患者出院生存率的影响。一项跨九个机构的多机构回顾性队列研究。电子病历检索发现302只符合入选标准的狗。收集的数据包括与狗相关、与肿瘤相关、与治疗相关、与手术相关和结果变量。使用单变量和多变量逻辑回归和cox比例风险模型来确定与出院前死亡和肿瘤相关生存率相关的变量。总体而言,87%的狗存活出院,与肿瘤相关的存活时间为3.96 年。术后并发症发生率为25%。手术时间增加(p = 0.002)和除苯氧基苯丙胺以外的术前药物治疗(p = 0.024)与输尿管肾切除术后围手术期死亡率增加显著相关(p = 0.021)、术后胰腺炎(p = 0.025)和术后吸入性肺炎(p
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来源期刊
Veterinary and comparative oncology
Veterinary and comparative oncology 农林科学-兽医学
CiteScore
4.80
自引率
9.50%
发文量
75
审稿时长
>24 weeks
期刊介绍: Veterinary and Comparative Oncology (VCO) is an international, peer-reviewed journal integrating clinical and scientific information from a variety of related disciplines and from worldwide sources for all veterinary oncologists and cancer researchers concerned with aetiology, diagnosis and clinical course of cancer in domestic animals and its prevention. With the ultimate aim of diminishing suffering from cancer, the journal supports the transfer of knowledge in all aspects of veterinary oncology, from the application of new laboratory technology to cancer prevention, early detection, diagnosis and therapy. In addition to original articles, the journal publishes solicited editorials, review articles, commentary, correspondence and abstracts from the published literature. Accordingly, studies describing laboratory work performed exclusively in purpose-bred domestic animals (e.g. dogs, cats, horses) will not be considered.
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