Risk Factors for Death in Dogs Treated for Esophageal Foreign Body Obstruction: A Retrospective Cohort Study of 222 Cases (1998–2017)

A. G. Burton, C. T. Talbot, Michael S Kent

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background: Limited data exist describing risk factors for death, and long-term outcomes in dogs with esophageal foreign body (EFB) obstruction. Hypothesis/Objectives: To evaluate short- and long-term outcomes, and analyze risk factors for death in dogs with EFB obstruction. We hypothesized duration of entrapment and treatment type would affect outcome. Animals: A total of 222 dogs were treated for EFB obstruction at an emergency and referral hospital between March 1998 and March 2017. Methods: Medical records for dogs with EFB were retrospectively evaluated. Results: Foreign material most frequently was osseous (180/222 [81%]), with distal esophagus the most common location (110/222 [49.5%]). Duration of clinical signs was not associated with risk of death (OR = 1.08, 95% CI 0.99–1.17; P = 0.2). Entrapment was treated by endoscopy (204/222 [91.8%]), surgery after endoscopic attempt (13/222 [5.9%]), and repeat endoscopy after surgery was recommended but declined (5/222 [2.3%]). In-hospital case fatality rate was 11/222 (5%). Risk of death was significantly higher with surgery (OR = 20.1, 95% CI 3.59–112.44; P = 0.001), and 5/5 (100%) of dogs died if undergoing endoscopy after surgery was recommended but declined. Increasing numbers of postprocedural complications (OR = 3.44, CI 2.01–5.91; P < 0.001), esophageal perforation (OR = 65.47, CI 4.27–1004.15; P = 0.003), and postprocedure esophageal hemorrhage (OR = 11.81, CI 1.19–116.77; P = 0.04) increased in-hospital risk of death. Esophageal strictures were reported in 4/189 (2.1%) of survivors available for follow-up. Conclusions and Clinical Importance: Death is uncommon in canine EFB; however, treatment type affects outcome, and these data should be used to guide decision-making in dogs with EFB.

Original languageEnglish (US)
Pages (from-to)1686-1690
Number of pages5
JournalJournal of Veterinary Internal Medicine
Volume31
Issue number6
DOIs
StatePublished - Nov 1 2017

Fingerprint

foreign bodies
intestinal obstruction
Foreign Bodies
cohort studies
Cohort Studies
risk factors
Retrospective Studies
Dogs
death
dogs
endoscopy
Endoscopy
surgery
Esophageal Perforation
Esophageal Stenosis
duration
Esophagus
Medical Records
esophagus
Survivors

Keywords

  • Canine
  • Endoscopy
  • Esophageal stricture
  • Esophagitis
  • Esophagoscopy

ASJC Scopus subject areas

  • veterinary(all)

Cite this

Risk Factors for Death in Dogs Treated for Esophageal Foreign Body Obstruction : A Retrospective Cohort Study of 222 Cases (1998–2017). / Burton, A. G.; Talbot, C. T.; Kent, Michael S.

In: Journal of Veterinary Internal Medicine, Vol. 31, No. 6, 01.11.2017, p. 1686-1690.

Research output: Contribution to journalArticle

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abstract = "Background: Limited data exist describing risk factors for death, and long-term outcomes in dogs with esophageal foreign body (EFB) obstruction. Hypothesis/Objectives: To evaluate short- and long-term outcomes, and analyze risk factors for death in dogs with EFB obstruction. We hypothesized duration of entrapment and treatment type would affect outcome. Animals: A total of 222 dogs were treated for EFB obstruction at an emergency and referral hospital between March 1998 and March 2017. Methods: Medical records for dogs with EFB were retrospectively evaluated. Results: Foreign material most frequently was osseous (180/222 [81{\%}]), with distal esophagus the most common location (110/222 [49.5{\%}]). Duration of clinical signs was not associated with risk of death (OR = 1.08, 95{\%} CI 0.99–1.17; P = 0.2). Entrapment was treated by endoscopy (204/222 [91.8{\%}]), surgery after endoscopic attempt (13/222 [5.9{\%}]), and repeat endoscopy after surgery was recommended but declined (5/222 [2.3{\%}]). In-hospital case fatality rate was 11/222 (5{\%}). Risk of death was significantly higher with surgery (OR = 20.1, 95{\%} CI 3.59–112.44; P = 0.001), and 5/5 (100{\%}) of dogs died if undergoing endoscopy after surgery was recommended but declined. Increasing numbers of postprocedural complications (OR = 3.44, CI 2.01–5.91; P < 0.001), esophageal perforation (OR = 65.47, CI 4.27–1004.15; P = 0.003), and postprocedure esophageal hemorrhage (OR = 11.81, CI 1.19–116.77; P = 0.04) increased in-hospital risk of death. Esophageal strictures were reported in 4/189 (2.1{\%}) of survivors available for follow-up. Conclusions and Clinical Importance: Death is uncommon in canine EFB; however, treatment type affects outcome, and these data should be used to guide decision-making in dogs with EFB.",
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N2 - Background: Limited data exist describing risk factors for death, and long-term outcomes in dogs with esophageal foreign body (EFB) obstruction. Hypothesis/Objectives: To evaluate short- and long-term outcomes, and analyze risk factors for death in dogs with EFB obstruction. We hypothesized duration of entrapment and treatment type would affect outcome. Animals: A total of 222 dogs were treated for EFB obstruction at an emergency and referral hospital between March 1998 and March 2017. Methods: Medical records for dogs with EFB were retrospectively evaluated. Results: Foreign material most frequently was osseous (180/222 [81%]), with distal esophagus the most common location (110/222 [49.5%]). Duration of clinical signs was not associated with risk of death (OR = 1.08, 95% CI 0.99–1.17; P = 0.2). Entrapment was treated by endoscopy (204/222 [91.8%]), surgery after endoscopic attempt (13/222 [5.9%]), and repeat endoscopy after surgery was recommended but declined (5/222 [2.3%]). In-hospital case fatality rate was 11/222 (5%). Risk of death was significantly higher with surgery (OR = 20.1, 95% CI 3.59–112.44; P = 0.001), and 5/5 (100%) of dogs died if undergoing endoscopy after surgery was recommended but declined. Increasing numbers of postprocedural complications (OR = 3.44, CI 2.01–5.91; P < 0.001), esophageal perforation (OR = 65.47, CI 4.27–1004.15; P = 0.003), and postprocedure esophageal hemorrhage (OR = 11.81, CI 1.19–116.77; P = 0.04) increased in-hospital risk of death. Esophageal strictures were reported in 4/189 (2.1%) of survivors available for follow-up. Conclusions and Clinical Importance: Death is uncommon in canine EFB; however, treatment type affects outcome, and these data should be used to guide decision-making in dogs with EFB.

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