Development and validation of a brachycephalic risk (BRisk) score to predict the risk of complications in dogs presenting for surgical treatment of brachycephalic obstructive airway syndrome

Abstract

Objective To develop and validate a preoperative brachycephalic risk (BRisk) score that objectively and accurately predicts the risk of major complications or death in dogs undergoing corrective surgery for brachycephalic obstructive airway syndrome (BOAS). Study design Retrospective multicenter cohort study. Sample population Score development n = 233 dogs, validation n = 50 dogs. Methods Data were collected on signalment, medical history, reason for presentation, physical examination, and preoperative diagnostic findings. The primary outcome measures included risk of major complications (requirement for postoperative oxygen support for >48 hours or postoperative temporary/permanent tracheostomy) or death within the hospitalization period. The score was developed by using data from two centers and was validated in a third center. The 10‐point BRisk score was modeled on breed, history of previous surgery, concurrent procedures, body condition score, airway status, and admission rectal temperature. Results The score was associated with negative outcome (P < .0001) and discriminated well in both the construction (area under the receiver operator characteristic [AUROC] = 0.83) and validation groups (AUROC = 0.84). Dogs with scores >3 were 9.1 times more likely to have a negative outcome (95% CI = 3.9–21.2) compared with dogs with scores ≤3. Conclusion The BRisk score developed from admission data in this study accurately rated the risk of negative outcome of dogs undergoing corrective surgery for BOAS. Clinical significance Preoperative determination of the BRisk score may assist triage, management of owner expectations, decision making regarding intervention selection, and characterization of populations in clinical research.

Abordagem terapêutica da síndrome obstrutiva braquicefálica: revisão de literatura

“…A intervenção cirúrgica das alterações obstrutivas das vias aéreas anteriores é o tratamento de eleição para a doença (Trappler & Moore, 2011, Dupré & Heidenreich, 2016Tarricone, Hayes, Singh, Davis, 2019).…”

“…Considerando esse fato, preconiza-se a realização das correções cirúrgicas dos componentes da síndrome o mais precocemente possível, a partir dos seis meses de idade, o que proporciona melhor prognóstico e maior bem estar na vida adulta (Trappler & Moore, 2011;Dupré & Heidenreich, 2016). Entretanto boa resposta pós-operatória também são obtidos por pacientes mais velhos, conferindo-lhes melhores condições de vida (Haimel & Dupré, 2015;Tarricone, Hayes, Singh, & Davis, 2019).…”

“…A rinoplastia é o procedimento cirúrgico que objetiva modificar a forma ou o tamanho do nariz (Lodato & Hedlund, 2012). Nos cães braquicefálicos acometidos, esse procedimento visa excisão da asa da narina que causa a obstrução (Tarricone, Hayes, Singh, & Davis, 2019).…”

Development of a veterinary trauma score (VetCOT) in canine trauma patients with performance evaluation and comparison to the animal trauma triage score: A VetCOT registry study

“…Similar scoring systems are available in veterinary medicine and are becoming increasingly adopted for the description and analysis of clinical research populations. [5][6][7][8][9][10] In the last 10 years, veterinary trauma research has been empowered by the development of the American College of Veterinary Emergency and Critical Care (ACVECC) Veterinary Committee on Trauma (VetCOT) registry and the identification and subsequent verification of Level I and II veterinary trauma centers. These centers routinely contribute trauma patient data to the registry, which, at the time of writing, contains data acquired from over 41,000 animals.…”

Evaluation of plasmatic levels of CK-MB and C-Reactive Protein in brachicephalic dogs who have narin stenosis before and after diode laser rhinoplasty

“…In brachycephalics with stenosis of the nostrils, this procedure aims at opening the most anterior portion of the nostril, which causes the obstruction. It is a simple and easy to perform technique (Dupré & Heidenrich, 2016), with minimal surgical risk for the animal (Tarricone, Hayes, Singh & Davis, 2019).…”