Prospective evaluation of the Animal Trauma Triage Score and Modified Glasgow Coma Scale in 25 cats with high-rise syndrome

Abstract

Objectives The purpose of this study was to prospectively evaluate the prognostic utility of the Animal Trauma Triage Score (ATTS) and Modified Glasgow Coma Scale (MGCS) in cats with high-rise syndrome. Methods ATTS and MGCS were obtained upon arrival from 25 client-owned cats presented for high-rise syndrome. Cases were followed during hospitalisation and several variables, including outcome, were recorded. Results The mortality rate in this cohort of cats with high-rise syndrome was 16%. Univariate statistical analysis showed that lactate ( P = 0.022), creatinine ( P = 0.01), body weight ( P = 0.036) and ATTS ( P = 0.02) were higher and MGCS ( P = 0.011) lower among non-survivors. Multivariable statistical analysis showed that ATTS was the only factor significantly associated with mortality (odds ratio 2.41, 95% confidence interval [CI] 1.02–5.71; P = 0.046). A receiver operating characteristics curve showed that ATTS was an excellent predictor of mortality (area under the curve 0.917, 95% CI 0.8–1.0; P = 0.009). An ATTS cut-off of 6.0 had a 75% sensitivity and 90% specificity for non-survival and a cut-off of 10 had a 25% sensitivity and 100% specificity for non-survival. Conclusions and relevance ATTS is predictive of severity and outcome in cats with high-rise syndrome and can help facilitate decision-making by owners and veterinarians.

Clinical parameters at time of admission as prognostic indicators in cats presented for trauma to an emergency centre in New Zealand: a retrospective analysis

“…These results corroborate findings from other previous studies in cats with ‘all-cause trauma’ 21 and specific causes of injury, namely high rise syndrome 20 and bite wounds. 19 Severity of illness scores could be used to aid owner decision-making; 20 however, score-based euthanasia is not appropriate in any clinical context as false positives can lead to unnecessary measures being taken. 46 Ultimately, prognostic indicators should be used with caution in clinical settings to avoid them becoming ‘self-fulfilling prophesies’.…”

“…17 The present study showed similar results, as an ATT score ⩾5 resulted in a significantly decreased likelihood of survival, although the distribution of scores in our data set precluded a precise quantitative analysis of the scale. These results corroborate findings from other previous studies in cats with ‘all-cause trauma’ 21 and specific causes of injury, namely high rise syndrome 20 and bite wounds. 19 Severity of illness scores could be used to aid owner decision-making; 20 however, score-based euthanasia is not appropriate in any clinical context as false positives can lead to unnecessary measures being taken.…”

“…We aimed to determine whether the ATT and MGCS scores perform similarly to the predominantly northern hemisphere populations in previous studies. 17,[19][20][21] We hypothesised that changes in admission perfusion parameters -defined as mentation, heart rate, pulse quality, capillary refill time and rectal temperature -would correlate with the outcomes.…”

Potential Factors Influencing Complete Functional Recovery in Traumatized Unowned Cats with Orthopedic Lesions—A Cohort Study

“…The small size of the feline patients predisposed them to multiple and more severe injuries following a traumatic event [ 28 ]. On the contrary, heavier cats were less likely to survive from high-rise syndrome in a recent study [ 29 ]. Probably, the forces generated by the traumatic impact from road traffic accidents are distributed over the body surface and larger animals can absorb and dissipate forces more than smaller ones [ 28 ], whereas heavier cats falling from a height produces a stronger impact force when they reach the landing surface [ 29 ].…”

“…On the contrary, heavier cats were less likely to survive from high-rise syndrome in a recent study [ 29 ]. Probably, the forces generated by the traumatic impact from road traffic accidents are distributed over the body surface and larger animals can absorb and dissipate forces more than smaller ones [ 28 ], whereas heavier cats falling from a height produces a stronger impact force when they reach the landing surface [ 29 ]. Hence, our results reinforce the hypothesis that smaller and lighter subjects suffer from more severe traumatic injuries, which are more complex to manage and jeopardize the possibility of restoring an acceptable function of the affected organs.…”