Publicação
Canine parvovirus and sepsis : SIRS criteria evaluation and implemmentation of a PIRO classification
| Resumo: | Sepsis is a severe condition associated with high prevalence and mortality rates. Parvovirus enteritis is a predisposing factor for sepsis, as it promotes intestinal bacterial translocation and severe immunosuppression. This makes naturally parvovirus infected dogs a suitable study population as far as sepsis is concerned. The main objective of the present study was to evaluate the differences between two sets of SIRS (Systemic Inflammatory Response Syndrome) criteria in outcome prediction, parallelly the possibility of stratifying and classify septic animals using a proposed animal adapted PIRO (Predisposition, Infection, Response, Organ dysfunction) scoring system was also assessed. The 72 animals enrolled in this study were subjected to a score for each of the PIRO elements (except for the Infection, as all were considered to have the same infection score) and to two sets of SIRS criteria, assessing their correlation with the outcome. The data was retrieved from the clinical records of the Infectious Disease Isolation Unit (IDIU) of the Veterinary Teaching Hospital (VTH) of the Faculty of Veterinary Medicine (FMV) of the University of Lisbon (ULisboa). Concerning the SIRS criteria, it was found that the proposed alterations were significantly associated with the outcome (OR = 4.09, p < 0,05), contrasting with the original SIRS criteria (p=0.352) that did not correlate with the outcome. No significant statistical association was found between Predisposition (p=1), Response (p=0.1135), Organ dysfunction (p=0.1135) or total PIRO score (p=0.093) and outcome. The results obtained reveal the need for consensual and more specific criteria to assess SIRS and sepsis. The results suggest that augmenting the criteria specificity may improve their prognostic value, thus making them more useful in clinical management and treatment decision. This work represents a contribution for the development of an approved set of criteria, to could contribute not only to the classification of septic dogs but also to the improvement of sepsis diagnosis. Further studies are still needed to conclude about the best criteria to be used, but this study can serve as base from which further studies can adapt and improve. Additional more specific criteria, mainly inflammatory and organ dysfunction biomarkers, should be added to the proposed PIRO scoring system in order to improve the its´ prognostic value and clinical utility. Further studies should focus on improving classification systems and finding new biomarkers that would allow a timely intervention in sepsis affected animals and improve sepsis survival rate. |
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| Autores principais: | Alves, Frederico Silva de Sousa |
| Assunto: | Sepsis Canine parvovirus SIRS PIRO IDIU Parvovirus canino SRIS UIDI |
| Ano: | 2020 |
| País: | Portugal |
| Tipo de documento: | dissertação de mestrado |
| Tipo de acesso: | acesso aberto |
| Instituição associada: | Universidade de Lisboa |
| Idioma: | inglês |
| Origem: | Repositório da Universidade de Lisboa |
| Resumo: | Sepsis is a severe condition associated with high prevalence and mortality rates. Parvovirus enteritis is a predisposing factor for sepsis, as it promotes intestinal bacterial translocation and severe immunosuppression. This makes naturally parvovirus infected dogs a suitable study population as far as sepsis is concerned. The main objective of the present study was to evaluate the differences between two sets of SIRS (Systemic Inflammatory Response Syndrome) criteria in outcome prediction, parallelly the possibility of stratifying and classify septic animals using a proposed animal adapted PIRO (Predisposition, Infection, Response, Organ dysfunction) scoring system was also assessed. The 72 animals enrolled in this study were subjected to a score for each of the PIRO elements (except for the Infection, as all were considered to have the same infection score) and to two sets of SIRS criteria, assessing their correlation with the outcome. The data was retrieved from the clinical records of the Infectious Disease Isolation Unit (IDIU) of the Veterinary Teaching Hospital (VTH) of the Faculty of Veterinary Medicine (FMV) of the University of Lisbon (ULisboa). Concerning the SIRS criteria, it was found that the proposed alterations were significantly associated with the outcome (OR = 4.09, p < 0,05), contrasting with the original SIRS criteria (p=0.352) that did not correlate with the outcome. No significant statistical association was found between Predisposition (p=1), Response (p=0.1135), Organ dysfunction (p=0.1135) or total PIRO score (p=0.093) and outcome. The results obtained reveal the need for consensual and more specific criteria to assess SIRS and sepsis. The results suggest that augmenting the criteria specificity may improve their prognostic value, thus making them more useful in clinical management and treatment decision. This work represents a contribution for the development of an approved set of criteria, to could contribute not only to the classification of septic dogs but also to the improvement of sepsis diagnosis. Further studies are still needed to conclude about the best criteria to be used, but this study can serve as base from which further studies can adapt and improve. Additional more specific criteria, mainly inflammatory and organ dysfunction biomarkers, should be added to the proposed PIRO scoring system in order to improve the its´ prognostic value and clinical utility. Further studies should focus on improving classification systems and finding new biomarkers that would allow a timely intervention in sepsis affected animals and improve sepsis survival rate. |
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