New Diagnostic Score for Sepsis in Adult Horses with Acute Gastrointestinal Disease

Context: Colic is a major equine disease with significant medical and economic impacts. It remains a leading cause of mortality, due to its frequent progression to systemic inflammation and organ dysfunction. As in human medicine, these complications are associated with sepsis, defined as organ dysfunction caused by a dysregulated, life-threatening host response to infection. Unlike human medicine, no consensual score exists to identify sepsis in adult horses. Objective: Develop a diagnostic score of sepsis to improve management and prognosis in adult horses. Study design: Retrospective clinical study based on the analysis of medical records from colic cases in adult horses admitted to an equine emergency department. Methods: Clinical data from all adult horses admitted to the equine emergency department for colic between July 2011 and November 2021 were collected. Included horses were divided in sepsis or colic group according to their final diagnosis and all reported clinical parameters were analysed. A sepsis score was developed through univariate and multivariate analyses, with logistic regression used to establish the predictive score. The optimal score threshold was determined by maximizing sensitivity and specificity. Results : Among the 295 horses included, 93 (31.5%) met sepsis diagnosis. The selected model identified 6 discriminant parameters for sepsis: temperature, heart rate, leukocyte count, red blood cells, creatine kinase and lactate levels. This model demonstrated an accuracy of 79%, with a sensitivity of 59% and a specificity of 88%. At the chosen threshold value of 3 for the sepsis diagnostic score derived from this model, the sensitivity is 52.69%, the specificity is 91.58%, and the Youden index is 0.44. Main limitations: The score, based on a single-centre cohort, requires prospective validation in multicentre studies. Conclusions: This study proposes a quick diagnostic sepsis score for adult horses suffering from acute gastrointestinal disease.