D-DIMER IMPROVES THE PROGNOSTIC VALUE OF COMBINED CLINICAL AND LABORATORY DATA IN EQUINE GASTROINTESTINAL COLIC

The discriminating ability of 15 parameters alone or in combinations, including results from analysis of plasma endotoxin, the Nycomed plasm a D-Dimer test and phospholipase A(2), were analyzed to predict morbid ity and mortality in equine gastrointestinal colic. Endotoxaemia was a characteristic feature of the colic horses. The problem of adequately predicting nonsurvivors among colic horses required several parameter s to be included in the logistic model: if the ''classical parameters' ', (heart rate, respiratory rate, PCV, anion gap) were included in the model, addition of plasma D-dimer, phospholipase A(2), and Cl- signif icantly improved the predictive value of the logistic model. Increasin g heart rate and D-dimer together with decreasing chloride was a risk factor for nonsurvival. The sensitivity of this three-parameter logist ic model to predict nonsurvival was 78% and specificity 77%. The Nycom ed D-Dimer test is recommended as a horse-site test to predict dissemi nated intravascular coagulation and nonsurvival in equine colic.