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英国初级兽医护理下犬单侧颅交叉韧带断裂诊断及临床管理的风险因素。

Risk factors for unilateral cranial cruciate ligament rupture diagnosis and for clinical management in dogs under primary veterinary care in the UK.

作者信息

Pegram C, Brodbelt D C, Diaz-Ordaz K, Chang Y, von Hekkel A Frykfors, Church D B, O'Neill D G

机构信息

Pathobiology and Population Sciences, The Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield Herts AL9 7TA, UK.

Pathobiology and Population Sciences, The Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield Herts AL9 7TA, UK.

出版信息

Vet J. 2023 Feb;292:105952. doi: 10.1016/j.tvjl.2023.105952. Epub 2023 Jan 25.

Abstract

This study aimed to evaluate demographic risk factors associated with unilateral cranial cruciate ligament (CCL) rupture diagnosis and to explore demographic and clinical risk factors associated with management of unilateral CCL rupture in dogs under primary veterinary care in the UK. A retrospective cohort study design was used. Clinical records were automatically searched and manually verified for incident cases of unilateral CCL rupture during 2019 and additional clinical management information extracted. Multivariable logistic regression modelling was used to evaluate associations between risk factors and: (1) CCL rupture diagnosis; and (2) clinical management (surgical or non-surgical). The analysis included 1000 unilateral CCL rupture cases and a random selection of 500,000 non-cases. After accounting for confounding factors, dogs aged 6 to < 9 years, male neutered and female neutered dogs, insured dogs, and Rottweiler, Bichon Frise, and West Highland White terrier breeds, in particular, had increased odds of unilateral CCL rupture diagnosis. Insured dogs and dogs ≥ 20 kg had increased odds of surgical management, while dogs ≥ 9 years and dogs with one non-orthopaedic comorbidity at diagnosis with CCL rupture had reduced odds. These findings inform identification of at-risk dogs, with Rottweilers and Bichon Frise particularly predisposed. Additionally, they contribute to a greater understanding of the clinical rationales used in primary-care veterinary practices to decide between surgical or non-surgical management of unilateral CCL rupture.

摘要

本研究旨在评估与单侧颅交叉韧带(CCL)断裂诊断相关的人口统计学风险因素,并探讨在英国初级兽医护理下与犬单侧CCL断裂治疗相关的人口统计学和临床风险因素。采用回顾性队列研究设计。自动检索临床记录并人工核实2019年期间单侧CCL断裂的病例,并提取额外的临床治疗信息。使用多变量逻辑回归模型评估风险因素与以下方面之间的关联:(1)CCL断裂诊断;(2)临床治疗(手术或非手术)。分析纳入了1000例单侧CCL断裂病例和随机选取的500,000例非病例。在考虑混杂因素后,6至<9岁的犬、去势公犬和去势母犬、参保犬,特别是罗威纳犬、卷毛比雄犬和西高地白梗犬种,单侧CCL断裂诊断的几率增加。参保犬和体重≥20 kg的犬接受手术治疗的几率增加,而年龄≥9岁的犬以及在诊断CCL断裂时有一项非骨科合并症的犬接受手术治疗的几率降低。这些发现有助于识别高危犬,其中罗威纳犬和卷毛比雄犬尤其易感。此外,它们有助于更好地理解初级兽医护理实践中用于决定单侧CCL断裂手术或非手术治疗的临床依据。

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