Evidence-based Decision making in Anaesthesia

What is the mortality rate in equine anaesthesia?
The results from a large prospective observational epidemiological multicentre study (confidential enquiry into perioperative equine fatalities [CEPEF]) carried out in the UK, provide accurate data regarding mortality in equine anaesthesia (1,2). These data indicate that approximately 1 in 100 healthy horses die during anaesthesia, which is a high mortality rate compared to humans, cats or dogs. Analysis of data collected by the researchers allowed potential contributors to the high risk of anaesthetic mortality to be highlighted.These results of the CEPEF study combined with other more recent studies investigating outcome during equine anaesthesia can be used to make informed decisions to improve equine anaesthetic management.

Causes of death during equine anaesthesia
By far the most common reasons for healthy horses to die during anaesthesia were cardiac arrest (33% of deaths) and fractures and myopathies during the recovery period (32% of deaths). The remaining deaths were attributed to a variety of causes including respiratory complications, post-operative haemorrhage or “found dead”. These findings highlight the significance of cardiovascular complications and poor recoveries from anaesthesia in contributing to the high mortality rate.

Risk factors for mortality
A multivariable model was developed to include significant terms associated with outcome, and odds ratios were calculated for different factors to assess their impact on mortality. [...]