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Complications and the Long Term Prognosis for Colic Patients and the Cost of Treatment
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As colic surgery has become more successful the average surgical patient now has an 80% chance of survival to discharge from the hospital. This increased survival rate has turned the focus into post-operative complications. These are unpleasant for the patient and costly for the owner, often adding considerably to the final bill for treatment. Recognising risk factors for these complications has allowed us to test strategies for minimising them. This presentation will review the major post-operative complications of colic surgery:
- Post-operative colic.
- Wound infection.
- Jugular thrombosis.
- Post-operative ileus.
- Re-laparotomy.
- Incisional hernias.
Endotoxaemia is a risk factor common to several of these post-operative complications. Early surgery, before the onset of severe endotoxaemia will minimise the risk of such complications occurring as well as maximising post-operative prognosis.
Studies of long-term prognosis have identified a number of predictive clinical parameters. These will be reviewed in relation to specific colic types. The key conclusions of work on long-term prognosis are: 1) Clinical signs of endotoxaemia are associated with reduced short-term and long-term survival; 2) age, up to approximately 25 years old is not associated with any significant decrease in prognosis; and 3) Increasing duration of surgery is associated with decreasing prognosis.
The price of colic surgery in a UK referral hospital will be discussed in relation to the costs of offering this service. Methods of making this surgery affordable for clients will be considered.
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