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European outbreaks of atypical myopathy in grazing horses (2006–2009): determination of indicators for risk and prognostic factors

G van Galen, C Saegerman, C Marcillaud Pitel, F Patarin, H Amory, JD Baily, D Cassart, V Gerber, C Hahn, P Harris, et al. (2012) EQUINE VETERINARY JOURNAL. 44(5). p.621-625
abstract
Reasons for performing study: Appropriate management of atypical myopathy (AM) requires the establishment of an accurate diagnosis and prognosis. Furthermore, preventive measures to avoid AM need to be refined. Objectives: The aims of the study were as follows: 1) to improve the diagnosis of AM; 2) to identify prognostic predictors; and 3) to refine recommended preventive measures based on indicators of risk factors. Methods: An exploratory analysis of cases in Europe between 2006 and 2009 reported to the Atypical Myopathy Alert Group was conducted. Based on clinical data, reported cases were allocated into 2 groups: confirmed or highly probable AM (AM group; further divided into survivors and nonsurvivors); and cases with a low probability of having AM or with another final diagnosis (non-AM group). Using Welch's test and odds ratios corrected for multiple comparisons, the AM vs. non-AM groups were compared to identify indicators for diagnosis and risk factors, and survivors vs. nonsurvivors in the AM group were compared to identify prognostic factors. Sensitivity, specificity and positive and negative predictive values were calculated for specific clinical signs related to final diagnosis and outcome. Results: From 600 reported cases, 354 AM cases (survival rate of 26%) and 69 non-AM cases were identified, while there were insufficient data to categorise the remainder. Variables valuable for diagnosing AM compared with similar diseases were as follows: presence of dead leaves and wood and/or trees on pastures; sloping pastures; full-time pasture access; no food supplementation; normal body condition; pigmenturia; normothermia; and congested mucous membranes. Nonsurvival was associated with recumbency, sweating, anorexia, dyspnoea, tachypnoea and/or tachycardia. Survival was associated with remaining standing most of the time, normothermia, normal mucous membranes, defaecation and vitamin and antioxidant therapy. Conclusions and potential relevance: This study refines the list of risk factors for AM. Clinical signs valuable for diagnosis and prognosis have been identified, enabling clinicians to improve management of AM cases.
Please use this url to cite or link to this publication:
author
organization
year
type
journalArticle (original)
publication status
published
subject
keyword
atypical myopathy, MYOGLOBINURIA, prognostic predictors, rhabdomyolysis, epidemiology, pasture, horse, DEFICIENCY
journal title
EQUINE VETERINARY JOURNAL
Equine Vet. J.
volume
44
issue
5
pages
621 - 625
Web of Science type
Article
Web of Science id
000307729100023
JCR category
VETERINARY SCIENCES
JCR impact factor
2.286 (2012)
JCR rank
8/142 (2012)
JCR quartile
1 (2012)
ISSN
0425-1644
DOI
10.1111/j.2042-3306.2012.00555.x
language
English
UGent publication?
yes
classification
A1
copyright statement
I have transferred the copyright for this publication to the publisher
id
2123142
handle
http://hdl.handle.net/1854/LU-2123142
date created
2012-05-30 22:03:56
date last changed
2016-12-19 15:42:56
@article{2123142,
  abstract     = {Reasons for performing study: Appropriate management of atypical myopathy (AM) requires the establishment of an accurate diagnosis and prognosis. Furthermore, preventive measures to avoid AM need to be refined. Objectives: The aims of the study were as follows: 1) to improve the diagnosis of AM; 2) to identify prognostic predictors; and 3) to refine recommended preventive measures based on indicators of risk factors. Methods: An exploratory analysis of cases in Europe between 2006 and 2009 reported to the Atypical Myopathy Alert Group was conducted. Based on clinical data, reported cases were allocated into 2 groups: confirmed or highly probable AM (AM group; further divided into survivors and nonsurvivors); and cases with a low probability of having AM or with another final diagnosis (non-AM group). Using Welch's test and odds ratios corrected for multiple comparisons, the AM vs. non-AM groups were compared to identify indicators for diagnosis and risk factors, and survivors vs. nonsurvivors in the AM group were compared to identify prognostic factors. Sensitivity, specificity and positive and negative predictive values were calculated for specific clinical signs related to final diagnosis and outcome. Results: From 600 reported cases, 354 AM cases (survival rate of 26\%) and 69 non-AM cases were identified, while there were insufficient data to categorise the remainder. Variables valuable for diagnosing AM compared with similar diseases were as follows: presence of dead leaves and wood and/or trees on pastures; sloping pastures; full-time pasture access; no food supplementation; normal body condition; pigmenturia; normothermia; and congested mucous membranes. Nonsurvival was associated with recumbency, sweating, anorexia, dyspnoea, tachypnoea and/or tachycardia. Survival was associated with remaining standing most of the time, normothermia, normal mucous membranes, defaecation and vitamin and antioxidant therapy. Conclusions and potential relevance: This study refines the list of risk factors for AM. Clinical signs valuable for diagnosis and prognosis have been identified, enabling clinicians to improve management of AM cases.},
  author       = {van Galen, G and Saegerman, C and Marcillaud Pitel, C and Patarin, F and Amory, H and Baily, JD and Cassart, D and Gerber, V and Hahn, C and Harris, P and Keen, JA and Kirschvink, N and Lef{\`e}re, Laurence and McGorum, B and Muller, JMV and Picavet, MTJE and Piercy, RJ and Roscher, K and Serteyn, D and Unger, L and van der Kolk, JH and van Loon, Gunther and Verwilghen, D and Westermann, CM and Votion, DM},
  issn         = {0425-1644},
  journal      = {EQUINE VETERINARY JOURNAL},
  keyword      = {atypical myopathy,MYOGLOBINURIA,prognostic predictors,rhabdomyolysis,epidemiology,pasture,horse,DEFICIENCY},
  language     = {eng},
  number       = {5},
  pages        = {621--625},
  title        = {European outbreaks of atypical myopathy in grazing horses (2006--2009): determination of indicators for risk and prognostic factors},
  url          = {http://dx.doi.org/10.1111/j.2042-3306.2012.00555.x},
  volume       = {44},
  year         = {2012},
}

Chicago
van Galen, G, C Saegerman, C Marcillaud Pitel, F Patarin, H Amory, JD Baily, D Cassart, et al. 2012. “European Outbreaks of Atypical Myopathy in Grazing Horses (2006–2009): Determination of Indicators for Risk and Prognostic Factors.” Equine Veterinary Journal 44 (5): 621–625.
APA
van Galen, G, Saegerman, C., Marcillaud Pitel, C., Patarin, F., Amory, H., Baily, J., Cassart, D., et al. (2012). European outbreaks of atypical myopathy in grazing horses (2006–2009): determination of indicators for risk and prognostic factors. EQUINE VETERINARY JOURNAL, 44(5), 621–625.
Vancouver
1.
van Galen G, Saegerman C, Marcillaud Pitel C, Patarin F, Amory H, Baily J, et al. European outbreaks of atypical myopathy in grazing horses (2006–2009): determination of indicators for risk and prognostic factors. EQUINE VETERINARY JOURNAL. 2012;44(5):621–5.
MLA
van Galen, G, C Saegerman, C Marcillaud Pitel, et al. “European Outbreaks of Atypical Myopathy in Grazing Horses (2006–2009): Determination of Indicators for Risk and Prognostic Factors.” EQUINE VETERINARY JOURNAL 44.5 (2012): 621–625. Print.