Diagnostic and prognostic value of plasma D-dimer concentration in horses with colic

peer reviewedIntroduction/Objectives: Coagulopathies in horses with gastrointestinal problems seem to be associated with diagnosis and out come. The aim of the present study was to assess the diagnostic and prognostic value of plasma D-Dimer concentration in horses with colic. Methods: Prospective observational clinical study. Horses presented for colic were grouped according to diagnosis/treatment received, outcome and the presence or absence of subclinical DIC. Plasma D-Dimer concentration was measured on admission, together with clotting times (PT and aPTT) and antithrombin activity. Positive Likelihood Ratios (LR1) and logistic regression models were used to determine cut-off values and to obtain a prediction model for the outcome of the colic patient. Results: The study included 493 horses. Horses with enteritis or peritonitis had significantly higher D-Dimer concentration and presented more severe coagulopathies. Non-survivors had significantly higher D-Dimer concentration than survivors, and 79.5% of discharged horses had values under 1,000 ng/mL. The percentage of subclinical DIC was higher in horses with enteritis, peritonitis, and non-survivors. Values of D-Dimer concentration above 3,900 ng/mL showed a LR1of 6.4. The logistic regression model resulted in an OR 5 8.8 (95%CI 5 4.52 to 17.05) for non-survival when D-dimer values on admission were around 4,000 ng/mL. Discussion: Both the results of LR1and logistic regression models suggested that a potential cut-off value for D-Dimer concentration on admission useful to orientate outcome of the colic patient in this population could be found above 4,000 ng/mL. Conclusions: Plasma D-Dimer concentration determined on admission can be useful for diagnosis and prognosis purposes in horses with colic