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Higher body mass index may increase the risk for the development of incisional complications in horses following emergency ventral midline celiotomy.

BACKGROUND
Obesity is common in the equine population and it has been associated with increased surgical morbidity and mortality in humans. The effect of increased body mass index (BMI) on the incidence of surgical site infections has not been investigated in horses OBJECTIVES: To determine if horses with increased body fat, as estimated by BMI, are more likely to develop post-operative complications, particularly incisional complications, following emergency ventral midline celiotomy STUDY DESIGN: Retrospective, multi-institutional clinical study.


METHODS
Medical records of horses >2 years old presenting with colic that underwent ventral midline celiotomy between January 2010 and September 2018 with follow-up of a minimum of 30 post-operative days were reviewed. Extracted data included signalment, operative details, and outcome. BMI was calculated by dividing the patient's weight (kg) by the withers height squared (m2 ).


RESULTS
Two hundred and eighty-seven horses fit inclusion criteria. Incisional complication prevalence was 23.7%. Horses with incisional complications had a higher BMI (median 203.6 kg/m2 , IQR=191.5-217.4) compared with those without (median 199.1 kg/m2 , IQR=184.7-210.2) (p=0.03). Multivariable analysis of the effects of age, sex, breed, and presence of metabolic disease on the association between BMI and risk of incisional complications, identified a tendency towards increased risk with a higher BMI, but statistical significance decreased to p=0.07. Breed had an association with BMI (p<0.01), but not with incisional complication risk.


MAIN LIMITATIONS
BMI as an estimate of body fat has limitations. Retrospective studies with reliance on owners reporting data and complete medical records is imperfect. When the data was subjected to multi-variable analysis the trend toward an increased incidence of incisional complications in horses with higher BMI persisted but it was not statistically significant.


CONCLUSION
Higher BMI may increase the risk for the development of incisional complications in horses following emergency ventral midline celiotomy.