Evaluation of outcome associated with feline trauma: A Veterinary Committee on Trauma registry study

J Vet Emerg Crit Care (San Antonio). 2023 Jan 12. doi: 10.1111/vec.13277. Online ahead of print.

Abstract

Objective: To evaluate outcome (survival to discharge) among trauma types (blunt, penetrating, both) in cats. Secondary objectives were to evaluate for associations between trauma type, injury severity, and the diagnostics and interventions selected by primary clinicians.

Design: Retrospective evaluation of veterinary trauma registry data.

Setting: Veterinary Committee on Trauma (VetCOT) veterinary trauma centers (VTCs).

Animals: A total of 3895 feline trauma patients entered in the VetCOT trauma registry from April 1, 2017 to December 31, 2019.

Interventions: Data collected included patient demographics, trauma type, Abdominal Fluid Score (AFS), Animal Trauma Triage (ATT) score, surgical intervention, glide sign on Thoracic Focused Assessment with Sonography for Trauma, Triage, and Tracking (TFAST), pleural effusion on TFAST, modified Glasgow Coma Scale (mGCS), and outcome (survival to discharge).

Measurements and main results: Data from 3895 cats were collected over a 30-month period. Incidence of trauma types was as follows: blunt, 58% (95% confidence interval [CI]: 56%-59%); penetrating, 35% (95% CI: 34%-37%); and combination, 7.4% (95% CI: 6.7%-8.3%). Differences in survival incidence among the trauma types were identified: blunt, 80% (95% CI: 78%-81%); penetrating, 90% (95% CI: 89%-92%); and combined, 68% (95% CI: 63%-74%) (P < 0.01). Cats in the penetrating trauma group had the lowest proportion of severe injuries (6%) and highest proportion of mGCS of 18 (89%); cats with combined trauma had the highest proportion of severe injuries (26%) and lowest proportion of mGCS of 18 (63%). Point-of-care ultrasound and surgery were not performed in the majority of cases. When surgery was performed, the majority of blunt cases' procedures occurred in the operating room (79%), and the majority of penetrating cases' procedures were performed in the emergency room (81%).

Conclusions: Cats suffering from penetrating trauma had the best outcome (survival), lower ATT scores, and higher mGCS overall. Cats that sustained a component of blunt trauma had a lower survival rate, higher ATT scores, and the highest proportion of mGCS <18.

Keywords: Animal Trauma Triage score; blunt; modified Glasgow Coma Scale; penetrating; point-of-care ultrasound.