Evaluation of a new multiple regression model based on biochemical parameters for the distinction of canine exudates and transudates.
albumin
bilirubin
cavitary effusion
cholesterol
general classification
Journal
Veterinary clinical pathology
ISSN: 1939-165X
Titre abrégé: Vet Clin Pathol
Pays: United States
ID NLM: 9880575
Informations de publication
Date de publication:
Sep 2021
Sep 2021
Historique:
revised:
12
11
2020
received:
11
06
2020
accepted:
01
12
2020
pubmed:
26
8
2021
medline:
1
10
2021
entrez:
25
8
2021
Statut:
ppublish
Résumé
The classification of effusions in human medicine currently uses biochemical parameters of verified analytical accuracy, while veterinary medicine is traditionally guided by protein content (TP) and total nucleated cell count (TNCC) in the effusion, without solid scientific support. We aimed to assess the accuracy of the current veterinary classification system to distinguish transudates from exudates and create new tools involving biochemical parameters that better classify canine cavitary effusions. Clinical, laboratory, and imaging data from 250 canine pleural and peritoneal effusions were retrospectively and prospectively collected, organized, and statistically evaluated. Multiple logistic regression analysis was performed using biochemical and cellular parameters. For identifying exudates, the accuracy (87.7%, n = 204) of the best traditional classification system (TNCC > 3000 cells/μL) was similar to that of the individual biochemical cutoff values with the greatest accuracy in the abdominal cavity (eg, cholesterol, CHO-E > 40.1 mg/dL, 87.3%, n = 55). The accuracy of albumin (ALB-E > 0.8 g/dL) in the pleural cavity was nonetheless higher (100%, n = 23). The best multiple predictive models for any cavity used the percentage of neutrophils and CHO-E (n = 72), presenting an accuracy, sensitivity, and specificity for the diagnosis of exudate of 88%, 96%, and 67%, respectively. Biochemical classification of pleural effusions has a higher accuracy than the traditional system (based on TP and TNCC). Utility and cutoff of analytes are different for each cavity. Implementing a multiple regression model or establishing ratios or gradients with concurrent serum values adds no significant improvement in the diagnostic potential of distinguishing transudate and exudates in dogs.
Sections du résumé
BACKGROUND
BACKGROUND
The classification of effusions in human medicine currently uses biochemical parameters of verified analytical accuracy, while veterinary medicine is traditionally guided by protein content (TP) and total nucleated cell count (TNCC) in the effusion, without solid scientific support.
OBJECTIVE
OBJECTIVE
We aimed to assess the accuracy of the current veterinary classification system to distinguish transudates from exudates and create new tools involving biochemical parameters that better classify canine cavitary effusions.
METHODS
METHODS
Clinical, laboratory, and imaging data from 250 canine pleural and peritoneal effusions were retrospectively and prospectively collected, organized, and statistically evaluated. Multiple logistic regression analysis was performed using biochemical and cellular parameters.
RESULTS
RESULTS
For identifying exudates, the accuracy (87.7%, n = 204) of the best traditional classification system (TNCC > 3000 cells/μL) was similar to that of the individual biochemical cutoff values with the greatest accuracy in the abdominal cavity (eg, cholesterol, CHO-E > 40.1 mg/dL, 87.3%, n = 55). The accuracy of albumin (ALB-E > 0.8 g/dL) in the pleural cavity was nonetheless higher (100%, n = 23). The best multiple predictive models for any cavity used the percentage of neutrophils and CHO-E (n = 72), presenting an accuracy, sensitivity, and specificity for the diagnosis of exudate of 88%, 96%, and 67%, respectively.
CONCLUSIONS
CONCLUSIONS
Biochemical classification of pleural effusions has a higher accuracy than the traditional system (based on TP and TNCC). Utility and cutoff of analytes are different for each cavity. Implementing a multiple regression model or establishing ratios or gradients with concurrent serum values adds no significant improvement in the diagnostic potential of distinguishing transudate and exudates in dogs.
Substances chimiques
Albumins
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
394-403Informations de copyright
© 2021 American Society for Veterinary Clinical Pathology.
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