The Confidential Enquiry into Perioperative Equine Fatalities: phase 4 (CEPEF4) – a worldwide observational, prospective, multicentre cohort study in 2025
Bibliographic record
Abstract
Objective to report on the Confidential Enquiry into Perioperative Equine Fatalities 4 (CEPEF4). Study design confidential, observational, prospective, multicentre, cohort study. Animals or animal population 47,396 horses/ponies undergoing general anaesthesia (GA). Methods characteristics of each GA (249 variables) were collected. Outcomes after seven days were ALIVE (or discharged), EUTHANASIA or DEAD. Logistic regression analysed patient demographics and the anaesthetic drugs ( p < 0.05). Results data were collected from 47,396 GAs in 93 centres in 28 countries. Death rates were 1.2% overall, 0.6% for cases classified as NON-COLIC and 4.2% for COLIC. For NON-COLICs (227 deaths from 39,798 NON-COLICs), the main three causes of death were fractures (35.7%), abdominal complications (18.1%) and central nervous system problems (13.2%). Logistic regression analyses revealed an increase in the odds of death for pregnant mares, geriatrics, thin horses, those with a higher American Society of Anesthesiologists (ASA) grade, urgent procedures and those lasting < 1 hour or > 2 hours. Ketamine infusions and plasma lactate measurement during maintenance were associated with elevated risk. In contrast, monitoring invasive arterial pressure, end-tidal CO 2 , blood gases and body temperature were each associated with reduced odds of death. Premedication with agonist-antagonist/partial-agonist opioids with non-steroidal anti-inflammatory drugs and administration of α 2 -adrenoceptor agonists during recovery, alone or with acepromazine were associated with reduced odds of death. Conclusion and clinical relevance CEPEF4 reports reduction in the death rate compared to CEPEF2 in 2002: overall 1.2% versus 1.9%, colic death rate 4.2% versus 7.8% and non-colic death rate 0.6% versus 0.9%. Healthy horses still die, the majority because of fractures during recovery. We identified factors that may influence clinical decision-making and enhance patient safety. The CEPEF4 database will continue to provide clinically applicable information, with potential for further insights and improvements in equine anaesthesia.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".