{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T04:20:21Z","timestamp":1787545221751,"version":"build-2736575974"},"reference-count":28,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T00:00:00Z","timestamp":1787443200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T00:00:00Z","timestamp":1787443200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100021853","name":"Horse Trust","doi-asserted-by":"publisher","award":["G2023"],"award-info":[{"award-number":["G2023"]}],"id":[{"id":"10.13039\/501100021853","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["beva.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Equine Veterinary Journal"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>CEPEF4 provides the most comprehensive contemporary dataset on perianaesthetic risk in horses. Intraoperative complications, monitoring and American Society of Anesthesiologists (ASA)\u2010stratified associations with death remain incompletely described.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To describe monitoring and complication incidence, assess associations with ASA physical status, and compare ASA\u2010stratified mortality by complication status.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>Secondary analysis of a prospective, multicentre cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Data from 47,371 equine general anaesthetics were analysed. Monitoring was described overall and by ASA grade. Complication incidence was calculated within monitored subsets for hypotension, hypoxaemia, hypercapnia, arrhythmias and hypothermia. Intraoperative awakening and severe haemorrhage were analysed in the full cohort. Logistic regression estimated ASA\u2010graded odds ratios for complications. The primary outcome analysis used the predefined CEPEF4\u2010DEAD endpoint and compared complication\u2010positive and complication\u2010negative horses within ASA I\u2013II and ASA III\u2013V strata. Sensitivity analyses used DEAD\u2010or\u2010EUTHANASIA, centre\u2010cluster and monitor\u2010restricted approaches.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Monitoring coverage was high for electrocardiography (92.2%), pulse oximetry (89.2%), capnography (86.8%) and invasive arterial pressure (82.0%). Among monitored cases, hypotension occurred in 16,926\/41,939 (40.4%), hypoxaemia in 2346\/44,279 (5.3%), hypercapnia in 2512\/42,941 (5.8%), arrhythmias in 720\/43,666 (1.6%) and hypothermia in 851\/18,358 (4.6%). Intraoperative awakening and severe haemorrhage occurred in 5499\/47,371 (11.6%) and 378\/47,371 (0.8%) cases, respectively. The odds of most complications increased with ASA grade, whereas intraoperative awakening showed no clear association. Within ASA strata, the main DEAD\u2010only associations were observed for hypotension, hypoxaemia, arrhythmias and severe haemorrhage; hypercapnia was associated with DEAD\u2010only outcome in ASA III\u2013V horses. Sensitivity analyses generally supported these findings, although marginal associations and estimates based on the broader DEAD\u2010or\u2010EUTHANASIA endpoint were interpreted cautiously.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Limitations<\/jats:title>\n                    <jats:p>Event detection depended on monitoring availability and clinician recording; causal inference was precluded.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Intraoperative complications increased with ASA grade, with hypotension most frequent. Findings provide contemporary reference values and identify clinically relevant complication patterns for future outcome\u2010focused analyses.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/evj.70317","type":"journal-article","created":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T04:14:52Z","timestamp":1787544892000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Intraoperative monitoring and anaesthetic complications in horses: A secondary analysis of the CEPEF4 multicentre cohort"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5377-9650","authenticated-orcid":false,"given":"J. I.","family":"Redondo","sequence":"first","affiliation":[{"name":"Departamento de Medicina y Cirug\u00eda Animal, Facultad de Veterinaria Universidad Cardenal Herrera\u2010CEU, CEU Universities  Valencia Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1322-3468","authenticated-orcid":false,"given":"P. M.","family":"Taylor","sequence":"additional","affiliation":[{"name":"Taylor Monroe, Little Downham  Cambridgeshire UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6259-9678","authenticated-orcid":false,"given":"R.","family":"Bettschart\u2010Wolfensberger","sequence":"additional","affiliation":[{"name":"Vetsuisse Faculty University of Z\u00fcrich  Z\u00fcrich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-0851-7747","authenticated-orcid":false,"given":"G. 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