Hearing hoofbeats? Think head and neck trauma: a 10-year NTDB analysis of equestrian-related trauma in the USA

Mutore, Kevin; Lim, Jiyun; Fofana, Demba; Torres-Reverón, Annelyn; Skubic, Jeffrey

doi:10.1136/tsaco-2021-000728

Cited by 20 publications

(17 citation statements)

References 30 publications

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“…The extended length of stay was caused by the significantly greater AIS and was accentuated by two patients with complete and incomplete tetraplegia after trauma to the cervical spine, who started early spinal rehabilitation. Previous studies also found 3% severely neurologically impaired patients [ 1 ]. This supports the conclusion by Lin et al, that in horseback riders spinal cord injuries are a significant cause of long-term morbidity [ 20 ].…”

Section: Discussionmentioning

confidence: 77%

“…Horseback riding seems to be a male sport in Israel with 79% injured boys [ 10 ]. Whereas, a 10-year national trauma database analysis in the US showed a 50/50 distribution between males and females [ 1 ]. Studies from Australia found 54–59% females with horse-related injuries [ 7 , 11 ].…”

Section: Discussionmentioning

confidence: 99%

“…Most studies report head trauma as the most common injury [ 1 , 9 , 10 , 18 ]. Especially studies with its focus on children reported up to 30% head injuries [ 10 , 16 , 18 ].…”

Section: Discussionmentioning

confidence: 99%

“…During the recent decades, in industrial countries the relationship with horses has focused on sports and leisure. The dangers of engaging with horses and their unpredictable behavior when it comes to unforeseen circumstances have been previously reported [ 1 , 2 ]. Among sporting activities, horse riding is well known for its risks in regards to their height, velocity, kicking force, and weight [ 2 , 3 ].…”

Section: Introductionmentioning

confidence: 99%

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Horse-related injury patterns: a single center report

et al. 2023

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Background For ages, humankind and horses have been closely related to occupational and recreational activities. The dangers of engaging with horses have been previously reported. Among sporting activities, horse riding is well-known for its risks. Despite multiple recommendations to wear protective gear, horse-related activities still comprise the risk of severe injuries. This study aimed to examine: (1) if specific mechanisms are correlated to particular injury patterns and (2) if injury types are related to patient demographics. Methods From one level I trauma center, between July 2019 and July 2022 (3 years) all emergency reports and discharge letters were retrospectively reviewed by full-text search regarding horse-related injuries. Patient demographics, body mass index, trauma mechanism, injury types, and initiated treatment were extracted from medical records and analyzed. Results During the study period, 95 patients with 99 horse-related injuries were included. The overwhelming majority of the patients was female (93.7%). Age averaged 35.3 years (range 6 to 71). BMI was 23.6 kg/m2. Inpatient treatment was required in 60.6%. Length of hospital stay averaged 10 days. Surgical treatment was performed in 55 patients (55.6%). Open reduction and internal fixation was the most common procedure (74.5%). Trauma mechanism was fall from a horse followed by being hit by a horse (60.6% and 23.2%, respectively). Injured upper extremities counted up for 52.5% followed by spinal and pelvic injuries (23.2%). Spinal and pelvic injuries were related to fall from a horse (p < 0.001). Injuries to the lower extremities were predominantly caused by a kick of the horse when the rider was unmounted (p = 0.001) and negatively related to a fall from a horse (p = 0.002). Ten patients got their fingers tangled while holding the reins and suffered from injuries to the upper extremity (p < 0.001). Three of them required an amputation (30%). Conclusion Despite the fact that patients are young and healthy, horse related injuries must not be underestimated. In our study, almost two-thirds of the patients required inpatient treatment and 50% underwent surgery. We could show that patient age was related to injury severity according to the Abbreviated Injury Scale (AIS). Spinal and pelvic injuries were significantly related to a fall from a horse with a significantly greater trauma impact according to the AIS. Therefore, these severe entities need to be ruled out in such events. Accidents caused by holding the reins, may result in serious injuries to the hand with 30% requiring an amputation. Doctors need to be aware of possible horse-related injury patterns to reduce morbidity.

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Section: Discussionmentioning

confidence: 77%

Section: Discussionmentioning

confidence: 99%

“…Most studies report head trauma as the most common injury [ 1 , 9 , 10 , 18 ]. Especially studies with its focus on children reported up to 30% head injuries [ 10 , 16 , 18 ].…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Horse-related injury patterns: a single center report

et al. 2023

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“…Nonetheless, during the studied 10-year period there was only one event in the cohort with a deadly outcome. A study conducted in the US with a similar design to the current study showed a mortality rate at approximately 1.3% [ 24 ]. This differs from the results presented here.…”

Section: Discussionmentioning

confidence: 92%

Horse-riding hazards: an observational cohort study mapping equestrian related injuries at a Scandinavian trauma centre

Lindgren

Hammarqvist

Hulme

2023

BMC Sports Sci Med Rehabil

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Introduction Horse-riding is practiced on a regular basis by 500,000 people in Sweden. It is reputed to be one of the most dangerous sports. On average, there were 1756 acute injuries and three fatalities each year between 1997 and 2014 in Sweden related to horses. The primary aim of this study was to outline the injury spectrum related to equestrian activities cared for at a large Swedish trauma centre. The secondary aim was to identify trends in clinical outcomes and to investigate the association between age and such outcomes. Material and methods The electronic medical records system at Karolinska University Hospital was queried for patients cared for due to equestrian related trauma between July 2010 and July 2020. Complementary data were gathered using the hospital’s Trauma Registry. No exclusion criteria were applied. Descriptive statistics were used to outline the injury spectrum. Age was split into four categories which were compared using the Kruskal–Wallis H test or the Chi-squared test. Logistic regression was used to analyse correlations between age and outcomes. Results A total of 3036 patients were included with 3325 injuries identified as equestrian related. The hospital admission rate was 24.9%. The cohort had one death. Regression analysis showed significant associations between decreasing risk of upper extremity injury (p < 0.001), increasing risk of vertebral fractures (p = 0.001) and increasing risk of thoracic injury (p < 0.001) with increasing age. Conclusions Equestrian activities are not without risks. The morbidity is high, and injuries are taken seriously by the medical profession, reflected by the high admission rate. There are age-related variations in the injury spectrum. Older age appears to predispose to vertebral fractures and thoracic injuries. Other factors than age appear more important in determining the need for surgery or admission to ICU.

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