Horse-related injuries in children – unmounted injuries are more severe: A retrospective review

Wolyncewicz, Grace E.L.; Palmer, Cameron S; Jowett, Helen; Hutson, John M.; King, Sebastian K.; Teague, Warwick J.

doi:10.1016/j.injury.2017.12.003

Cited by 20 publications

(16 citation statements)

References 17 publications

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“…Despite the significant consequences of paediatric trauma for both the patient and their family, there are relatively few population-based studies of the epidemiology of paediatric trauma when compared with adults, particularly in the setting of major trauma. Most cohort studies of paediatric trauma are limited to short time frames that do not facilitate investigation of trends over time,5–7 are single-centre studies8 or are limited to specific injury types, such as traumatic brain injury,9 or causes of injury 10. The exception is a study from Mitchell et al 2 which reported no change in the incidence of child injury hospitalisations in Australia from July 2002 to June 2012.…”

Section: Introductionmentioning

confidence: 99%

Causes and characteristics of injury in paediatric major trauma and trends over time

et al. 2018

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ObjectiveTo investigate causes, characteristics and temporal trends of paediatric major trauma.DesignA retrospective review of paediatric major trauma (<16 years of age) was conducted using data from the population-based Victorian State Trauma Registry from 2006 to 2016. Temporal trends in population-based incidence rates were evaluated using Poisson regression.SettingVictoria, Australia.ResultsOf the 1511 paediatric major trauma patients, most were male (68%), had sustained blunt trauma (87%) and had injuries resulting from unintentional events (91%). Motor vehicle collisions (15%), struck by/collisions with an object or person (14%) and low falls (13%) were the leading mechanisms of injury. Compared with those aged 1–15 years, a greater proportion of non-accidental injury events were observed in infants (<1 year) (32%). For all patients, isolated head injury (29%), other/multitrauma (27%) and head and other injuries (24%) were the most prevalent injury groups. The incidence of paediatric major trauma did not change over the study period (incidence rate ratio (IRR)=0.97; 95% CI 0.92 to 1.02; p=0.27), which was consistent in all age groups. There was a 3% per year decline in the incidence of transport events (IRR=0.97; 95% CI 0.94 to 0.99; p=0.005), but no change in the incidence of falls of any type (IRR=1.01; 95% CI 0.97 to 1.04; p=0.70) or other events (IRR=1.00; 95% CI 0.97 to 1.02; p=0.79). The overall in-hospital mortality rate was 7.2%.ConclusionsThis study demonstrated no change in the incidence of paediatric major trauma over an 11-year period. Given the potential lifelong impacts of serious injury in children, additional investment and coordination of injury prevention activities are required.

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Section: Introductionmentioning

confidence: 99%

Causes and characteristics of injury in paediatric major trauma and trends over time

et al. 2018

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“…A quarter of all paediatric sports fatalities are due to equine-related injuries [9]. However, none of the paediatric admissions in our study resulted in mortality.…”

Section: Discussionmentioning

confidence: 52%

“…Wolyncewicz et al had noted upper limb fractures and spinal injuries to be more prevalent in mounted versus unmounted paediatric patients aged 16 and below. While Wolyncewicz et al had found head injuries to be the most common horserelated injury in children, unmounted riders were also noted to be more than 8 times as likely to sustain a severe head injury [9]. In comparison, our inclusion criteria had included only mounted riders.…”

Section: Discussionmentioning

confidence: 99%

Injury Patterns of Equine-Related Trauma

Liaw¹,

Govilkar²,

Woo³

et al. 2019

TOORTHJ

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Introduction:Equestrian sports are popular in the United Kingdom (UK), with approximately 2.7 million people of all ages participating in equine-related sports in 2015. These sports are not without risk; the position of the mounted rider puts them at risk of injuries sustained by fall from a height, compounded by movement at speed. The aim of this study was to characterise demographics and injury patterns of equine-related trauma presentations at a major trauma centre in the UK.Methods:From a trauma admissions database and electronic search of radiology requests including keywords “equine”, “equestrian”, “horse”, and “pony” with cross-referencing from ICD-10 coding, 144 patients were identified to have presented to an adult major trauma centre with equine-related injuries from falls while mounted over a 3-year period.Results:Females accounted for 86% of patients (n = 123). The most common presenting age group was age 20-29, but most injuries occurred with patients of ages 50-59. Spinal injuries accounted for 41% (n = 69) of all injuries and occurred in a similar proportion in all age groups. Upper limb injuries accounted for 100% of injuries in those aged 0-9. 39% (n = 56) of patients required operative management for their injuries.Conclusion:We have been able to identify which body zones of injury are more at-risk in equine-related sports following falls from mounted riders, and recognize how certain injury patterns may be more prevalent in particular age groups. Spinal injuries have been demonstrated to be a new leading zone of injury, possibly due to stricter legislation from government and industry leading to the relative reduction of head injuries. Reducing the number and severity of these injuries will not only improve patient outcomes but reduce the burden on the healthcare system.

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“…Previous studies of paediatric trauma have commonly used composite scores to describe the severity of injuries, e.g., ISS [4,21], while other studies have used the most severe injury [42] or the presence of specific (non-mutually exclusive) injury types [43]. This study identified patterns of injury in paediatric trauma to allow for a more informed and likely impactful modelling of injury in future paediatric trauma research.…”

Section: Discussionmentioning

confidence: 99%

Identifying Homogeneous Patterns of Injury in Paediatric Trauma Patients to Improve Risk-Adjusted Models of Mortality and Functional Outcomes

Dipnall

Gabbe

Teague

et al. 2020

IJERPH

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Injury is a leading cause of morbidity and mortality in the paediatric population and exhibits complex injury patterns. This study aimed to identify homogeneous groups of paediatric major trauma patients based on their profile of injury for use in mortality and functional outcomes risk-adjusted models. Data were extracted from the population-based Victorian State Trauma Registry for patients aged 0–15 years, injured 2006–2016. Four Latent Class Analysis (LCA) models with/without covariates of age/sex tested up to six possible latent classes. Five risk-adjusted models of in-hospital mortality and 6-month functional outcomes incorporated a combination of Injury Severity Score (ISS), New ISS (NISS), and LCA classes. LCA models replicated the best log-likelihood and entropy > 0.8 for all models (N = 1281). Four latent injury classes were identified: isolated head; isolated abdominal organ; multi-trauma injuries, and other injuries. The best models, in terms of goodness of fit statistics and model diagnostics, included the LCA classes and NISS. The identification of isolated head, isolated abdominal, multi-trauma and other injuries as key latent paediatric injury classes highlights areas for emphasis in planning prevention initiatives and paediatric trauma system development. Future risk-adjusted paediatric injury models that include these injury classes with the NISS when evaluating mortality and functional outcomes is recommended.

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Horse-related injuries in children – unmounted injuries are more severe: A retrospective review

Cited by 20 publications

References 17 publications

Causes and characteristics of injury in paediatric major trauma and trends over time

Causes and characteristics of injury in paediatric major trauma and trends over time

Injury Patterns of Equine-Related Trauma

Identifying Homogeneous Patterns of Injury in Paediatric Trauma Patients to Improve Risk-Adjusted Models of Mortality and Functional Outcomes

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