Patterns of injury following equine trauma: a non-trauma centre experience

Abstract

Introduction Horse riding carries risk of injury which can result in fatality. The majority of published literature describes major trauma centre experience. We aimed to characterise injury patterns following equine trauma at a Scottish district general hospital. Methods A retrospective review of admissions following equine trauma was undertaken from 2014 to 2019. Mechanism and nature of injuries were noted. Patient management and outcomes were recorded and analysed to determine correlation. Results Of the 162 patients identified, 121 (74.7 per cent) were female. The commonest mechanism and injury sustained were falling from a horse (86.4 per cent) and head injury (17.9 per cent) respectively. Forty-four (27.2 per cent) had multiple injuries identified. Being crushed or kicked resulted in more abdominal visceral injuries (22.7 vs 0.7 per cent, p = <0.05) and ITU admissions (18.2 vs 6.4 per cent, p = 0.06) when compared with falling from alone. Eight (4.9 per cent) required transfer to a major trauma centre and 30-day mortality was 0.6 per cent. Conclusion Although variable, injuries following equine trauma can be life threatening. Increased awareness and development of safety legislation is needed. In addition, research could be directed at assessing functional outcomes given the large number of orthopaedic injuries.

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

“…Our results demonstrate that this group of patients is dominated by the female sex, has a heavy majority of patients who are under the age of 18, and most commonly sustain injuries due to falling off the horse. These findings are corroborated by other studies [ 3 , 15 , 16 ]. Although mortality and the need for intensive care in the total cohort were very low at 0.03% and 1.2%, respectively, 24.9% of the cohort required hospital admission.…”

“…Nonetheless, of all the equestrian related injuries from the admitted subgroup, 43.3% (n = 328) required surgery. Other publications on equine trauma have found similar, or even higher, surgical rates ranging between 24% and 50% [ 4 , 16 , 30 ]. This indicates that injuries sustained in equestrian sports require surgery more frequently than those from many other sports.…”

“…A total of 36 patients (4.8% of patients admitted to hospital) required ICU admission, 30 out of the 36 had an ISS of nine or higher. The proportion of patients requiring ICU is lower than that of similar studies on equestrian related injury [ 16 ]. In the US, more than half of patients admitted to ICU is constituted of older adults [ 19 ].…”

Epidemiology of horse trauma: a literature review

“…The type of data available and the methods of data collection also influence consistent reporting. Despite this, four studies reported a decrease in horse trauma over their study periods [ 19 , 21 , 22 , 36 ], one reported no change [ 39 ], and Jones et al [ 7 ] reported a slight non-significant annual increase. A recent assessment of fatal incidents on Australian farms involving children (2001–2019) found that horses were the agent of injury in 5.4% of cases [ 47 ].…”

“…The most common mechanism of injury was a fall from a horse, with the proportion ranging from 45.1 to 86.4% of all mechanisms [ 36 , 41 ]. Equestrians who had fallen had the highest injury scores, were most likely to be admitted to hospital, had the most diagnostic imaging performed, and tied with horse kick injuries for the longest mean hospital stay [ 6 ].…”