Weber CD, et al. – This research strived to analyze the nature, management, and outcome of major injuries related to equestrian sports. In, addition, it focused on defining the at–risk groups for serious and life–threatening injuries. The findings revealed that young female riders were at risk from falling, horse–kicks, and crush–injuries. It was found that older males in carriage–related accidents sustained the highest injury severity and mortality rate. These ought to be targeted by prospective, prevention initiatives.

Methods

• The demographic, pre-hospital, clinical, and outcome data were assessed from an international population-based prospective trauma database (TraumaRegister DGU).
• The enrolled candidates were patients with major injuries (Injury Severity Score [ISS] ≥9 points) associated with equestrian sports activities (January 1, 1993, to December 31, 2012).
• Clinical and outcome parameters were stratified for four different types of injury mechanisms: Fall from horse (FFH), horse-kick (HK), horse crush (HC), and carriage-related accidents (CRA).
• Germany, Austria, Switzerland, Finland, Slovenia, Belgium, Luxembourg, and The Netherlands were the participating countries.
• Statistical analyses were performed with SPSS (Version 22, IBM Inc., Armonk, NY).

Results

• The Database identified 122,000 documented patients, of whom 679 were equestrian incidents.
• The four major injury mechanisms were: FFH (n = 427), HK (n = 188), HC (n = 34), and the CRA (n = 30).
• Females displayed a greater tendency to sustain FFH (75.5%, p < 0.001), leading to head injuries (n = 204, 47.8%) and spinal fractures (n = 109, 25.5%).
• HK injuries often resulted in facial fractures (29.3%, p < 0.001).
• Individuals sustaining HC injuries had a high risk for pelvic (32.4%, p < 0.001) and abdominal injuries (35.2%, p < 0.001).
• As opposed to the FFH cohort, the CRA cohort involved older males (57 ± 13 years), with chest (63.3% p = 0.001), and extremity injuries, causing prominent injury severity (ISS 20.7 ± 10.6).
• In the CRA cohort, 16% were in haemorrhagic shock on scene, and highest in-hospital mortality (14.8%, p = 0.006) was reported.