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International orthopaedics2017; 41(10); 2105-2112; doi: 10.1007/s00264-017-3592-1

Blunt injuries related to equestrian sports: results from an international prospective trauma database analysis.

Abstract: The objective of this study was to investigate the nature, management, and outcome of major injuries related to equestrian sports and to define the at-risk groups for serious and life-threatening injuries. We analyzed demographic, pre-hospital, clinical, and outcome data from an international population-based prospective trauma database (TraumaRegister DGU®). Patients with major injuries (Injury Severity Score [ISS] ≥9 points) related to equestrian sports activities were included (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). Participating countries included Germany, Austria, Switzerland, Finland, Slovenia, Belgium, Luxembourg, and The Netherlands. Statistical analyses were performed with SPSS (Version 22, IBM Inc., Armonk, NY). The Database identified 122,000 documented patients, of whom 679 were equestrian incidents. Among these, the four major injury mechanisms were: FFH (n = 427), HK (n = 188), HC (n = 34), and the CRA (n = 30). Females were more likely 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). In contrast to the FFH cohort, the CRA cohort involved older males (57 ± 13 years), with chest (63.3% p = 0.001), and extremity injuries, resulting in significant injury severity (ISS 20.7 ± 10.6). In the CRA cohort, 16% were in haemorrhagic shock on scene, and also the highest in-hospital mortality (14.8%, p = 0.006) was observed. Young female riders are at risk from falling, horse-kicks, and crush-injuries. Older males in carriage-related accidents sustained the highest injury severity and mortality rate, and must specifically be targeted by future prevention initiatives. Level of evidence Descriptive Epidemiologic Study, Level II.
Publication Date: 2017-08-11 PubMed ID: 28801837DOI: 10.1007/s00264-017-3592-1Google Scholar: Lookup
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  • Journal Article
  • Multicenter Study

Summary

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This study aims to understand the types, treatment, and results of severe injuries related to equestrian sports, and identify groups at highest risk for serious or fatal injuries. By analyzing data from an international trauma database, the research reveals the varying impacts of different injuries, including falls, kicks, crushing incidents, and carriage accidents, with different demographics more prone to certain types of injuries.

Methodology

  • The researchers used pre-hospital, demographic, clinical, and outcome information from the TraumaRegister DGU®, an international trauma database.
  • The study focused on major injuries (those with an Injury Severity Score [ISS] of 9 or more) that were linked to equestrian sports activities.
  • The observation period spanned from January 1, 1993 to December 31, 2012.
  • The participating countries were Germany, Austria, Switzerland, Finland, Slovenia, Belgium, Luxembourg, and The Netherlands.
  • The study classified the cases based on four types of injury mechanisms: Fall from Horse (FFH), Horse-Kick (HK), Horse Crush (HC), and Carriage-Related Accidents (CRA).
  • Statistical analyses were done using the SPSS software (Version 22).

Findings

  • Out of 122,000 documented patients in the database, 679 were involved in equestrian incidents.
  • The four major injury mechanisms were: FFH (427 cases), HK (188 cases), HC (34 cases), and CRA (30 cases).
  • Women were more likely to experience FFH, which often resulted in head injuries and spinal fractures.
  • HK injuries most frequently ended in facial fractures.
  • People who experienced HC injuries were at a high risk for abdominal and pelvic injuries.
  • Different from the FFH group, the CRA group was typically older males, with injuries produced severe chest and limb injuries, and exhibited a lot of injury severity.
  • In the CRA group, 16% were in hemorrhagic shock at the scene and had the highest in-hospital mortality rate (14.8%).

Conclusion

  • Young female riders are at a high risk from falls, kicks and crush injuries.
  • Older males involved in carriage-related accidents presented the highest injury severity and mortality rate, meaning they should be the focus of future injury prevention efforts.

Cite This Article

APA
Weber CD, Nguyen AR, Lefering R, Hofman M, Hildebrand F, Pape HC. (2017). Blunt injuries related to equestrian sports: results from an international prospective trauma database analysis. Int Orthop, 41(10), 2105-2112. https://doi.org/10.1007/s00264-017-3592-1

Publication

ISSN: 1432-5195
NlmUniqueID: 7705431
Country: Germany
Language: English
Volume: 41
Issue: 10
Pages: 2105-2112

Researcher Affiliations

Weber, Christian D
  • Department of Orthopaedics and Trauma, RWTH Aachen University Medical Center, Pauwels Street 30, 52074, Aachen, Germany. chrweber@ukaachen.de.
  • CHIO Aachen Medical Center and Olympic Center Rhineland, Aachen, Germany. chrweber@ukaachen.de.
Nguyen, Anthony R
  • Department of Orthopaedics and Trauma, Royal Adelaide Hospital, Adelaide, Australia.
Lefering, Rolf
  • Committee on Emergency Medicine, Intensive Care and Trauma Management (Sektion NIS) of the German Trauma Society (DGU), Cologne, Germany.
Hofman, Martijn
  • Department of Orthopaedics and Trauma, RWTH Aachen University Medical Center, Pauwels Street 30, 52074, Aachen, Germany.
Hildebrand, Frank
  • Department of Orthopaedics and Trauma, RWTH Aachen University Medical Center, Pauwels Street 30, 52074, Aachen, Germany.
Pape, Hans-Christoph
  • Department of Orthopaedics and Trauma, RWTH Aachen University Medical Center, Pauwels Street 30, 52074, Aachen, Germany.
  • CHIO Aachen Medical Center and Olympic Center Rhineland, Aachen, Germany.
  • Department of Trauma Surgery, University of Zurich, Zurich, Switzerland.

MeSH Terms

  • Adult
  • Aged
  • Animals
  • Athletic Injuries / epidemiology
  • Athletic Injuries / mortality
  • Austria / epidemiology
  • Belgium / epidemiology
  • Databases, Factual
  • Female
  • Finland / epidemiology
  • Germany / epidemiology
  • Horses
  • Humans
  • Injury Severity Score
  • Luxembourg / epidemiology
  • Male
  • Middle Aged
  • Netherlands / epidemiology
  • Prospective Studies
  • Slovenia / epidemiology
  • Sports
  • Switzerland / epidemiology
  • Wounds, Nonpenetrating / epidemiology
  • Wounds, Nonpenetrating / mortality
  • Young Adult

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Citations

This article has been cited 7 times.
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