World journal of urology2026; 44(1); 378; doi: 10.1007/s00345-026-06498-8

Equine-related injuries in rural Oklahoma: a 10-year experience emphasizing genitourinary trauma.

Charles, J
·
Shurkhay, V
·
Huo, J
·
Tamo, E
·
Jagadeesh, M
·
Obermark, A
·
Hollman, N
·
Khorgami, Z
·
Charles, M

Abstract: Equine-related injuries are a significant yet under-researched cause of trauma in rural areas, particularly in high-equine-density states like Oklahoma. This study describes patterns, severity, and outcomes of equine-related injuries over a 10-year period at a Level II trauma center, with emphasis on genitourinary (GU) trauma. Methods: This retrospective cohort study included all patients admitted with equine-related injuries from May 2015 to December 2025 (n = 259). Data were abstracted from the trauma registry, including demographics, injury mechanisms, anatomic locations (with GU injuries consolidated as kidney, ureter, bladder, penis, and scrotum), Injury Severity Score (ISS), length of stay (LOS), and mortality. Severe injuries were defined as ISS > 15. Only descriptive statistics are reported. Results: The mean age was 48.0 years (SD 17.5); 56.0% were male. Mean ISS was 9.1 (SD 6.0), with 12.4% of cases classified as severe (ISS > 15). The most common mechanisms were falls from a horse (44.8%) and being struck by a horse (32.8%). Predominant injury locations included brain/craniofacial (35.5%), chest (28.2%), and spinal (25.1%). Genitourinary injuries occurred in 9.3% of all cases and were more frequent among patients with severe trauma. Kidney injuries specifically accounted for 3.1% overall. Median hospital LOS was 2.0 days (IQR 3.0) overall and longer among severe cases. In-hospital mortality was 1.5% (4 cases), all attributable to traumatic brain injury. Conclusions: In rural Oklahoma, equine-related trauma commonly involves head and torso injuries. Genitourinary injuries represent an under-recognized but clinically relevant subset, particularly in severe cases. These findings underscore the need for targeted prevention strategies in high-equine-density rural communities, including mandatory helmet use and education regarding risks of direct horse contact.

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Publication Date: 2026-05-23 PubMed ID: 42177362PubMed Central: PMC13198469DOI: 10.1007/s00345-026-06498-8Google Scholar: Lookup

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Summary
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Affiliations
MeSH
Conflict of Interest
References
Citations

Journal Article

Summary

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Equine-related injuries in rural Oklahoma over ten years were studied to understand their patterns, severity, and outcomes, with a special focus on injuries to the genitourinary system.

Study Overview

Retrospective cohort study conducted at a Level II trauma center in rural Oklahoma.
Study period: May 2015 to December 2025.
Sample size: 259 patients admitted with equine-related injuries.
Focus on general injury characteristics and genitourinary (GU) trauma specifically.

Patient Demographics and Injury Mechanisms

Average patient age: 48 years (standard deviation of 17.5 years).
Gender distribution: 56% male.
Primary injury mechanisms:
- Falls from horses accounted for 44.8% of injuries.
- Being struck by a horse accounted for 32.8% of injuries.

Injury Severity and Types

Mean Injury Severity Score (ISS) was 9.1 (SD 6.0).
Severe injuries defined as ISS greater than 15 occurred in 12.4% of patients.
Common anatomical injury sites:
- Brain and craniofacial region: 35.5% of cases.
- Chest: 28.2%.
- Spinal injuries: 25.1%.
Genitourinary injuries were present in 9.3% of patients:
- More frequent in those with severe trauma.
- Kidney injuries accounted for 3.1% overall.

Hospital Course and Outcomes

Median hospital length of stay across all patients was 2 days (interquartile range of 3 days).
Patients with severe injuries had a longer hospital stay than those with less severe injuries.
In-hospital mortality rate was 1.5%, with all deaths due to traumatic brain injury.

Clinical and Public Health Implications

Equine-related injuries in this rural context often involve significant head and torso trauma.
Genitourinary trauma is an important but under-recognized type of injury, particularly in severe cases.
Findings highlight the importance of preventive measures in high-equine-density areas, such as:
- Mandatory helmet use to help reduce craniofacial and brain injuries.
- Educational programs to raise awareness about risks associated with direct contact with horses.

Summary

This decade-long study provides valuable insights into the epidemiology of equine-related injuries in rural Oklahoma.
The data emphasize the prevalence of serious injuries, including head trauma and genitourinary damage.
It underscores the need for targeted injury prevention strategies tailored to rural communities where horse activities are common.

Cite This Article

APA

Charles J, Shurkhay V, Huo J, Tamo E, Jagadeesh M, Obermark A, Hollman N, Khorgami Z, Charles M. (2026). Equine-related injuries in rural Oklahoma: a 10-year experience emphasizing genitourinary trauma. World J Urol, 44(1), 378. https://doi.org/10.1007/s00345-026-06498-8

Publication

World journal of urology

ISSN: 1433-8726

NlmUniqueID: 8307716

Country: Germany

Language: English

Volume: 44

Issue: 1

PII: 378

Researcher Affiliations

Charles, James

Department of Surgery, Louisiana State University Health Science Center, New Orleans, LA, USA.

Shurkhay, Vsevolod

The Neuroscience and Trauma Institute, Ascension St John Medical Center, Tulsa, OK, USA. vsevolod.shurkhay@ascension.org.

Huo, Jianqiang

The Neuroscience and Trauma Institute, Ascension St John Medical Center, Tulsa, OK, USA.

Tamo, Elvis

The Neuroscience and Trauma Institute, Ascension St John Medical Center, Tulsa, OK, USA.

Jagadeesh, Manoj

Department of Surgery, College of Medicine, The University of Oklahoma, Tulsa, OK, USA.

Obermark, Alex

Department of Surgery, College of Medicine, The University of Oklahoma, Tulsa, OK, USA.

Hollman, Nicholas

Office for Research Development and Scholarly Activity, College of Medicine, The University of Oklahoma, Tulsa, OK, USA.

Khorgami, Zhamak

Department of Surgery, College of Medicine, The University of Oklahoma, Tulsa, OK, USA.

Charles, Michael

The Neuroscience and Trauma Institute, Ascension St John Medical Center, Tulsa, OK, USA.

MeSH Terms

Male
Oklahoma / epidemiology
Humans
Retrospective Studies
Horses
Middle Aged
Female
Adult
Animals
Urogenital System / injuries
Rural Population
Aged
Injury Severity Score
Young Adult
Time Factors

Conflict of Interest Statement

Declarations. Conflict of interest: The authors declare no competing interests. Ethical approval and consent to participate: The present study was approved by the local IRB. Consent for publication: Not applicable.

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