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BMC sports science, medicine & rehabilitation2023; 15(1); 46; doi: 10.1186/s13102-023-00646-y

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

Abstract: Horse-riding is practiced on a regular basis by 500,000 people in Sweden. It is reputed to be one of the most dangerous sports. On average, there were 1756 acute injuries and three fatalities each year between 1997 and 2014 in Sweden related to horses. The primary aim of this study was to outline the injury spectrum related to equestrian activities cared for at a large Swedish trauma centre. The secondary aim was to identify trends in clinical outcomes and to investigate the association between age and such outcomes. Methods: The electronic medical records system at Karolinska University Hospital was queried for patients cared for due to equestrian related trauma between July 2010 and July 2020. Complementary data were gathered using the hospital's Trauma Registry. No exclusion criteria were applied. Descriptive statistics were used to outline the injury spectrum. Age was split into four categories which were compared using the Kruskal-Wallis H test or the Chi-squared test. Logistic regression was used to analyse correlations between age and outcomes. Results: A total of 3036 patients were included with 3325 injuries identified as equestrian related. The hospital admission rate was 24.9%. The cohort had one death. Regression analysis showed significant associations between decreasing risk of upper extremity injury (p < 0.001), increasing risk of vertebral fractures (p = 0.001) and increasing risk of thoracic injury (p < 0.001) with increasing age. Conclusions: Equestrian activities are not without risks. The morbidity is high, and injuries are taken seriously by the medical profession, reflected by the high admission rate. There are age-related variations in the injury spectrum. Older age appears to predispose to vertebral fractures and thoracic injuries. Other factors than age appear more important in determining the need for surgery or admission to ICU.
Publication Date: 2023-03-28 PubMed ID: 36978116PubMed Central: PMC10045660DOI: 10.1186/s13102-023-00646-yGoogle Scholar: Lookup
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  • Journal Article

Summary

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The study discusses the risks associated with horse-riding. Over a ten-year period, it examined the type and severity of injuries cared for at a Swedish trauma center, noting a significant connection between increasing age and certain injury types like vertebral fractures and thoracic injuries.

Study Purpose and Methodology

The purpose of this research revolves around two main objectives:

  • Delineate the scope of injuries related to equestrian activities treated at a significant Swedish trauma center.
  • Spot trends in clinical outcomes and inspect the relationship between age and these outcomes.

To achieve these objectives, the researchers used the electronic medical records system at Karolinska University Hospital to search for patients treated for equestrian related trauma from July 2010 to July 2020. The hospital’s Trauma Registry was also used to gather complementary data.

A combination of descriptive statistics, the Kruskal-Wallis H test or the Chi-squared test, and logistic regression were used in analyzing the data and reviewing correlations between age and outcomes.

Study Findings

The study found out that out of 3036 patients with 3325 injuries classified as equestrian-related:

  • About 24.9% were admitted to the hospital indicating the severity of the injuries sustained
  • One death was recorded
  • There was an decreasing risk of upper extremity injury with increasing age
  • An association was noted between increasing age and a higher risk of vertebral fractures and thoracic injuries

Conclusions

The study concluded that equestrian activities do have significant associated risks. There’s substantial morbidity and the medical profession takes these injuries very seriously, as evidenced by the high hospital admission rates. There’s a clear variation in the injury spectrum according to age with older age predisposing individuals to vertebral fractures and thoracic injuries. However, age doesn’t seem to be a significant factor in determining the need for surgery or ICU admission.

Cite This Article

APA
Franzén Lindgren E, Hammarqvist F, Ahl Hulme R. (2023). Horse-riding hazards: an observational cohort study mapping equestrian related injuries at a Scandinavian trauma centre. BMC Sports Sci Med Rehabil, 15(1), 46. https://doi.org/10.1186/s13102-023-00646-y

Publication

ISSN: 2052-1847
NlmUniqueID: 101605016
Country: England
Language: English
Volume: 15
Issue: 1
Pages: 46
PII: 46

Researcher Affiliations

Franzén Lindgren, Emilie
  • Medical School, Karolinska Institute, Stockholm, Sweden.
Hammarqvist, Folke
  • Division of Surgery, Department of Clinical Science, Intervention and Technology, Karolinska Institute, Stockholm, Sweden.
  • Division of Trauma and Emergency Surgery, Department of Surgery, Karolinska University Hospital, Stockholm, Sweden.
Ahl Hulme, Rebecka
  • Division of Surgery, Department of Clinical Science, Intervention and Technology, Karolinska Institute, Stockholm, Sweden. rebecka.ahl@ki.se.
  • Division of Trauma and Emergency Surgery, Department of Surgery, Karolinska University Hospital, Stockholm, Sweden. rebecka.ahl@ki.se.

Conflict of Interest Statement

The authors declare no conflicts of interest or competing interests with regards to this manuscript.

References

This article includes 31 references
  1. World Horse Welfare, Eurogroup for Animals. Removing the blinkers: the health and welfare of European Equidae in 2015. .
  2. HNS. The Swedish horse sector. .
  3. Meredtih L, Stigson H. Mapping equestrian injuries and injury incidence in Sweden using insurance registry data. Transl Sports Med 2019;3(1):46–54.
    doi: 10.1002/tsm2.114google scholar: lookup
  4. Meredith L, Thomson R, Ekman R, Kovaceva J, Ekbrand H, Bálint A. Equestrian-related injuries, predictors of fatalities, and the impact on the public health system in Sweden.. Public Health 2019 Mar;168:67-75.
    doi: 10.1016/j.puhe.2018.11.023pubmed: 30690221google scholar: lookup
  5. O'Brien D. Look Before You Leap: What Are the Obstacles to Risk Calculation in the Equestrian Sport of Eventing?. Animals (Basel) 2016 Feb 16;6(2).
    doi: 10.3390/ani6020013pmc: PMC4773740pubmed: 26891334google scholar: lookup
  6. Meredith L, Ekman R, Thomson R. Horse-related incidents and factors for predicting injuries to the head.. BMJ Open Sport Exerc Med 2018;4(1):e000398.
    doi: 10.1136/bmjsem-2018-000398pmc: PMC6109796pubmed: 30167320google scholar: lookup
  7. Andres SA, Bushau-Sprinkle AM, Brier ME, Seger YR. Effects of body protection vests and experience levels in prevention of equestrian injuries.. BMJ Open Sport Exerc Med 2018;4(1):e000426.
    doi: 10.1136/bmjsem-2018-000426pmc: PMC6267465pubmed: 30555716google scholar: lookup
  8. Nylund LE, Sinclair PJ, Hitchens PL, Cobley S. Do riders who wear an air jacket in equestrian eventing have reduced injury risk in falls? A retrospective data analysis.. J Sci Med Sport 2019 Sep;22(9):1010-1013.
    doi: 10.1016/j.jsams.2019.05.012pubmed: 31160233google scholar: lookup
  9. ridsportförbundet S. Statistik. 2019 [cited 20200923].
  10. Ridsportförbundet S. Säker med häst. [cited 20200923].
  11. Swedish Civil Contingencies Agency. Statistics and analysis - physical activity and injuries. .
  12. Hall Angerås M. [Horse-related injuries - prevention very important].. Lakartidningen 2019 Nov 14;116.
    pubmed: 31742653
  13. Folksam. Equestrian Helmets 2018. [cited 20200925].
  14. Clark JM, Adanty K, Post A, Hoshizaki TB, Clissold J, McGoldrick A, Hill J, Annaidh AN, Gilchrist MD. Proposed injury thresholds for concussion in equestrian sports.. J Sci Med Sport 2020 Mar;23(3):222-236.
    doi: 10.1016/j.jsams.2019.10.006pubmed: 31690492google scholar: lookup
  15. Asa N, Newton A, Sullivan L, Shi J, Wheeler K, Smith GA, Yang J. Horseback riding-related injuries treated in emergency departments: Risk factors and prevention strategies.. J Safety Res 2019 Dec;71:251-257.
    doi: 10.1016/j.jsr.2019.09.004pubmed: 31862037google scholar: lookup
  16. Dick L, Yule M, Green J, Young J. Patterns of injury following equine trauma: a non-trauma centre experience.. Scott Med J 2021 May;66(2):73-76.
    doi: 10.1177/0036933021994264pubmed: 33573510google scholar: lookup
  17. Altgärde J, Redéen S, Hilding N, Drott P. Horse-related trauma in children and adults during a two year period.. Scand J Trauma Resusc Emerg Med 2014 Jul 17;22:40.
    doi: 10.1186/s13049-014-0040-8pmc: PMC4347583pubmed: 25030979google scholar: lookup
  18. Thomas KE, Annest JL, Gilchrist J, Bixby-Hammett DM. Non-fatal horse related injuries treated in emergency departments in the United States, 2001-2003.. Br J Sports Med 2006 Jul;40(7):619-26.
    doi: 10.1136/bjsm.2006.025858pmc: PMC2564310pubmed: 16611723google scholar: lookup
  19. Sinvani L, Kozikowski A, Patel V, Mulvany C, Talukder D, Akerman M, Pekmezaris R, Wolf-Klein G, Hajizadeh N. Nonadherence to Geriatric-Focused Practices in Older Intensive Care Unit Survivors.. Am J Crit Care 2018 Sep;27(5):354-361.
    doi: 10.4037/ajcc2018363pubmed: 30173167google scholar: lookup
  20. Hung KK, Yeung JHH, Cheung CSK, Leung LY, Cheng RCH, Cheung NK, Graham CA. Trauma team activation criteria and outcomes of geriatric trauma: 10 year single centre cohort study.. Am J Emerg Med 2019 Mar;37(3):450-456.
    doi: 10.1016/j.ajem.2018.06.011pubmed: 30041911google scholar: lookup
  21. Brooks SE, Peetz AB. Evidence-Based Care of Geriatric Trauma Patients.. Surg Clin North Am 2017 Oct;97(5):1157-1174.
    doi: 10.1016/j.suc.2017.06.006pubmed: 28958363google scholar: lookup
  22. Myers MA, Hall S, Wright A, Dare C, Griffith C, Shenouda E, Nader-Sepahi A, Sadek AR. Spinal Fractures Incurred by Sports-Related Injuries.. World Neurosurg 2021 Jul;151:e747-e752.
    doi: 10.1016/j.wneu.2021.04.111pubmed: 33957284google scholar: lookup
  23. Moon Y, Sosnoff JJ. Safe Landing Strategies During a Fall: Systematic Review and Meta-Analysis.. Arch Phys Med Rehabil 2017 Apr;98(4):783-794.
    doi: 10.1016/j.apmr.2016.08.460pubmed: 27592402google scholar: lookup
  24. Mutore K, Lim J, Fofana D, Torres-Reveron A, Skubic JJ. Hearing hoofbeats? Think head and neck trauma: a 10-year NTDB analysis of equestrian-related trauma in the USA.. Trauma Surg Acute Care Open 2021;6(1):e000728.
    doi: 10.1136/tsaco-2021-000728pmc: PMC8442081pubmed: 34595353google scholar: lookup
  25. Theodore JE, Theodore SG, Stockton KA, Kimble RM. Paediatric horse-related trauma.. J Paediatr Child Health 2017 Jun;53(6):543-550.
    doi: 10.1111/jpc.13471pubmed: 28268253google scholar: lookup
  26. Hedström EM, Bergström U, Michno P. Injuries in children and adolescents--analysis of 41,330 injury related visits to an emergency department in northern Sweden.. Injury 2012 Sep;43(9):1403-8.
    doi: 10.1016/j.injury.2011.01.027pubmed: 21411086google scholar: lookup
  27. Denning GM, Jennissen CA. Pediatric and adolescent injury in all-terrain vehicles.. Res Sports Med 2018;26(sup1):38-56.
    doi: 10.1080/15438627.2018.1438279pubmed: 30431365google scholar: lookup
  28. Shults RA, West BA. ATV riding and helmet use among youth aged 12-17 years, USA, 2011: results from the YouthStyles survey.. Inj Prev 2015 Feb;21(1):10-4.
  29. Taree A, Charen D, Huang HH, Poeran J, Colvin A. Analysis of surgery rates among 25 national collegiate athletic association sports.. Phys Sportsmed 2022 Feb;50(1):30-37.
    doi: 10.1080/00913847.2020.1862632pubmed: 33306441google scholar: lookup
  30. Naef S, Steiger CN, Tabard-Fougère A, Dayer R, Ceroni D. Epidemiological Study of Equestrian Trauma in Geneva.. J Pediatr Orthop 2022 Feb 1;42(2):e126-e131.
    doi: 10.1097/BPO.0000000000002025pubmed: 34857726google scholar: lookup
  31. Buchanan FR, Cardenas TC, Leede E, Riley CJ, Brown LH, Teixeira PG, Aydelotte JD, Coopwood TB, Trust MD, Ali S, Brown CVR. A national trauma data bank analysis of large animal-related injuries.. Injury 2021 Sep;52(9):2677-2681.
    doi: 10.1016/j.injury.2021.03.020pubmed: 33846000google scholar: lookup

Citations

This article has been cited 2 times.
  1. Stigson H, Klingegård M. Characteristics of equestrian accidents and injuries leading to permanent medical impairment. BMC Sports Sci Med Rehabil 2024 Sep 4;16(1):184.
    doi: 10.1186/s13102-024-00973-8pubmed: 39232810google scholar: lookup
  2. Crawford AE, Picken LK, Gabriel FD, Quade J, Gould S. CNS and Thorax Injury and Associated Risks Factors in Equestrian Sports. Sports Health 2025 Jul;17(4):697-702.
    doi: 10.1177/19417381241275655pubmed: 39206526google scholar: lookup