Major trauma in equestrian activities in New South Wales, Australia: An eleven-year review.

Overview

• This study reviews major injuries related to horse riding activities in New South Wales (NSW), Australia, over an 11-year period to understand who is most affected, the nature of their injuries, and where these injuries typically happen, with the aim of informing better safety measures.

Background and Purpose

• Equestrian activities, popular in Australia for both work and leisure, carry a higher risk of injury compared to many other sports and physical activities.
• Despite the high risk, there is limited research focusing specifically on major trauma resulting from horse riding.
• This study aims to fill this gap by analyzing major trauma cases related to equestrian activities in NSW over an 11-year span (2012-2022).
• The goal is to identify injury patterns and risk factors to support the development of effective injury prevention initiatives.

Methods

• Data Source: The study used retrospective data from the New South Wales Trauma Registry.
• Inclusion Criteria: Cases classified as major trauma were included, defined as:
• Injury Severity Score (ISS) greater than 12
• Patients admitted to the Intensive Care Unit (ICU)
• Patients who died in hospital regardless of ISS
• Statistical Analysis: Incidence rates per 100,000 population were calculated and analyzed using Poisson regression to track trends and differences across demographics.

Results

• Total Cases: 624 equestrian-related major trauma cases were identified between 2012 and 2022.
• Demographics:
  • Median age was 49 years, indicating middle-aged adults were most affected.
  • Females made up 56.74% of cases and had a significantly higher incidence rate of major trauma compared to males, suggesting gender differences in risk or exposure.
  • Older age groups, specifically those aged 40-59 years, exhibited the highest risk for major trauma.
• Location and Activity:
  • Most injuries occurred on farms (55.93%).
  • Leisure riding accounted for 28.21% of cases, indicating many injuries happened during recreational activities rather than work-related riding.
  • The majority of incidents resulted from falls or being thrown from a horse (60.90%), highlighting a common mechanism of injury.
• Injury Characteristics:
  • The thorax (chest area), spine, and head were the most frequently injured body regions.
  • Severity was particularly high in injuries to the thorax (65.08%), head (46.97%), and lower extremities (legs) (43.97%), indicating these areas are vulnerable to critical trauma.
• Trends Over Time:
  • There was a steady increase in the incidence rate of major trauma related to equestrian activities during the 11-year period.
  • This suggests the risk may be growing or that there are changing patterns in equestrian participation or safety practices.

Conclusions and Implications

• The study provides a comprehensive overview of serious horse riding injuries in NSW, identifying key demographic groups and injury patterns.
• Major trauma due to equestrian activities predominantly affects females and middle-aged to older adults, which may guide targeted prevention efforts.
• The thorax, spine, and head are critical areas for injury prevention focus, possibly through protective gear or improved training.
• Farms as the primary injury setting suggest workplace safety protocols and leisure riding environments need enhanced safety measures.
• The observed rise in injury incidence over time underscores the importance of ongoing surveillance and community education to reduce risks.
• These findings can assist policymakers, healthcare providers, and equestrian organizations in developing focused injury prevention strategies, such as promoting helmet use and fall-prevention training, especially for high-risk groups on farms.