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Retrospective analysis of equestrian-related injuries presenting to a level 1 trauma center

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Abstract

Objective

Report the incidence, pattern, and severity of equestrian-related injuries presenting to a rural level 1 trauma center and detail the total radiation dose, imaging, and hospital charges related to those injuries.

Methods

An IRB-approved retrospective review of patients presenting to our facility following equine-related trauma was conducted. Demographics, mechanism of injury, types and number of imaging exams, approximate radiation dose administered, imaging findings, Injury Severity Score (ISS), rate/length of hospitalization, and approximate cost of care were recorded.

Results

A total of 222 patients (161 F:61 M; mean age 38.5 years (range 4–79)) presented to our emergency department following horse-related injury. Mechanisms of injury included the following: fall (n = 186), kick (n = 18), stepped on (n = 9), and other (n = 9). Body part injured included extremity (26.1%), torso (26.6%), spine (25.7%), and head/neck (18.5%). Longer hospital admission, higher expenditure, increased CT/MR imaging, higher ISS, and radiation dose were noted in older patients and those injured by a fall or kick. Head injuries were more frequent following a horse kick (p = 0.006). Spinal and torso injuries were more common in patients older than 54 years (p = < 0.001) and those with falls (p < 0.04). Extremity injuries were more common in older patients (p < 0.001).

Conclusion

Patient age greater than 54 years and mechanism of injury are strong predictors of the ISS, injury localization, healthcare expenditure, and mean hospital stay. With the exception of obvious minor wounds, full trauma work-ups (CT chest/abdomen/pelvis and cervical spine) are encouraged for equestrian-related injuries in older patients and those injured by a fall.

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References

  1. Daly RF, House J, Stanek D, Stobierski MG (2017) Compendium of measures to prevent disease associated with animals in public settings, 2017. J Am Vet Med Assoc 251(11):1268–1292

    Article  Google Scholar 

  2. Mayberry JC, Pearson TE, Wiger KJ, Diggs BS, Mullins RJ (2007) Equestrian injury prevention efforts need more attention to novice riders. J Trauma Inj Infect Crit Care 62(3):735–739

    Article  Google Scholar 

  3. Centers for Disease Control and Prevention (CDC) (1996) Horseback-riding-associated traumatic brain injuries—Oklahoma, 1992–1994. MMWR Morb Mortal Wkly Rep 45(10):209–211

    Google Scholar 

  4. Waller AE, Daniels JL, Weaver NL, Robinson P (2000) Jockey injuries in the United States. JAMA 283(10):1326

    Article  CAS  Google Scholar 

  5. Majeedkutty N, Khairulanuar NB (2017) Prevalence, patterns, and correlates of equestrian injuries in Malaysia: a cross-sectional study. J Fam Community Med 24(1):18–22

    Article  Google Scholar 

  6. Ball CG, Ball JE, Kirkpatrick AW, Mulloy RH (2007) Equestrian injuries: incidence, injury patterns, and risk factors for 10 years of major traumatic injuries. Am J Surg 193(5):636–640

    Article  Google Scholar 

  7. Ghosh A, DiScala C, Drew C, Lessin M, Feins N (2000) Horse-related injuries in pediatric patients. J Pediatr Surg 35(12):1766–1770

    Article  CAS  Google Scholar 

  8. Sorli JM (2000) Equestrian injuries: a five year review of hospital admissions in British Columbia, Canada. Inj Prev 6(1):59–61

    Article  CAS  Google Scholar 

  9. Hasler RM, Gyssler L, Benneker L, Martinolli L, Schötzau A, Zimmermann H, Exadaktylos AK (2011) Protective and risk factors in amateur equestrians and description of injury patterns: a retrospective data analysis and a case–control survey. J Trauma Manag Outcomes 5:4

    Article  Google Scholar 

  10. Thomas KE, Annest JL, Gilchrist J, Bixby-Hammett DM (2006) Non-fatal horse related injuries treated in emergency departments in the United States, 2001–2003. Br J Sports Med 40(7):619–626

    Article  CAS  Google Scholar 

  11. Exadaktylos AK, Eggli S, Inden P, Zimmermann H (2002) Hoof kick injuries in unmounted equestrians. Improving accident analysis and prevention by introducing an accident and emergency based relational database. Emerg Med J 19(6):573–575

    Article  CAS  Google Scholar 

  12. Chitnavis JP, Gibbons CL, Hirigoyen M, Lloyd Parry J, Simpson AH (1996) Accidents with horses: what has changed in 20 years? Injury 27(2):103–105

    Article  CAS  Google Scholar 

  13. Grossman JA, Kulund DN, Miller CW, Winn HR, Hodge RH Jr (1978) Equestrian injuries. Results of a prospective study. JAMA 240(17):1881–1882

    Article  CAS  Google Scholar 

  14. Meredith L, Ekman R, Thomson R (2018) Horse-related incidents and factors for predicting injuries to the head. BMJ Open Sport Exerc Med 4(1):e000398

    Article  Google Scholar 

  15. Carmichael SP, Davenport DL, Kearney PA, Bernard AC (2014) On and off the horse: mechanisms and patterns of injury in mounted and unmounted equestrians. Injury 45(9):1479–1483

    Article  Google Scholar 

  16. Jagodzinski T, DeMuri GP (2005) Horse-related injuries in children: a review. WMJ 104(2):50–54

    PubMed  Google Scholar 

  17. Abu-Kishk I, Klin B, Gilady-Doron N, Jeroukhimov I, Eshel G (2013) Hospitalization due to horse-related injuries: has anything changed? A 25 year survey. Isr Med Assoc J 15:4

    Google Scholar 

  18. Guyton K, Houchen-Wise E, Peck E, Mayberry J (2013) Equestrian injury is costly, disabling, and frequently preventable: the imperative for improved safety awareness. Am Surg 79(1):76–83

    PubMed  Google Scholar 

  19. Bilaniuk JW, Adams JM, Difazio LT, Siegel BK, Allegra JR, LujÁN JJ, et al. (2014) Equestrian trauma: injury patterns vary among age groups. Am Surg;80

  20. Loder RT (2008) The demographics of equestrian-related injuries in the United States: injury patterns, orthopedic specific injuries, and avenues for injury prevention. J Trauma Inj Infect Crit Care 65(2):447–460

    Article  Google Scholar 

  21. Samin OA, Civil ID (1999) The new injury severity score versus the injury severity score in predicting patient outcome: a comparative evaluation on trauma service patients of the Auckland hospital. Annu Proc/Assoc Adv Automot Med 43:1–15 Available from:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3400229/

  22. Eckert V, Lockemann U, Püschel K, Meenen NM, Hessler C (2011) Equestrian injuries caused by horse kicks: first results of a prospective multicenter study. Clin J Sport Med 21(4):353–355

    Article  Google Scholar 

  23. Bond GR, Christoph RA, Rodgers BM (1995) Pediatric equestrian injuries: assessing the impact of helmet use. Pediatrics. 95(4):487–489

    CAS  PubMed  Google Scholar 

  24. Andres SA, Bushau-Sprinkle AM, Brier ME, Seger YR (2018) Effects of body protection vests and experience levels in prevention of equestrian injuries. BMJ Open Sport Exerc Med ;4(1)

    Article  Google Scholar 

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Acknowledgments

The data for this study originated from and was provided by the University of Virginia.

Author information

Authors and Affiliations

  1. Mayo Clinic Arizona, 5777 E. Mayo Blvd., Phoenix, AZ, 85054, USA

    Cameron R. Adler, Alix Hopp & Michael G. Fox

  2. Medical Center Radiologists, 5544 Greenwich Rd., Suite 200, Virginia Beach, VA, 23462, USA

    Dawn Hrelic

  3. Department of Radiology and Medical Imaging, University of Virginia, 1218 Lee Street, Box 800170, Charlottesville, VA, 22908, USA

    Dawn Hrelic & Michael G. Fox

  4. Department of Public Health Sciences, University of Virginia, Charlottesville, VA, USA

    Jim T. Patrie

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  1. Cameron R. Adler
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  2. Alix Hopp
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  3. Dawn Hrelic
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  5. Michael G. Fox
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Correspondence to Michael G. Fox.

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Adler, C.R., Hopp, A., Hrelic, D. et al. Retrospective analysis of equestrian-related injuries presenting to a level 1 trauma center. Emerg Radiol 26, 639–645 (2019). https://doi.org/10.1007/s10140-019-01718-8

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  • DOI: https://doi.org/10.1007/s10140-019-01718-8

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