The risk of injury is severely under-appreciated say US researchers.

By Mark Andrews

A recent study has found that the risk of an injury requiring hospital admission is higher for horse riding than for other potentially risky sporting activities such as football, motor racing, or skiing.

Kevin Mutore and colleagues examined data supplied from Levels I and II trauma centers to the US National Trauma Data Bank (NTDB) on injuries sustained by adults while horse riding between 2007 and 2016. 

They retrieved details of 45,671 patients with equestrian injuries for this period. Data were incomplete for 20,880 patients, leaving 24,791 for inclusion in the analysis. The average age of those injured was 47, with almost equal proportions of men and women. 

Analysis showed that the most common site of injury was the chest (37 percent) followed by arms and legs (26.5 percent). Head and neck injuries, although occurring less commonly (23 percent), were the most likely to prove fatal.

Severe neurological damage, classified as a Glasgow Coma Scale (GCS) score of 3 to 8, was observed in 888 (3.5 percent) of patients. The GCS is a clinical scale used to measure a person's level of consciousness after a brain injury. It ranges from 3 (deep coma) to 15 (normal consciousness.) 

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Riders with head and neck injuries were 44 times as likely to die as those with arm/leg injuries, while those with chest and abdominal injuries were around six times as likely to do so. 

The researchers point out that the study only included data from patients treated at US trauma centers that reported data to the NTDB. Nevertheless, the findings prompt them to conclude: “Equestrian-related injuries are a frequently ignored public health issue.”

They further explain, “When taken together, these data suggest that the dangers of equestrian activities have been severely underappreciated. When controlled for hours of activity, horseback riding resulted in a higher proportion of hospital admission than other higher risk activities like skiing.”

Protective gear can save lives, but is not always worn, they highlight. “Studies have shown that a large fraction of riders involved in equestrian injuries were not wearing helmets at the time of their accident. It stands to reason that raising awareness of the possible injuries and increasing preventive measures to protect against head injuries would significantly reduce mortality.

“We suggest that preventive measures and campaigns should be instituted to highlight safety practices. Implementing the consistent use of personal protective equipment, such as helmets and vests, will provide added protection to all riders (working or leisure) while on horseback. It is also imperative that medical professionals examine patients injured during horseback riding for head and neck injuries as these contribute to the highest mortality.”

Full details of the research are available in the open access paper published in the online journal Trauma Surgery & Acute Care Open.

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Published with the kind permission of Mark Andrews, Equine Science Update