Chest is the most common site for horse riding injury, but neck and head injuries are most deadly
Research published in the online journal Trauma Surgery and Acute Care Open found that horse riding is more likely to cause injury than other risky sports like motor racing, skiing or football.
The findings showed that while the chest was the most commonly inflicted, neck and head injuries were more fatal.
The US Centers for Disease Control and Prevention have data that shows more than 30,000,000 Americans participate in horse riding and leisure each year. However, little information is available about the incidence and consequences of injuries that horses sustain while riding.
The researchers used data from the US National Trauma Data Bank, level I and II trauma centers, to fill this knowledge gap. They looked at injuries suffered by horses riding adults between 2007 and 2016.
The NTDB contained details of 45,671 horses injured during this period. Data were not available for 20,880. However, 24,791 could be included in the analysis. With almost equal numbers of women and men, the average age of those who were injured was 47.
The chest was 9189 (37%), the most common location for horse riding injuries. 6560 (26.5%) suffered injuries to the arms or legs, and 5689 (23%) sustained head injuries. The most common type of abdominal injury was 3353 (13.5%).
In 888 (3%) cases, severe neurological damage was seen. It was a Glasgow Coma Scale score of 3-8. GCS is a clinical scale that can be used to measure consciousness levels after brain injuries. It can range from 3 to 15.
Head and neck injuries were the most common cause of death in this group. They occurred in 706 patients. Only 258 patients (1%) had moderate impairment (score 9-12).
21917 (or 88%) patients had a GCS that was between 13 and 15. However, 4508 (20.5%), of these patients still had a neck and head injury. Although horse riding injuries were mostly classified as mild (33% to moderate) to severe (43.5%) in severity (88%), the majority of these patients needed admission to hospital. More than a quarter (28%) had to be admitted to intensive care. About 1 in 10 patients required surgery.
The average length of hospital stay was 4.5 days. There were an average of 6 days in intensive care and 4 days in ventilator.
The most likely people to present to trauma centers were those aged 50-59, who account for more than 1 out 4 of all injured: 5939 (26.5%). The injured comprised 4883 (22%) of those 60+. The least likely to be among the injured were those aged 30-39, who accounted for only 2946 (13%) of the patients.
14,096 (57%) of patients were discharged at home, while 1747 (7%) were transferred into rehab or skilled nursing facilities.
Injuries to the head and neck caused the deaths of 320 people during the study period (237,75%). Only 7 (2%) people who died from horse riding injuries to their legs or arms had suffered such an injury.
Horse riders who sustained head or neck injuries were 44 percent more likely to die than those who suffered arm/leg injuries. Those with chest or abdominal injuries were only 6 percent as likely.
Patients with a systolic pressure less than 90mm Hg were 23 times more likely than patients with a higher reading to die in the emergency department.
This observational study only included horse riding patients who were treated at US trauma centers that reported data to the NTDB. The researchers conclude that “equestrian-related injuries” is a common public health problem.
The authors conclude that these data show that the dangers associated with equestrian activities are severely underestimated. Horseback riding was found to have a higher rate of hospital admissions than other high-risk activities, such as skiing.
They highlight that protective gear is important, but not always worn. Studies have shown that helmets were not worn by a majority of riders who suffered equestrian injuries. It is obvious that increasing awareness about possible injuries and taking preventative measures to reduce the risk of head injuries could significantly decrease mortality.
They also stated that horseback riding has a higher risk of hospitalization than motorcycling, football, and auto racing. Equestrian sporting organizations have been paying attention to the use protective equipment to prevent injury, particularly in relation to brain injuries and concussion. However, there are very few public health campaigns that focus on injuries to riders who ride horses for pleasure or work.