Citation

Acton AS, Gaw CE, Chounthirath T, Smith GA. Am. J. Emerg. Med. 2019; ePub(ePub): 158366.

Affiliation

Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital, Columbus, OH, United States of America; The Ohio State University College of Medicine, Department of Pediatrics, Columbus, OH, United States of America; Child Injury Prevention Alliance, Columbus, OH, United States of America. Electronic address: gary.smith@nationwidechildrens.org.

Copyright

(Copyright © 2019, Elsevier Publishing)

DOI

10.1016/j.ajem.2019.158366

PMID

31402233

Abstract

BACKGROUND: Horse-related injuries can cause severe morbidity and mortality. The objective of this study is to investigate the epidemiological features of horse-related injuries treated in emergency departments (EDs) in the United States.

METHODS: A retrospective analysis of horse-related injuries from 1990 through 2017 was conducted utilizing the National Electronic Injury Surveillance System (NEISS). Cases were identified using the NEISS code 1239 (Horseback Riding: Activity, Apparel, or Equipment). Analyses performed included calculation of national injury estimates, relative risks (RRs) with 95% confidence intervals (CIs), and linear regression.

RESULTS: From 1990 through 2017, an estimated 1,836,536 (95% CI: 1,494,788-2,178,284) individuals presented to United States EDs with horse-related injuries. The annual injury rate decreased by 30.8% from 1990 to 1996, increased by 33.0% from 1996 to 2000, and then decreased by 46.0% from 2000 to 2017. Among older adults >60 years of age, the annual injury rate increased by 139.6% during the study period. The number of concussion and closed head injury diagnoses increased by 337.2% from 1990 to 2009. The most common mounted mechanism of injury was a fall or being thrown (73.9%), while the most common unmounted mechanism was being kicked (42.1%). Mounted injuries were more likely to lead to hospitalization than unmounted injuries (RR, 2.10, 95% CI: 1.59-2.77).

CONCLUSIONS: Despite the recent decline in horse-related injuries, these injuries are still common. Clinicians should be aware of the spectrum of ED presentations of horse-related injuries. Prevention efforts focused on older adults and concussions and closed head injuries warrant special attention.

Copyright © 2019 Elsevier Inc. All rights reserved.

Language: en

Keywords

Equestrian; Horse; Injury; Trauma