Head, neck injuries reported as leading cause of mortality in equestrian-related trauma
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Published results showed head and neck injuries as the leading cause of mortality in equestrian-related injuries, with increased injury severity score and systolic blood pressure of less than 90 mm Hg as significant predictors of mortality.
Using the National Trauma Data Bank, researchers collected age, sex, race, payer status, injury severity score (ISS), hospital length of stay, Glasgow Coma Scale score, systolic blood pressure at presentation, discharge disposition and mortality among 24,791 adult patients involved in equestrian-related injuries from 2007 to 2016. Researchers divided injuries into categories based on anatomic location.
Results showed the most common type of injury occurred in the thoracic region (37.07%), while the least common type of injury was abdominal injuries (13.53%). Researchers found 3.58% of patients had severe neurological impairment on presentation. Patient ISS values resulted in 88.19% of admissions to the hospital, despite patients presenting with mostly minor (33.28%) or moderate (43.59%) scores. Patients 50 to 59 years of age were most likely to present to trauma centers, accounting for 26.58% of injuries, while patients 30 to 39 years of age were least likely to present with equestrian injuries, accounting for 13.18% of injuries, according to results.
Researchers found equestrian-related injuries resulted in 320 deaths in the study period, with head and neck injuries as the leading cause of mortality (74.83%). Compared with patients with a minor ISS, results showed patients with a moderate ISS had double the risk of mortality, patients with a severe ISS had eight times the risk of mortality and patients with very severe injuries had more than 100 times the risk of mortality. Patients who arrived at the ED with a systolic blood pressure of less than 90 mm Hg were 23 times more likely to die vs. patients with a systolic blood pressure of 90 mm Hg or greater, according to researchers.
“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,” the authors wrote. “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. Together, [with] awareness of injury patterns, we can continue to enjoy this popular sport while simultaneously reducing the number of severe injuries.”
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