Major trauma in equestrian activities in New South Wales, Australia: An eleven-year review

Equestrian activities are popular in Australia for both work and recreation. However, these activities are associated with high rates of injury [including major trauma] when compared to other physical activities and sports. Research assessing equestrian-related major trauma is limited. This study analyses the characteristics of equestrian-related major trauma in New South Wales, Australia, to guide injury prevention initiatives.

A retrospective analysis was conducted using data from the New South Wales Trauma Registry on equestrian-related major trauma cases over an 11-year period from 2012 to 2022. Major trauma was defined as patients with an Injury Severity Score (ISS) greater than 12, as well as those admitted to the Intensive Care Unit or those who died in hospital, regardless of ISS. Incidence rates per 100,000 NSW population were analysed using Poisson regression.

A total of 624 equestrian-related major trauma cases were identified over the study period. The median age was 49 years (IQR 29-60), and the median ISS was 17 (IQR: 13-50). Females comprised 56.74 % of cases, with a significantly higher incidence rate than males (IRR 1.24, 95 % CI: 1.19-1.45, p = 0.007). Older individuals were at greater risk, with the highest incidence in the group aged between 40 to 59 (IRR 2.64, 95 % CI: 2.04-3.42). Most injuries occurred on farms (55.93 %), during leisure riding (28.21%) and were a result of a fall or being thrown from a horse (60.90 %). The most frequently injured anatomical regions included the thorax (25.40 %), spine (20.29 %), and head (18.73 %). Severe-to-critical injuries were proportionally highest in the thorax (65.08 %), head (46.97 %), and lower extremities (43.97 %). The incidence rate of major trauma increased steadily during the study period (IRR 1.027, 95 % CI: 1.002-1.053, p = 0.036).

The data presented in this paper provides an overview of the characteristics of equestrian-related major trauma. Salient points are that major equestrian-related trauma predominantly affects females and older individuals, with the thorax, spine, and head the most frequently injured anatomical regions. Farms are identified as the primary location of injuries across all age groups. These findings can guide future injury prevention initiatives.