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. 2011 Feb 4:5:4.
doi: 10.1186/1752-2897-5-4.

Protective and risk factors in amateur equestrians and description of injury patterns: A retrospective data analysis and a case - control survey

Rebecca M Hasler #  1 , Lena Gyssler  1 , Lorin Benneker  2 , Luca Martinolli  1 , Andreas Schötzau  3 , Heinz Zimmermann  1 , Aristomenis K Exadaktylos  1
Affiliations

Protective and risk factors in amateur equestrians and description of injury patterns: A retrospective data analysis and a case - control survey

Rebecca M Hasler et al. J Trauma Manag Outcomes. .

Abstract

Background: In Switzerland there are about 150,000 equestrians. Horse related injuries, including head and spinal injuries, are frequently treated at our level I trauma centre.

Objectives: To analyse injury patterns, protective factors, and risk factors related to horse riding, and to define groups of safer riders and those at greater risk

Methods: We present a retrospective and a case-control survey at conducted a tertiary trauma centre in Bern, Switzerland.Injured equestrians from July 2000 - June 2006 were retrospectively classified by injury pattern and neurological symptoms. Injured equestrians from July-December 2008 were prospectively collected using a questionnaire with 17 variables. The same questionnaire was applied in non-injured controls. Multiple logistic regression was performed, and combined risk factors were calculated using inference trees.

Results: RETROSPECTIVE SURVEY: A total of 528 injuries occured in 365 patients. The injury pattern revealed as follows: extremities (32%: upper 17%, lower 15%), head (24%), spine (14%), thorax (9%), face (9%), pelvis (7%) and abdomen (2%). Two injuries were fatal. One case resulted in quadriplegia, one in paraplegia. CASE-CONTROL SURVEY: 61 patients and 102 controls (patients: 72% female, 28% male; controls: 63% female, 37% male) were included. Falls were most frequent (65%), followed by horse kicks (19%) and horse bites (2%). Variables statistically significant for the controls were: Older age (p = 0.015), male gender (p = 0.04) and holding a diploma in horse riding (p = 0.004). Inference trees revealed typical groups less and more likely to suffer injury.

Conclusions: Experience with riding and having passed a diploma in horse riding seem to be protective factors. Educational levels and injury risk should be graded within an educational level-injury risk index.

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Figures

Figure 1
Figure 1
Odds ratios of multiple logistic regression analysis for each variable. The white part of the bar indicates 95% CI or more. Continuous (age) and ordinal variables (risk), are expressed as the ratio of the odds from the 3rd to the 1st quartile (listed in the numbers after the corresponding variable). Dichotomous variables are coded as follows: Gender (0 = male, 1 = female), helmet (1 = use of helmet, no use of helmet).
Figure 2
Figure 2
Example of a conditional inference tree used to indicate groups of riders at less risk of injury and groups at risk by a combination of the most significant risk factors (see reference (23) for an explanation of the interpretation of conditional inference trees).
See this image and copyright information in PMC

References

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