Equestrian Trauma in an Urban Environment: A Retrospective Analysis in a Level I Trauma Center

Abstract

Introduction: Equestrian trauma is recognized as a high-risk injury mechanism with the potential for significant morbidity and mortality. Although horse-related injuries are more frequently seen in a rural environment, they can also occur in urban settings. Urban physicians should be mindful of these potential cases.

Methods: A retrospective review was performed on all patients treated at Nassau University Medical Center, East Meadow, New York, for equestrian-related trauma from January 1, 2000, to December 31, 2024.

Results: Twenty-nine equestrian trauma patients ages 10-70 were included, with injuries observed in all six Abbreviated Injury Scale (AIS) body regions. Admission was required in 93% of patients. Intensive care unit (ICU) admission was required in 41% of the cases. Head and extremity injuries were the most common reasons for admission. Polytrauma patients were seen both in patients who fell from a horse and those who were kicked by a horse. The mean Injury Severity Score (ISS) was 6.9 and 11.8, respectively.

Conclusion: Both falling from a horse and being kicked by a horse have been shown to have a high risk of serious morbidity. Equestrian trauma can occur in urban environments. Urban physicians should be aware of injury patterns in equestrian trauma and maintain a high index of suspicion for serious injuries, as most patients will require admission and intervention.

Keywords: equestrian; horse; injuries; sports medicine; trauma; urban.