Objectives Head injuries are the leading cause of death in horse-related injury events and, even since the introduction of helmets, represent a sizeable proportion of all horse-related injuries. Falls from horseback and kicks to the head are the most frequent type of incident causing head injuries, but it is unknown whether these incidents are predictors of head injury. This study aimed to investigate head injuries and the association between incident type and head injury.
Method Retrospective review of 7815 horse-related injury events was conducted. Data were gathered from hospitals, local healthcare centres and public dental services in Skaraborg, Sweden. Binary logistic regression was used to analyse the association between the incident type and occurrence of head injury while controlling for risk factors.
Results Approximately 20% of riders sustained a head injury, mostly soft tissue injuries (56.3%) and concussions (33.4%). A fall from or with the horse was the primary cause of head injury (63.9%). Those who fell from a carriage or other height or who were injured through contact with the horse had no difference in the likelihood of head injury when compared with those that fell from or with the horse. However, those who sustained an injury without any horse contact had lower odd of head injury (OR: 0.640, p<0.00005, 95% CI 0.497 to 0.734). Additionally, the older the rider, the lower the odds of head injury (OR=0.989, p<0.00005, 95% CI 0.985 to 0.993).
Conclusion Improved protection for those suffering falls from horseback as well as those who are kicked in the head should be investigated.
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Contributors LM was responsible for conception and design of the study, conducting the analysis, interpreting of the data and writing the final report. RE was responsible for conception and design of the study, providing access to the data, interpretation of the data and critically reviewing the final report. RT was responsible for conception and design of the study, interpretation of the data and critically reviewing the final report.
Funding This study was funded by Västra Götalandsregionen, Natural Resource Management and Chalmers University of Technology.
Competing interests None declared.
Patient consent Not required.
Ethics approval Ethical approval was obtained through Regionala etikprövningsnömnden I Göteborg, with project entitled ‘Kartläggning av hästrelaterade skador samt deras orsaker och strategier för prevention’.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement Currently, no unpublished data are available for sharing. Any requests, however, can be directed to the primary author firstname.lastname@example.org.
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