Weber Christian D, Nguyen Anthony R, Lefering Rolf, Hofman Martijn, Hildebrand Frank, Pape Hans-Christoph
Department of Orthopaedics and Trauma, RWTH Aachen University Medical Center, Pauwels Street 30, 52074, Aachen, Germany.
CHIO Aachen Medical Center and Olympic Center Rhineland, Aachen, Germany.
Int Orthop. 2017 Oct;41(10):2105-2112. doi: 10.1007/s00264-017-3592-1. Epub 2017 Aug 11.
The objective of this study was to investigate the nature, management, and outcome of major injuries related to equestrian sports and to define the at-risk groups for serious and life-threatening injuries.
We analyzed demographic, pre-hospital, clinical, and outcome data from an international population-based prospective trauma database (TraumaRegister DGU®). Patients with major injuries (Injury Severity Score [ISS] ≥9 points) related to equestrian sports activities were included (January 1, 1993, to December 31, 2012). Clinical and outcome parameters were stratified for four different types of injury mechanisms: fall from horse (FFH), horse-kick (HK), horse crush (HC), and carriage-related accidents (CRA). Participating countries included Germany, Austria, Switzerland, Finland, Slovenia, Belgium, Luxembourg, and The Netherlands. Statistical analyses were performed with SPSS (Version 22, IBM Inc., Armonk, NY).
The Database identified 122,000 documented patients, of whom 679 were equestrian incidents. Among these, the four major injury mechanisms were: FFH (n = 427), HK (n = 188), HC (n = 34), and the CRA (n = 30). Females were more likely to sustain FFH (75.5%, p < 0.001), leading to head injuries (n = 204, 47.8%) and spinal fractures (n = 109, 25.5%). HK injuries often resulted in facial fractures (29.3%, p < 0.001). Individuals sustaining HC injuries had a high risk for pelvic (32.4%, p < 0.001) and abdominal injuries (35.2%, p < 0.001). In contrast to the FFH cohort, the CRA cohort involved older males (57 ± 13 years), with chest (63.3% p = 0.001), and extremity injuries, resulting in significant injury severity (ISS 20.7 ± 10.6). In the CRA cohort, 16% were in haemorrhagic shock on scene, and also the highest in-hospital mortality (14.8%, p = 0.006) was observed.
Young female riders are at risk from falling, horse-kicks, and crush-injuries. Older males in carriage-related accidents sustained the highest injury severity and mortality rate, and must specifically be targeted by future prevention initiatives. Level of evidence Descriptive Epidemiologic Study, Level II.
本研究的目的是调查与马术运动相关的重大损伤的性质、处理方法及结果，并确定严重和危及生命损伤的高危人群。
我们分析了来自一个基于国际人群的前瞻性创伤数据库（TraumaRegister DGU®）的人口统计学、院前、临床及结果数据。纳入与马术运动相关的重大损伤（损伤严重程度评分[ISS]≥9分）患者（1993年1月1日至2012年12月31日）。临床和结果参数按四种不同损伤机制分层：从马背上跌落（FFH）、马踢伤（HK）、马挤压伤（HC）和与马车相关的事故（CRA）。参与国家包括德国、奥地利、瑞士、芬兰、斯洛文尼亚、比利时、卢森堡和荷兰。使用SPSS（版本22，IBM公司，纽约州阿蒙克）进行统计分析。
该数据库识别出122,000例有记录的患者，其中679例为马术事故。其中，四种主要损伤机制为：从马背上跌落（n = 427）、马踢伤（n = 188）、马挤压伤（n = 34）和与马车相关的事故（n = 30）。女性更易发生从马背上跌落（75.5%，p < 0.001），导致头部损伤（n = 204，47.8%）和脊柱骨折（n = 109，25.5%）。马踢伤常导致面部骨折（29.3%，p < 0.001）。遭受马挤压伤的个体骨盆损伤（32.4%，p < 0.001）和腹部损伤（35.2%，p < 0.001）风险较高。与从马背上跌落组相比，与马车相关事故组涉及年龄较大的男性（57±13岁），有胸部损伤（63.3%，p = 0.001）和四肢损伤，损伤严重程度较高（ISS 20.7±10.6）。在与马车相关事故组中，16%在现场处于失血性休克状态，且观察到最高的院内死亡率（14.8%，p = 0.006）。
年轻女性骑手有跌落、被马踢和挤压伤的风险。在与马车相关事故中的老年男性损伤严重程度和死亡率最高，未来的预防措施必须特别针对他们。证据水平 描述性流行病学研究，二级。
