University of Kentucky, College of Medicine, Lexington, KY, USA.
Department of Surgery, Division of Health Outcomes and Optimal Services, University of Kentucky, Lexington, KY, USA.
Injury. 2022 Jan;53(1):171-175. doi: 10.1016/j.injury.2021.10.033. Epub 2021 Nov 1.
Nineteen million people participate in horseback riding activities in the US, and the horse industry employs more than 460,000 full-time workers. Emergency department data suggest young female amateurs and male professionals are most at risk of death from horse-related injuries. However, there has been no investigation into factors that may increase severe injury and mortality risk in these populations. This study investigates demographics and injury pattern differences between occupational and non-occupational horse-related injuries in the US.
The 2017 American College of Surgeons National Trauma Databank (ACS NTDB) was analyzed for horse-related injury using ICD 10 codes. Demographics, injury data, protective device use, and hospital procedures were analyzed. Occupational versus non-occupational injuries based on incident location (farm, sports, recreational, residential) were compared using ANOVA or Pearson's Chi-squared test.
Of 3911 incidents, the most common injury mechanism was falling from the horse, but occupational and non-occupational farm injuries showed higher incidence of being struck by a horse. One-third required surgery. Upper extremity injuries were most common. Occupational injuries more often affected upper extremities of working age, minority males with commercial insurance. Non-occupational injuries most often affected heads of women at the extremes of age. Helmet use was higher in occupational, non-occupational sports, and non-occupational recreation injuries, and severe head injury incidence was decreased in these groups. Complications and discharge dispositions were not different across groups.
In the largest trauma center study to date, we have shown equine-related trauma to be common and affect a predictable demographic that may permit injury prevention initiatives. Helmets may reduce severe head injury, but the efficacy of protective clothing remains to be validated.
在美国，有 1900 万人参与骑马活动，马业雇佣了超过 46 万名全职员工。急诊科的数据表明，年轻的女性业余爱好者和男性专业人士因与马有关的受伤而死亡的风险最高。然而，尚未有研究调查可能增加这些人群严重受伤和死亡风险的因素。本研究调查了美国职业和非职业与马有关的伤害之间的人口统计学和伤害模式差异。
使用 ICD-10 代码分析了 2017 年美国外科医师学院国家创伤数据库（ACS-NTDB）中与马有关的伤害。分析了人口统计学、伤害数据、防护设备使用情况和医院程序。使用 ANOVA 或 Pearson's Chi-squared 检验比较基于事件地点（农场、运动、娱乐、住宅）的职业和非职业与马有关的伤害。
在 3911 例事件中，最常见的伤害机制是从马背上摔下，但职业和非职业农场伤害显示出更高的被马撞击的发生率。三分之一需要手术。上肢受伤最常见。职业伤害更常见于从事工作的上肢、少数族裔男性和商业保险。非职业伤害最常见于年龄极端的女性头部。职业、非职业运动和非职业娱乐伤害中头盔使用率更高，这些群体中严重头部受伤的发生率降低。并发症和出院处置在各组之间没有差异。
在迄今为止最大的创伤中心研究中，我们已经表明，与马有关的创伤很常见，并且会影响到可预测的人群，这可能允许采取伤害预防措施。头盔可能减少严重的头部受伤，但防护服装的效果仍有待验证。
