title: A retrospective case-control study of horse falls in the sport of horse trials and three-day eventing.
abstract: BACKGROUND
  Serious injuries to horses and riders in horse trials (HT) and three-day events (3DE) are usually associated with falls of horses, which invariably involve falls of the riders. Many potential causes for these falls have been discussed.
  
  
  OBJECTIVE
  The aim of this case-control study was to investigate the risk factors for horse falls on the cross-country phase of horse trials and three-day events.
  
  
  METHODS
  Using retrospective data, significant risk factors identified with unvariable analysis (P value <0.2) were entered into a multivariable logistic regression model. Significant risk factors (P value <0.05) were included in the final model.
  
  
  RESULTS
  It was revealed that a number of course, obstacle and rider variables were significantly and independently associated with the risk of falling. Falling was associated with obstacles sited downhill (Odds ratio [OR] 8.41) and with obstacles with ditches in front (OR = 5.77).
  
  
  CONCLUSIONS
  The relationship between course variables and the risk of falling was characterised and showed a significantly increased risk with increasing numbers of jumps on the course and for jumping efforts later in the course. In contrast, after allowing for the total number of obstacles on the course, an increase in the total number of jumping efforts appeared to have a protective effect. A later cross-country start time was associated with a decreased risk of a horse fall. Amateur event riders were approximately 20 times more likely to fall than professional riders.
  
  
  CONCLUSIONS
  This study has identified a number of risk factors associated with horse falls and highlights areas that can be altered to improve safety in cross-country competitions.
authors.affiliation: Division of Equine Studies, University of Liverpool, Leahurst, Chester High Road, Neston, South Wirral CH64 7TE, UK.
authors.forename: E R
authors.initials: ER
authors.lastname: Singer
authors.forename: F
authors.initials: F
authors.lastname: Saxby
authors.forename: N P
authors.initials: NP
authors.lastname: French
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control / Q000706:statistics & numerical data*; D000293:Adolescent; D000328:Adult; D000818:Animals; D001265:Athletic Injuries / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control / Q000662:veterinary*; D016022:Case-Control Studies; D002648:Child; D016001:Confidence Intervals; D005260:Female; D006736:Horses / Q000293:injuries*; D006801:Humans; D016015:Logistic Models; D008297:Male; D016017:Odds Ratio; D012189:Retrospective Studies; D012307:Risk Factors; D012449:Safety; D013177:Sports / Q000592:standards