title: Five year analysis of Jockey Club horse-related injuries presenting to a trauma centre in Hong Kong.
abstract: BACKGROUND
  Professional horse riding-related injuries have not been studied before in Hong Kong, although horse racing takes place very regularly in the territory. In addition, the equestrian events of the 2008 Beijing Olympic Games will come to Hong Kong. This study analysed the pattern of horse-related injury among patients who presented to a trauma centre in a teaching hospital in Hong Kong.
  
  
  METHODS
  Information from the trauma centre database was analysed retrospectively. The database includes trauma patients who had sustained potentially severe injuries that warranted initial assessment and resuscitation in a trauma resuscitation room (triage category 1 or 2). Data analysed included demographic variables, causes and mechanisms of injury, anatomical injuries, anatomical and physiological trauma scores, and patient outcome.
  
  
  RESULTS
  Between January 2001 and June 2005, 2312 trauma patients were entered into the database. Thirty-six (1.6%) patients had sustained horse-related injuries (mean age 34 years, range 17-54; male to female ratio 32:4), all whilst at work in the Jockey Club. Twenty-two patients were injured between midnight and 09:00 h. This group stayed in the resuscitation room for longer prior to admission compared with patients presenting between 09:00h and midnight (median time 127 min (interquartile range [IQR] 57-183) versus 58 min (IQR 43-83), p=0.06). Twenty-five patients fell from horseback, whilst 11 were kicked by the horse. Twenty patients had a single injury and 16 patients had multiple injuries. Eighteen patients had injuries to the thorax, abdomen, thoracolumbar spine or pelvis. Eleven patients had head, face and cervical spine injuries and 11 had limb injuries. Twenty-five patients were admitted, including four admitted to the intensive care unit (ICU). Ten patients required surgery. Median (standard deviation [S.D.]) probability of survival was 0.996 (0.052) and median revised trauma score (RTS) (S.D.) was 7.841 (0.624). There were no fatalities. Potentially serious horse-related injuries presented once every 6 weeks.
  
  
  CONCLUSIONS
  Most injuries are minor and affect the trunk but occur out of hours. Helmets, face shields and body protectors should be worn when riding or handling horses.
authors.affiliation: Accident & Emergency Medicine Academic Unit, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong. veronyim@hotmail.com
authors.forename: Veronica W T
authors.initials: VW
authors.lastname: Yim
authors.forename: Janice H H
authors.initials: JH
authors.lastname: Yeung
authors.forename: Paulina S K
authors.initials: PS
authors.lastname: Mak
authors.forename: Colin A
authors.initials: CA
authors.lastname: Graham
authors.forename: Paul B S
authors.initials: PB
authors.lastname: Lai
authors.forename: Timothy H
authors.initials: TH
authors.lastname: Rainer
mesh_terms: D000062:Accidents, Occupational / Q000706:statistics & numerical data*; D000293:Adolescent; D000328:Adult; D000818:Animals; D001265:Athletic Injuries / Q000209:etiology* / Q000473:pathology / Q000517:prevention & control / Q000601:surgery; D005260:Female; D050723:Fractures, Bone / Q000209:etiology; D006723:Hong Kong; D006736:Horses; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014193:Trauma Centers; D016896:Treatment Outcome; D014218:Triage