title: Large animal-related injury requiring hospital admission: injury pattern disparities.
abstract: BACKGROUND
  Due to the infrequent occurrence of large animal-related injury (LARI) in many areas, their significance as a public health problem could be overlooked. The purpose of this study was to examine the demographics and injury disparities associated with LARI.
  
  
  METHODS
  The Healthcare Cost and Utilization Project Nationwide Inpatient Survey from 2001 was used to construct a cohort of patients admitted after LARI. Patients were stratified by age, gender, race, and median household income of patient's zip code. Where available total hospital charges were converted to cost using the hospital's cost-to-charge ratio. To determine variables associated with injury type, univariable and multivariable logistic regression analysis were used.
  
  
  RESULTS
  2424 LARI admissions were identified within the database. The largest proportion of admitted patients were female (53.8%), Caucasian (64.6%), and from areas with median income >$45,000 (41.8%). Average hospital cost was $5062. Overall, the most common injuries were rib fractures (15.2%), vertebral fractures (11.6%) and haemo-pneumothorax (9%). Multivariable logistic regression analysis revealed that age disparities with older patients receiving more rib fractures, haemo-pneumothorax, vertebral fractures, and pelvic fractures. Skull fractures and head injuries are disproportionately seen in younger patients. Gender disparities were also present, with females more likely to have vertebral fractures but less likely to have rib fractures and heart and lung injuries.
  
  
  CONCLUSIONS
  Disparities based on age and gender are associated with hospital admission for LARI in the United States. These admissions have a significant impact on the healthcare system with nationwide cost estimates of nearly $60 million. These findings represent potential areas for targeted prevention efforts.
authors.affiliation: University of Tennessee Health Science Center, United States. cshahan@uthsc.edu
authors.forename: C Patrick
authors.initials: CP
authors.lastname: Shahan
authors.forename: Katrina
authors.initials: K
authors.lastname: Emmett
authors.forename: Ben L
authors.initials: BL
authors.lastname: Zarzaur
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000704:Analysis of Variance; D000818:Animals; D001733:Bites and Stings / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D002417:Cattle; D002648:Child; D002675:Child, Preschool; D004285:Dogs; D005260:Female; D050723:Fractures, Bone / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D017048:Health Care Costs; D006736:Horses; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011030:Pneumothorax / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D012189:Retrospective Studies; D012720:Severity of Illness Index; D017678:Sex Distribution; D014481:United States / Q000453:epidemiology; D014949:Wounds, Nonpenetrating / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D014950:Wounds, Penetrating / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D055815:Young Adult