Characteristics of horse riding-related falls in patients presenting to emergency departments in manche department, france: a multicenter retrospective analysis.

BACKGROUND

Horse riding-related falls are a frequent cause of emergency department (ED) presentations; however, their regional epidemiology in France is poorly described. We aimed to quantify the incidence of ED visits after falling from a horse in the Manche Department and characterize the injury patterns, resource use, and short-term outcomes.

METHODS

We conducted a multicenter retrospective study across six hospitals in Manche (France), including all patients presenting to the ED after a fall from a horse between May 1, 2021, and October 31, 2024. Demographics, initial clinical status, imaging findings, anatomical injuries (Abbreviated Injury Scale [AIS]), management, and use of protective equipment were extracted from the electronic records. The incidence was standardized according to the catchment population of each center. Reporting was performed in accordance with the Strengthening the Reporting of Observational Studies in Epidemiology guidelines.

RESULTS

This study included 669 ED visits after falling from horses. The average annual incidence was 93.6 per 100,000 inhabitants, with substantial geographical variation. Most patients were women (87%), with a median age of 18 years. Spinal (43%), head (39%), and upper limb (33%) injuries were most common. Helmet use was high (97%) and likely contributed to the low rate of severe intracranial injuries. Imaging was performed in 93% of the patients, with 42% showing abnormalities. Most patients (80%) were discharged home, whereas 18% required hospitalization (median stay, 2 days), and 8.5% required surgery, mainly for fractures.

CONCLUSIONS

Horse riding-related falls are a prevalent cause of ED visits in the Manche region, with substantial geographic variation in incidence. Although most injuries are minor, the high frequency of head and spine involvement underscores the importance of protective equipment and targeted prevention strategies. Standardized imaging and discharge pathways can streamline resource utilization while ensuring the detection of clinically significant injuries.

TRIAL REGISTRATION: Not applicable (retrospective observational study).