Equestrian-Related Injuries in Regional Trauma Units: A Prospective Cohort Study from Region Zealand, Denmark

Purpose: Equestrian trauma represents a distinct and understudied trauma mechanism. Understanding injury characteristics and risk patterns is essential to improve prevention and treatment. This study aimed to describe the nature and management of equestrian trauma in a regional context. Methods: This sub-population analysis was derived from a larger prospective trauma cohort. All patients with equestrian-related trauma triggering trauma team activation across four trauma units in Region Zealand (1 March 2024 and 28 February 2025) were included. Predefined variables included demographics, injury severity, interventions, and outcomes, analyzed using descriptive statistics. Results: A total of 211 patients (13% of the cohort) were included. Patients were predominantly female (97%) with a median age of 21 years (IQR 15–38). Pediatric patients constituted 38% and 67% were ASA 1. The most common injuries involved the thorax (25%) followed by the upper extremity (20%). The mean Injury Severity Score was 2,0 and 91% sustained minor or no injuries (ISS 0–8). Helmet use was reported in 67% and combined helmet and body protector use in 37%. Full trauma CT scan was performed in 70%, while medical interventions were rare. Most patients (62%) were discharged directly from the emergency department. All patients were alive after 90 days. Conclusion: Most equestrian patients were young females without comorbidities. Thoracic injuries predominanted and helmet use was common, while body protector use was rare. Despite low injury severity and infrequent interventions, imaging and admission rates were high.