Background: The size, strength, and unpredictability of horses, makes any interaction a potential situation for minor to severe injury. Despite this, horses continue to be popular for work and recreational activities. There have been five recent Australian publications that have examined various aspects of horse-related trauma, but none have been conducted in regional New South Wales (NSW). This study aims to report on the pattern of horse-related trauma that met the Institute of Trauma Injury Management's (ITIM) Trauma Registry criteria for people who presented to the emergency department at a regional NSW hospital, Australia.

Methods: An analysis of horse-related trauma extracted from the Wagga Wagga Base Hospital's Trauma Registry from 2012 to 2023 was undertaken. Demographic and clinical variables were reported on all people (n = 85) and statistically evaluated.

Results: The cohort median age was 46 years (range 2-78). Males represented 51.8%. Fall from mounted position was the most common mechanism of injury (84.7%) followed by kick while unmounted (11.7%). The head (45.9%) and chest (32.9%) were the most common regions of injury with head (45.9%) and fractures (44.7%) the most common types of injury. 11.8% of people required ICU admission.

Conclusion: Horse-related trauma, whether a person is mounted or unmounted, causes mild to severe injuries and can require hospitalization. Horse-related trauma has the potential to significantly impact morbidity, result in death and must not be underestimated. Establishing a protocol for horse-related trauma presentations and increasing awareness of injury patterns sustained from this mechanism has the potential to improve diagnosis and reduce morbidity.

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