Fédération Equestre Internationale eventing: Fence‐level risk factors for falls during the cross‐country phase (2008–2018)

Abstract Background The equestrian discipline of eventing tests athletes' and horses' skill over three phases: dressage, jumping and cross-country. Falls during cross-country can be particularly serious and result in serious or fatal injury for both horse and athlete. Cross-country course and fence design are crucial contributory factors to safety. Objectives To provide descriptive statistics and identify fence-level risk factors for horses competing in Fédération Equestre Internationale (FEI) events worldwide. Study Design Retrospective cohort study. Methods Data were collected for every horse start worldwide in all international (CI), championship (CH), Olympics (OG) and World Equestrian Games (WEG) eventing competitions between January 2008 and December 2018 and univariable logistic regression, followed by multivariable logistic regression were applied. The final model was built in a stepwise bi-directional process, with each step assessed by the Akaike information criterion. Results Risk factors were identified at the fence level covering aspects of fence design and course design. Ten fence types were at increased odds of a fall occurring compared with square spread fences, and seven types were at reduced odds. Fences with an approach downhill (odds ratio [OR] 1.35, 95% confidence interval [CI] 1.19–1.52), with landing into water (OR 1.82, CI 1.62–2.01), frangible devices (OR 1.28, CI 1.15–1.41) and later elements of combined obstacles (OR 1.33 CI 1.25–1.42 for the second element, OR 1.21 CI 1.10–1.32 for later elements) were associated with increased risk of falls occurring. Main Limitations Although the dataset covers every international competition worldwide, it does not include national-level competitions. Conclusions It is recommended that the most challenging fences are placed near the beginning of the course, and not in downhill or water settings. The complexity of individual elements in combined fences should be reduced. Adopting evidence-based course design is a crucial intervention for reducing the incidence of horse falls and associated serious and fatal injuries to horse and human athletes

Fédération Equestre Internationale (FEI) eventing: risk factors for horse falls and unseated riders during the cross‐country phase (2008‐2018)

Background: Eventing is an equestrian sport that tests athletes’ and horses’ skill over three phases: dressage, jumping, and cross-country. Falls during the cross-country phase can have very serious outcomes up to and including death for both horse and athlete. Therefore, understanding risk factors associated with falls is essential for improving equine and human welfare. Objectives: To provide descriptive statistics and identify risk factors at the horse-, athlete-, and course-level affecting horses competing in Fédération Equestre Internationale (FEI) events worldwide. Study design: Retrospective cohort study. Methods: Data collected by the FEI of every horse start worldwide in all international (CI), championship (CH), Olympics (OG), and World Equestrian Games (WEG) competitions between January 2008 and December 2018 were analysed. Descriptive statistics followed by univariable logistic regression to identify risk factor candidates for inclusion in the final multivariable logistic regression model. Models were constructed stepwise using a bi-directional process and assessed using the Akaike information criterion. Results: Factors associated with increased risk of falls and or unseated rider included: higher event levels, longer course distances, more starters at cross-country phase, and less experienced horses and athletes. Main limitations The data set is geographically comprehensive but covers only FEI competitions, not National Federation events i.e. not every competition started by every individual horse. Nor does the data set include any prior veterinary information or data on training or schooling. Conclusions: This is the first large-scale epidemiological study of cross-country falls in FEI eventing. Results suggest that a potential risk profile can be constructed for each horse-athlete combination prior to entering a given competition, based on individual histories and course-level factors. This could lead to interventions that can reduce the number of falls, thus protecting equine and human welfare

The association between clinical parameters recorded at vet gates during Fédération Equestre International endurance rides and the imminent risk of elimination

Background: Endurance competitions over distances of 80 to 160 km are required by Fédération Equestre Internationale (FEI) rules to be divided into between three and six stages, known as “loops”. Veterinary inspections, designed to ensure horse welfare, are conducted at the end of each loop, with details recorded on a separate “vet card” for each horse. Objectives: To identify risk factors recorded on vet cards that were associated with elimination at subsequent loops. Study design: Retrospective cohort study. Methods: Data relating to 3,213 horse starts worldwide in international (CEI) events during 2014 were analysed. Descriptive statistics and univariable logistic regression to identify risk factors for potential inclusion in the final multivariable logistic regression models. Models were constructed stepwise using backwards‐removal and assessed using the Bayesian information criterion. Results: Risk factors were identified, which would allow an “in‐ride” risk profile to be constructed for each horse which evolves as the horse progresses through the ride. Some risk factors such as abnormal gait and high heart rate were found to be repeatedly associated with imminent failure to qualify. Main limitations: This is a relatively small study in terms of cohort size, based on the data that were available at the time of the study. Although comprehensive ride history data were also available for each horse via the main FEI database, training data was not. Conclusions: By identifying risk factors observed during the veterinary inspections at the end of a loop that are strongly associated with elimination at the end of the next or subsequent loops, these results provide an evidence‐base for educational initiatives and regulatory changes that will inform the way veterinary delegates use veterinary inspections to help identify horses at risk of imminent FTQ

Fifteen risk factors associated with sudden death in Thoroughbred racehorses in North America (2009-2021)

Objective: To identify risk factors associated with race-related sudden death in Thoroughbred racehorses in the US and Canada. Animals: 4,198,073 race starts made by 284,387 Thoroughbred horses at 144 racetracks in the US and Canada between 2009 and 2021. Procedures: Study data were extracted from the Equine Injury Database, which contains detailed records of 92.2% of all official race starts made in the US and Canada during the study period. Forty-nine potential risk factors were analyzed using univariable and multivariable logistic regression. Cases were defined as race starts that resulted in fatality within 3 days of racing, in which at least 1 of 5 codes relating to sudden death was recorded. Fatalities due to catastrophic musculoskeletal injury were omitted from the study cohort. Results: 536 race starts resulted in sudden death, an incidence rate of 0.13/1,000 starts. Fifteen risk factors were significantly associated with sudden death, including horse age and sex, season and purse of race, race distance, and horses’ recent history of injury and lay-up. Horses racing while on furosemide medication were at 62% increased odds of sudden death. Clinical Relevance: Associations found between previous injury and sudden death suggests preexisting pathology could contribute in some cases. The association between furosemide and sudden death prompts further study to understand which biological processes could contribute to this result

Anomalous incidence of fatal musculoskeletal injury in North American 2-year-old Thoroughbred racehorses in the year 2020

Racehorse training and racing schedules in many parts of the United States and Canada were interrupted or otherwise reduced during the first three to six months of 2020. This was an indirect consequence of mitigations to prevent the spread of the pandemic virus COVID-19. Data from the Equine Injury Database, a census-level survey of all race starts made in the USA and Canada, were used to analyse the incidence of fatalities in 2009–2022 among three age cohorts of racehorses within each year. There was a statistically significant increase in the incidence of musculoskeletal fatalities among 2-year-old Thoroughbreds in 2020, compared to the period 2009–2019. In 2021 and 2022, the training schedules of 2-year-old horses returned to pre-2020 levels, as did the incidence of fatalities. The delayed start to training for 2-year-old horses was associated with an increase in risk of fatal musculoskeletal injury for those horses during 2020, but the risk for the same horses in 2021—when they were 3 years old—was not significantly different to the risk for 3-year-olds in any other year. The increased risk of fatal musculoskeletal injury in 2020 was only found among horses that were 2 years old in 2020—horses aged 3 years or more in 2020 were not at increased risk

We have demonstrated the potential to make eventing safer: What will happen next?

No abstract available

Factors associated with completion of Fédération Équestre Internationale endurance rides (2012–2019): modelling success to promote welfare-oriented decisions in the equestrian sport of endurance

Endurance riding is a popular equestrian sport organised at the international level by the Fédération Équestre Internationale (FEI). The sport involves prolonged exercise at speed over significant distances, which puts a substantial load on equine athletes’ musculoskeletal systems and metabolism and contributes to the risk of injuries and other veterinary problems. The FEI employs a system of in-ride veterinary inspections aimed at early detection of such problems and elimination of horses unfit to continue in the ride. To date, risk factors for elimination due to irregular gait or metabolic problems have been the primary focus of scientific enquiry. The present study is the first large-scale multivariable study to report factors associated with the positive outcome of endurance rides – their successful completion. This retrospective observational cohort study used data from the FEI’s Global Endurance Database. The study cohort included 74,629 starts made by 21,346 unique horses in one-day international-level competitions held worldwide between July 2012 and December 2019. Forty-one potential factors identified based on previous studies and a priori hypotheses were considered in the analysis. Univariable and multivariable logistic regression analyses were performed to investigate associations between ride completion and predictor variables and their interactions. The study identified 19 factors and four interactions associated with an increased or decreased likelihood of successful ride completion. High competition frequency (fewer days over mandatory out of competition period; Wald χ2 71.35, P-value <0.0001), fast riding speed (236.57, <0.0001), upward changes in competition level and riding speed between two successive rides (103.59, <0.0001 and 87.60, <0.0001) were associated with a decrease in the likelihood of ride completion. These factors can be effectively regulated by appropriate rules and considered by athletes when planning competition schedules, preparing ride strategies, or indeed during the ride itself. Other identified factors, including horse and rider age, sex, completions and eliminations history, contribute to an estimate of the likelihood that a particular combination completes a ride and thus can aid veterinarians at veterinary inspections as additional inputs supporting their decision-making when assessing horses’ fitness to continue in the competition. The study’s main limitation is an absence of data on national-level rides. Such data and data on training and veterinary histories remain difficult to access and were unavailable for the analysis. The present study’s results demonstrate that shifting the focus to modelling the positive outcome is a valuable approach offering evidence-based recommendations for good horsemanship, better-informed veterinary inspections, and welfare-oriented rules