Mechanisms and patterns of injuries related to large animals

Background., Injuries from encounters with large animals represent a signif icant health risk for rural communities. We evaluated our regional trauma c enters' experience with large-animal injuries to determine whether certain mechanisms and patterns of injury predicted either major head/craniofacial or torso (chest/abdomen/pelvis) trauma. Methods: The hospital courses of 145 patients with injuries related to larg e animals were reviewed retrospectively to determine patterns of injury, sp ecific injury mechanisms, species-specific injuries, and predictors of mult iple body region trauma. Results: Seventy-nine patients (55%) were injured by horses, 47 patients (3 2%) by bulls, 16 patients (11%) by cows, and 3 patients (2%) by wild animal attacks. The predominant species-specific mechanisms of injury were fails (horses), tramplings (bulls), and kicks (cows). Brain/craniofacial injuries were most common from horse-related encounters (32%), whereas bull and cow encounters usually resulted in torso injuries (45% and 56%, respectively). Multiple body region injuries occurred in 32% of patients, Fractures of th e upper extremities were more often associated with torso and head/craniofa cial injuries (48%) than lower extremity injuries (17%) (p = 0.02). Conclusion: Large animal injuries frequently involve multiple body regions with species-specific mechanisms. Upper extremity injuries are associated w ith a significantly higher percentage of torso and head/craniofacial injuri es, which may have implications for field triage.