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