Pediatric Dog Bite Injuries: A 5-year Nationwide Study Of Over 56,000 Patients
Natalie M. Plana, MD, Christopher L. Kalmar, MD, MBA, Liana Cheung, MBBS, Jordan W. Swanson, MD, MSc, Jesse A. Taylor, MD.
Children's Hospital of Philadelphia, Philadelphia, PA, USA.
Introduction Dog bites encompass a high percentage of pediatric ED visits, with little epidemiological data reported. This study aims to explore nationwide incidence of pediatric dog bites and assess risk factors for specific injury patterns. Methods A retrospective cohort study was conducted of pediatric dog bite injuries in the United States from 2015-2020 referencing the Pediatric Health Information System database. Patient characteristics, anatomic distributions, and intervention rates were analyzed. Results 56,106 patients were included, majority male (55.1%) with a median age 6.8 years. Incidence cycled seasonally, with peaks in July (median=1,217) and nadirs in February (median=760). A significant increase was seen per overall ED presentations during the COVID pandemic (p<0.05). The most common anatomic location of injury was the head (62.1%), followed by upper extremities (25.1%), with relative proportions varying with age. Overall, 8.0% patients required repair in the operating room. Injuries isolated to the head (OR=2.6,p<.001) and multiple anatomic regions (OR=2.6,p<.001) more likely required operative intervention. Conclusions Incidence of pediatric dog bites remains high, with significant seasonal variability. Infants and toddlers disproportionately suffer injuries to the head and neck, with anatomic location of bites successively lower as children grow. The COVID pandemic ushered a spike in injuries, the cause of which is unknown and is difficult to discern from our data; nevertheless, new dog adoptions and prolonged human contact during quarantine are potential drivers.
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