J. A. Cook1, T. Soleimani3, S. T. Greathouse4, B. L. Eppley5,7, M. W. Chu6, S. S. Tholpady1,2,5 4Reid Plastic & Reconstructive Surgery,Richmond, IN, USA 5Riley Hospital for Children,Division Of Plastic & Reconstructive Surgery,Indianapolis, IN, USA 6Kaiser Permanente West Los Angeles,Division Of Plastic & Reconstructive Surgery,Los Angeles, CA, USA 7Eppley Plastic Surgery,Indianapolis, IN, USA 1Indiana University School Of Medicine,Division Of Plastic & Reconstructive Surgery,Indianapolis, IN, USA 2R.L. Roudebush Veterans Affairs Medical Center,Division Of Plastic & Reconstructive Surgery,Indianapolis, IN, USA 3Michigan State University,Department Of Surgery,Lansing, MI, USA
Introduction: An estimated 800,000 dog bites require medical attention per year. Previous studies of dog bite injuries have predominantly focused on patient and dog-specific characteristics to characterize the nature of these injuries. The purpose of this study is to investigate changes in the incidence and epidemiology of dog bite-related hospitalizations in the United States over a decade.
Methods: The Kids’ Inpatient Database (KID) was interrogated for dog bite injuries in patients younger than 18 years of age over a ten-year period. Data points collected were age, race, primary payer, and median household income quartile for the patient’s zip-code. Site of injury, rate of cellulitis, and presence of fractures were included. Outcome measures of interest were incidence of hospitalization, rate and type of surgical procedures, and length of stay.
Results: A total of 6,308 patients were identified over the study period. Average age at time of injury was 6.4 years. The majority of the patients were male (56.1%), Caucasian (64.8%), and under 11 years of age (83.9%). Over the study period, the percentage of children younger than 5 years old increased significantly from 39.3% to 44.7% (p <0.001) while the percentage of those aged 5 to 11 decreased from 45.8% to 39.8% (p <0.001). Patients in the lowest median income quartile had the largest number of patients with injuries (27.8%). Dog bites affecting the head and neck were the most affected site of injury (55.7%), followed by upper extremity (35.3%) and lower extremity (14.6%) sites. Over the study period, rates of cellulitis increased from 33.7% to 44.8% over the study period (p <0.001). More than 50% of the patients underwent at least one surgical procedure, 31.2% of the patients underwent invasive surgical procedures, and 5.1% of the hospitalized patients required skin grafts or flaps.
Conclusion: Dog bites are one the most common causes of non-fatal pediatric injuries and impose a significant burden on families as well as the health care system. Head and neck injuries were of greatest significance in the pediatric population, and cellulitis was the most common complication. Evaluating the characteristics of pediatric dog bite injuries will help develop future educational efforts.