Original Article

Characteristics of Dog Bites in Arkansas

Authors: Aaron M. Smith, MD, Jacob Carlson, MD, Ashley B. Bartels, MD, Cody B. McLeod, MD, Michael S. Golinko, MD
diagnostic:276628

Abstract

Objective: Dog bite injuries are encountered frequently in emergency departments and can cause significant morbidity. The objective of this study was to explore the associations between the multiple variables at play during these occurrences (eg, the patient’s age, the bite location, the bite severity, the dog’s relationship with the patient, the breed of dog).

Methods: This two-institution study collected and analyzed dog bite data from Arkansas’ only Level I trauma centers. The charts of 740 patients were included in our retrospective chart review. The chart review extracted data, including each individual patient’s age, sex, dog bite location, and dog bite severity, as well as the patient’s relationship to the dog and the dog’s breed. To determine the relation between and among variables, contingency tables were created and analyzed to determine odds ratios (ORs) and confidence intervals (CIs). In addition, standard t tests were used in statistical comparisons of means and proportions.

Results: Of the 740 patient charts reviewed, 574 were for patients who presented to Arkansas Children’s Hospital and 166 were for patients who presented to the University of Arkansas for Medical Sciences. Of the patients across both institutions, 267 (37.1%) required some form of repair, with 225 (30.4%) receiving closure within the emergency department and 42 (6.7%) requiring an operative intervention. Among children, those younger than age 5 years were >8 times as likely to require an operative repair (OR 8.1, 95% CI 2.77–23.58, P < 0.0001), >4 times as likely to be bitten on the head and neck (OR 4.30, 95% CI 3.00–6.16, P < 0.0001), and ≤3 times as likely to be bitten by a family dog (OR 2.97, 95% CI 2.10–4.20, P < 0.0001). Conversely, children older than age 12 years were >3 times as likely to be bitten on an extremity (OR 3.43, 95% CI 2.08–5.65, P < 0.0001).

Conclusions: The results of this retrospective review are aligned mostly with the general trends found in previous national and global studies, supporting the notion that family dogs represent a more significant threat than often is realized and that, among the breeds identified, pit bulls are proportionally linked with more severe bite injuries. Our data further validate previous studies that note an increased risk of bites and bite severity in children younger than 5 years. In addition, our data show that bites to the head and neck occurred more frequently among children younger than 5 years than among older children, and that boys younger than 5 years were bitten more frequently than girls.

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References

1. Centers for Disease Control and Prevention. Nonfatal dog bite-related injuries treated in hospital emergency departments-United States, 2001. https://www.cdc.gov/mmwr/PDF/wk/mm5226.pdf. Published July 4, 2003. Accessed May 30, 2017.
 
2. American Society of Plastic Surgeons. 2016 national plastic surgery statistics cosmetic and reconstructive procedure trends. https://d2wirczt3b6wjm.cloudfront.net/News/Statistics/2016/2016-plastic-surgery-statistics-report.pdf. Accessed June 1, 2017.
 
3. Weiss HB, Friedman DI, Coben JH. Incidence of dog bite injuries treated in emergency departments. JAMA 1998;279:51-53.
 
4. Golinko MS, Arslanian B, Williams JK. Characteristics of 1616 consecutive dog bite injuries at a sngle institution. Clin Pediatr (Phila) 2017;56:316-325.
 
5. Morrongiello BA, Corbett MR, Kane A. A measure that relates to elementary school children’ risk of injury: the supervision attributes and risk-taking questionnaire (SARTQ). Inj Prev 2011;17:189-194.
 
6. Barton BK, Schwebel DC. The roles of age, gender, inhibitory control, and parental supervision in children’ pedestrian safety. J Pediatr Psychol 2007;32:517-526.
 
7. Daniels DM, Ritzi RB, O’Neil J, et al. Analysis of nonfatal dog bites in children. J Trauma 2009;66( 3 Suppl ):S17-S22.
 
8. Bini JK, Cohn SM, Acosta SM, et al. Mortality, mauling, and maiming by vicious dogs. Ann Surg 2011;253:791-797.
 
9. Reisner IR, Nance ML, Zeller JS, et al. Behavioural characteristics associated with dog bites to children presenting to an urban trauma centre. Inj Prev 2011;17:348-353.
 
10. Patronek GJ, Sacks JJ, Delise KM, et al. Co-occurrence of potentially preventable factors in 256 dog bite-related fatalities in the United States (2000-2009). J Am Vet Med Assoc 2013;243:1726-1736.
 
11. Dwyer JP, Douglas TS, van As AB. Dog bite injuries in children-a review of data from a South African paediatric trauma unit. S Afr Med J 2007;97:597-600.
 
12. Kaye AE, Belz JM, Kirschner RE. Pediatric dog bite injuries: a 5-year review of the experience at the Children’ Hospital of Philadelphia. Plast Reconstr Surg 2009;124:551-558.
 
13. Bernardo LM, Gardner MJ, Rosenfield RL, et al. A comparison of dog bite injuries in younger and older children treated in a pediatric emergency department. Pediatr Emerg Care 2002;18:247-249.
 
14. Fleisher GR. The management of bite wounds. N Engl J Med 1999;340:138-140.
 
15. Ellis R, Ellis C. Dog and cat bites. Am Fam Physician 2014;90:239-243.
 
16. Rhea S, Weber DJ, Poole C, et al. Risk factors for hospitalization after dog bite injury: a case-cohort study of emergency department visits. Acad Emerg Med 2014;21:196-203.
 
17. Abrahamian FM, Goldstein EJ. Microbiology of animal bite wound infections. Clin Microbiol Rev 2011;24:231-246.