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Mattice T, Schnaith A, Ortega HW, Segura B, Kaila R, Amoni I, Shanley R, Louie JP. A Pediatric Level III Trauma Center Experience With Dog Bite Injuries. Clin Pediatr (Phila) 2024; 63:914-920. [PMID: 37705176 DOI: 10.1177/00099228231200097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/15/2023]
Abstract
Dog bite injuries often present to Emergency Departments (ED), and between 2001 and 2003, approximately 4.5 million adults and children were injured. Injuries may range from puncture wounds to deep tissue lacerations or avulsions. Deaths have been described. Our objective was to describe dog bite injuries, the overall location of injuries, and need for vaccination among children who presented to a Pediatric ED designated as a level III trauma center with a robust facial surgical infrastructure. This was a 6-year retrospective study. Charts were identified by International Classification of Diseases, Tenth Revision (ICD-10) codes for lacerations or injuries secondary to animal bites and accessing the hospital's trauma database. Variables abstracted were age, sex, type of injury, location, need for antibiotics, immunization states and requirement of tetanus or rabies vaccine, disposition from ED to the operating room, home, or any in-patient unit. We excluded children older than 17 years of age and children who had a post-bite injury infection or injury not initially managed in our facility or medical system. The final cohort consisted of 152 children. The median age was 52 months and age ranged from 2 to 215 months. Children with a single bite injury were older when compared with those with numerous injuries, 81 and 62 months of age, respectively. Among young children, 75% of injuries occurred above the neck and 15.1% were managed in the operating room. Twenty-four percent of children required either a tetanus or rabies vaccination. Most dog bite injuries occurred to facial structures. Comprehensive care of dog victims included awareness of both dog and injured child vaccination status.
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Affiliation(s)
- Taylor Mattice
- University of Minnesota Masonic Children's Hospital, Minneapolis, MN, USA
| | - Abigail Schnaith
- University of Minnesota Masonic Children's Hospital, Minneapolis, MN, USA
| | - Henry W Ortega
- Children's Hospitals and Clinics of Minnesota, Minneapolis, MN, USA
| | - Bradley Segura
- Department of Surgery, University of Minnesota, Minneapolis, MN, USA
| | - Rahul Kaila
- University of Minnesota Masonic Children's Hospital, Minneapolis, MN, USA
| | - Iluonose Amoni
- University of Minnesota Masonic Children's Hospital, Minneapolis, MN, USA
| | - Ryan Shanley
- University of Minnesota, Twin Cities, Minneapolis, MN, USA
| | - Jeffrey P Louie
- University of Minnesota Masonic Children's Hospital, Minneapolis, MN, USA
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Westgarth C, Provazza S, Nicholas J, Gray V. Review of psychological effects of dog bites in children. BMJ Paediatr Open 2024; 8:e000922. [PMID: 38844383 PMCID: PMC11163822 DOI: 10.1136/bmjpo-2020-000922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Accepted: 05/20/2024] [Indexed: 06/12/2024] Open
Abstract
BACKGROUND Dog bites are a concerning health problem in children and one of the leading causes of non-fatal injuries in this population. Dog attacks not only cause physical injuries but can also lead to long-term psychological problems. A review was performed to investigate the scope of literature on the psychological effects of dog bites on a paediatric population. METHODS A literature search was performed on Web of Knowledge database between 1982 to June 2023, returning 249 results. 14 primary studies reporting the psychological consequences of dog bites in children or adolescents were classed as eligible and 9 further studies were added from prior knowledge and bibliographical searches. 23 studies involving 1894 participants met the criteria and were included in this review. RESULTS Of these 23 studies, 8 were case studies or small case series reports (up to n=4), 14 larger descriptive studies and 1 analytical cross-sectional study. There was a mixture of retrospective and prospective data-gathering. The most common psychological consequences of dog bites in children were post-traumatic stress disorder, dog phobia, nightmares and symptoms of anxiety and avoidance behaviours. CONCLUSIONS Studies on dog bites in a paediatric population with a specific focus on the psychological consequences associated with dog bites and their management are sparse. Future research and practice should more greatly consider the psychological impact on child victims of dog bites and their family members, as well as their management to avoid the development of mental health issues and improve their quality of life. Future research also needs to ascertain the efficacy of using virtual reality in treating children with dog phobia.
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Affiliation(s)
- Carri Westgarth
- Department of Livestock and One Health, Faculty of Health and Life Sciences, University of Liverpool, Neston, Cheshire, UK
| | - Serena Provazza
- Department of Clinical Health Psychology, Alder Hey Children's NHS Foundation Trust, Liverpool, Merseyside, UK
| | | | - Victoria Gray
- Department of Clinical Health Psychology, Alder Hey Children's NHS Foundation Trust, Liverpool, Merseyside, UK
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Kelly SK, Hoffman GR. The K9-Teen Pandemic: When Good Boy Goes Bad. The Epidemiology, Management and Public Health Ramifications of Facial Dog Bite Injuries: Newcastle, Australia, Experience. Craniomaxillofac Trauma Reconstr 2024; 17:47-55. [PMID: 38371213 PMCID: PMC10874210 DOI: 10.1177/19433875231161941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2024] Open
Abstract
The purpose of this study was to investigate the epidemiology, pattern of injury and management of facial dog bite injuries. Methods: The authors conducted a retrospective cohort study over a 5-year period of patients who sustained a facial dog bite injury. The study setting was an Oral and Maxillofacial Surgery Department at a level 1 trauma centre, servicing an estimated catchment population in excess of 950,000 people. Results: In total, 171 patients were managed in the designated period from January 2017 to January 2022. The median age was 9 years (range 11 months to 77 years), with the highest incidence of a single age 4 years. The frequency was slightly greater amongst males (n = 93) than females (n = 78). The most common responsible breed were Pitbull types (n = 26). Overall, bites most often resulted from the family dog (n = 87), in the victim's own home (n = 84) and whilst playing with the dog (n = 64). The primary sites involved were the lips (n = 70), cheek (n = 53) and nose, representing the so called 'target area'. In 53 cases, the injuries were classified as severe. 138 patients required hospital admission, and of these, 130 required surgical management under general anaesthesia. Conclusions: Facial dog bite injuries present a significant burden on the healthcare system and result in physical, functional and/or emotional distress for the patient. As the rates of dog ownership continue to rise, a consequential increase in these injuries is also likely. Further, public health intervention is essential, particularly as the most susceptible demographic remains young male children.
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Affiliation(s)
| | - Gary R. Hoffman
- Department of Oral-Maxillofacial Surgery, John Hunter Hospital, Medical School, University of Newcastle, Newcastle, Australia
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Francis JM, Mowat FM, Ludwig A, Hicks JM, Pumphrey SA. Quantifying refractive error in companion dogs with and without nuclear sclerosis: 229 eyes from 118 dogs. Vet Ophthalmol 2024; 27:70-78. [PMID: 37986551 PMCID: PMC10842750 DOI: 10.1111/vop.13163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 11/03/2023] [Accepted: 11/09/2023] [Indexed: 11/22/2023]
Abstract
OBJECTIVE To evaluate the relationship between nuclear sclerosis (NS) and refractive error in companion dogs. ANIMALS STUDIED One hundred and eighteen companion dogs. PROCEDURES Dogs were examined and found to be free of significant ocular abnormalities aside from NS. NS was graded from 0 (absent) to 3 (severe) using a scale developed by the investigators. Manual refraction was performed. The effect of NS grade on refractive error was measured using a linear mixed effects analysis adjusted for age. The proportion of eyes with >1.5 D myopia in each NS grade was evaluated using a chi-square test. Visual impairment score (VIS) was obtained for a subset of dogs and compared against age, refractive error, and NS grade. RESULTS Age was strongly correlated with NS grade (p < .0001). Age-adjusted analysis of NS grade relative to refraction showed a mild but not statistically significant increase in myopia with increasing NS grade, with eyes with grade 3 NS averaging 0.58-0.88 D greater myopia than eyes without NS. However, the myopia of >1.5 D was documented in 4/58 (6.9%) eyes with grade 0 NS, 12/91 (13.2%) eyes with grade 1 NS, 13/57 (22.8%) eyes with grade 2 NS, and 7/23 (30.4%) eyes with grade 3 NS. Risk of myopia >1.5 D was significantly associated with increasing NS grade (p = .02). VIS was associated weakly with refractive error, moderately with age, and significantly with NS grade. CONCLUSIONS NS is associated with visual deficits in some dogs but is only weakly associated with myopia. More work is needed to characterize vision in aging dogs.
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Affiliation(s)
- Jenelle M Francis
- Department of Clinical Sciences, Cummings School of Veterinary Medicine at Tufts University, North Grafton, Massachusetts, USA
| | - Freya M Mowat
- Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, Wisconsin, USA
- Department of Ophthalmology and Visual Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Allison Ludwig
- Department of Ophthalmology and Visual Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Jacqueline M Hicks
- Department of Biostatistics, School of Public Health, Boston University, Boston, Massachusetts, USA
- Dr. Francis's current address is Animal Eye Clinic, Matthews, North Carolina, USA
| | - Stephanie A Pumphrey
- Department of Clinical Sciences, Cummings School of Veterinary Medicine at Tufts University, North Grafton, Massachusetts, USA
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Giovannini E, Roccaro M, Peli A, Bianchini S, Bini C, Pelotti S, Fais P. Medico-legal implications of dog bite injuries: A systematic review. Forensic Sci Int 2023; 352:111849. [PMID: 37783138 DOI: 10.1016/j.forsciint.2023.111849] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Revised: 09/13/2023] [Accepted: 09/25/2023] [Indexed: 10/04/2023]
Abstract
Dog bites pose a significant global public health issue and are the most common type of injury caused by animals. While most dog bites result in minor harm, they can also lead to severe or even fatal consequences. In cases involving serious injury or death, forensic pathologists investigate various aspects, including the crime scene, the injuries sustained by the victim, and the characteristics of the dog suspected to have caused the bite. The aim of this study is to provide a systematic review of the literature on the medical-legal implications of dog bites in forensic practice, in order to recognize the dog bite victim features, the injuries and their consequences related to, and to identify the offending dogs. The literature search was performed using PubMed, Scopus and Web of Science from January 1980 to March 2023. Eligible studies have investigated issues of interest to forensic medicine about dog bites to humans. A total of 116 studies met the inclusion criteria and were included in the review and they were organized and discussed by issue of interest (biting dog features, dog bite victim features, anatomical distribution of dog bites, injuries related to dog bites, cause of death, bite features, dog identification and post-mortem dog depredation). The findings of this systematic review highlight the importance of bite mark analysis in reconstructing the events leading to the attack and identifying the dog responsible. In medical forensic evaluations of dog bite cases, a multidisciplinary approach is crucial. This approach involves thorough analysis of the crime scene, identification of risk factors, examination of dog characteristics, and assessment of the victim's injuries. By combining expertise from both human and veterinary forensic fields, a comprehensive understanding can be achieved in dog bite cases.
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Affiliation(s)
- Elena Giovannini
- Department of Medical and Surgical Sciences, Unit of Legal Medicine, University of Bologna, Via Irnerio 49, 40126 Bologna, Italy.
| | - Mariana Roccaro
- Department of Veterinary Medical Sciences, University of Bologna, Via Tolaradi Sopra, 50, Ozzano dell'Emilia, 40064 Bologna, Italy.
| | - Angelo Peli
- Department of Veterinary Medical Sciences, University of Bologna, Via Tolaradi Sopra, 50, Ozzano dell'Emilia, 40064 Bologna, Italy.
| | - Simone Bianchini
- Department of Medical and Surgical Sciences, Unit of Legal Medicine, University of Bologna, Via Irnerio 49, 40126 Bologna, Italy.
| | - Carla Bini
- Department of Medical and Surgical Sciences, Unit of Legal Medicine, University of Bologna, Via Irnerio 49, 40126 Bologna, Italy.
| | - Susi Pelotti
- Department of Medical and Surgical Sciences, Unit of Legal Medicine, University of Bologna, Via Irnerio 49, 40126 Bologna, Italy.
| | - Paolo Fais
- Department of Medical and Surgical Sciences, Unit of Legal Medicine, University of Bologna, Via Irnerio 49, 40126 Bologna, Italy.
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Brahmbhatt PS, Taha I, Nahal C, Raju S. Pediatric Long Bone Fractures After Dog Bites: A Case Series and Systematic Review. Cureus 2023; 15:e47230. [PMID: 38022042 PMCID: PMC10654008 DOI: 10.7759/cureus.47230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/13/2023] [Indexed: 12/01/2023] Open
Abstract
This study presents a case series and systematic review of pediatric patients who sustained long bone fractures following dog bites. A systematic review of the studies on "pediatric fracture dog bite" based on a search of PubMed and OVID Medline databases was performed by adhering to PRISMA guidelines. Articles in English describing pediatric long bone fractures due to dog bites were included. Studies not differentiating pediatric from adult patients and not describing long bone fractures due to dog bites were excluded. Study characteristics, fracture epidemiology, management decisions, and follow-up data were extracted. Additionally, a seven-year retrospective chart review of cases treated at our level one pediatric trauma center was performed. Data on fracture characteristics, surgical management, choice of antibiotic therapy, and follow-up were collected. Five studies that met our criteria were analyzed. Pediatric long bone fractures from dog bites were identified in 0.35% (11/3,156) of patients. Such fractures most commonly involved the upper extremity (9/11, 82%). None of the studies described the choice of antibiotics, surgical decision-making, or wound closure preference for an underlying fracture. Our chart review elicited three cases of long bone fractures due to dog bites. Pediatric long bone fractures after dog bites are a rare injury pattern in the United States. These injuries should be treated as contaminated open fractures, and urgent immunization, intravenous antibiotic administration, wound care, and fracture stabilization should be provided. We recommend meticulous surgical debridement in the operating room, as wounds often probe deep into the bone. Nevertheless, there is much that remains unclear about these injuries. Hence, further research with greater power is needed to improve treatment decisions.
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Affiliation(s)
- Purav S Brahmbhatt
- Department of Orthopedic Surgery, Saint Louis University School of Medicine, St. Louis, USA
| | - Isra Taha
- Department of Orthopedic Surgery, Saint Louis University School of Medicine, St. Louis, USA
| | - Chadi Nahal
- Department of Orthopedic Surgery, Saint Louis University School of Medicine, St. Louis, USA
| | - Sivashanmugam Raju
- Department of Orthopedic Surgery, Saint Louis University School of Medicine, St. Louis, USA
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Sandhaus H, Boakye EA, Johnson M. Incidence of facial fractures in association with facial laceration from dog bites in the pediatric patient. Int J Pediatr Otorhinolaryngol 2023; 172:111639. [PMID: 37478789 DOI: 10.1016/j.ijporl.2023.111639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 06/05/2023] [Accepted: 06/16/2023] [Indexed: 07/23/2023]
Abstract
INTRODUCTION Dog bite injuries occur in approximately 102 of every 100,000 population. Pediatric facial injuries due to dog bites are more common than in the adult largely due to height difference and ease of access for the dog to the head and neck region. Although majority are soft tissue injuries, pediatric facial fractures from dog bites are estimated at approximately 5%, with the true incidence unknown. We hypothesize that depth and facial subsite of laceration can indicate likelihood of facial fracture presence in pediatric patients with dog bite injuries. METHODS This single-institution retrospective study included 162 patients 18 years or younger (n = 162) who had an ICD-9 code of E906.0 or ICD-10 code of W54.0 for dog bites in the head and neck region between 1/1/2015 and 12/31/2019 and were treated in the emergency department by either an emergency department, otolaryngology, or plastics surgery provider. Multivariable logistic regressions were used to examine the association between patient age, sex, and dog size, and the outcomes: laceration depth (epidermis, dermis, muscle, bone), and facial subsite (upper, middle, lower third). RESULTS Males had a lower laceration penetration at the epidermis level (aOR = 0.36; 95% CI 0.19, 0.69) but a higher laceration penetration at the muscle level (aOR = 2.29; 95% CI 1.04, 5.04) compared to females. No significant findings were observed for the levels of dermis and bone. In the multivariable analysis, there were no significant associations to suggest facial fractures found between facial subsites and age, sex and dog size. CONCLUSION No significant associations between depth or facial subsite of facial injury from dog bites and the presence of facial fractures in pediatric patients except with regard to male sex and laceration level of epidermis and muscle.
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Affiliation(s)
- Henya Sandhaus
- Department of Otolaryngology - Head and Neck Surgery, Southern Illinois University School of Medicine, Springfield, IL, USA
| | - Eric Adjei Boakye
- Department of Public Health Sciences, Henry Ford Health, Detroit, MI, USA; Department of Otolaryngology - Head and Neck Surgery, Henry Ford Health, Detroit, MI, USA
| | - Matthew Johnson
- Department of Otolaryngology - Head and Neck Surgery, Southern Illinois University School of Medicine, Springfield, IL, USA.
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Alessio-Bilowus D, Kumar N, Donoghue L, Ridelman E, Shanti C. Factors affecting length and complexity of hospital stay in pediatric dog bite patients. Trauma Surg Acute Care Open 2023; 8:e001071. [PMID: 37529295 PMCID: PMC10387659 DOI: 10.1136/tsaco-2022-001071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 07/02/2023] [Indexed: 08/03/2023] Open
Abstract
Background Dog bite injuries are a source of significant morbidity and expense in the USA, and rates of hospitalization have been rising. Children are at increased risk of dog bites compared with adults, yet there is a lack of published material on factors affecting hospital course. The objective of this study is to explore factors associated with increased length of stay (LOS), more complex course of care and post-discharge return rates in this population. Methods A retrospective review was conducted of all patients presenting to our urban, academic children's hospital for dog bite injuries between January 2016 and May 2021. Only those patients admitted for inpatient care were included, as identified through our institution's trauma registry, and variables were examined prior to, during, and after hospital stay. Results 739 pediatric patients in total were treated for dog bites during the study period, of which 349 were admitted. Analysis revealed two pre-admission predictors of increased LOS: bone fracture (mean LOS=5.3 days vs. 2.5 days, p=0.013) and prior medical comorbidity (4.3 days vs. 2.8 days, p=0.042). After admission, fractures were associated with a higher rate of postoperative complications (16% vs. 5.6%, p=0.014) and return (13% vs. 2.0%, p<0.001), primarily due to wound infection. Although the facial region represented the largest proportion of fractures, long bone fractures of the arm and leg were noted to have comparatively higher LOS and complication rates. Postoperative complications were not associated with any documented infection at admission. Conclusions Our findings suggest that long bone fractures in pediatric dog bites can be an underappreciated source of latent wound infection associated with late-presenting negative outcomes. Increased awareness of these relationships could lead to earlier detection of infection in this vulnerable population. Level of evidence Level III, Prognostic / Epidemiological.
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Affiliation(s)
- Dominic Alessio-Bilowus
- Department of Surgery, Wayne State University School of Medicine, Detroit, Michigan, USA
- Division of Pediatric Surgery, Department of Surgery, Children's Hospital of Michigan, Detroit, Michigan, USA
| | - Nishant Kumar
- Division of Pediatric Surgery, Department of Surgery, Children's Hospital of Michigan, Detroit, Michigan, USA
| | - Lydia Donoghue
- Department of Surgery, Wayne State University School of Medicine, Detroit, Michigan, USA
- Division of Pediatric Surgery, Department of Surgery, Children's Hospital of Michigan, Detroit, Michigan, USA
| | - Elika Ridelman
- Department of Surgery, Wayne State University School of Medicine, Detroit, Michigan, USA
- Division of Pediatric Surgery, Department of Surgery, Children's Hospital of Michigan, Detroit, Michigan, USA
| | - Christina Shanti
- Department of Surgery, Wayne State University School of Medicine, Detroit, Michigan, USA
- Division of Pediatric Surgery, Department of Surgery, Children's Hospital of Michigan, Detroit, Michigan, USA
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Aydin O, Aydin Goker ET, Arslan ZA, Sert HM, Teksam O. Clinical features and management of animal bites in an emergency department: a single-center experience. Postgrad Med 2023; 135:31-37. [PMID: 36093812 DOI: 10.1080/00325481.2022.2124089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
OBJECTIVES This study aimed to evaluate the clinical features, management, and outcomes of patients with animal bites presented to the pediatric emergency department of a tertiary center. METHODS Patients with ICD-10 code W54 (contact with dog) and W55 (contact with other mammals) between March 1st, 2017, and July 1st, 2021, were included in the study. Demographic characteristics of the patients, type of contacted animal, wound characteristics (muscle involvement, soft tissue defect, vascular injury, type of nerve injury, and Lackmann's classification), wound care measurements, tetanus prophylaxis, administration of rabies immunoglobulin and antibiotics, location of the injury, existing fractures, suturing, splinting, surgical consultations and hospitalization status were recorded. RESULTS Four hundred and nineteen incidents of animal bites (240 males and 179 females) occurred over a four-year period. 51% was due to a dog bite; 47% was by a cat. The median age was nine years (IQR: 5-14 years). Most bites (91.6%) involved only a single anatomical site. The extremities were the commonly involved part (right upper limb [35.3%], left upper limb [21.2%], right lower limb [12.6%], left lower limb [16%]). Head-neck and face injury ratio was 17.6%. Torso (5.7%) and genitalia (5.2%) were uncommonly involved. A consultation was requested from at least one surgical department for 8% of the patients. 97.1% of patients received a rabies vaccine. Most attacks were trivial and did not require hospitalization. CONCLUSION Animal bites often cause minor injuries. However, multiple dog attacks can be seen related to a high number of stray animals in our country. Therefore, these patients may present with major traumas. Surgical intervention and hospitalization may be required. Emergency physicians play an essential role in acute management and rabies prophylaxis in these patients.
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Affiliation(s)
- Orkun Aydin
- Division of Pediatric Emergency, Department of Pediatrics, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | | | | | | | - Ozlem Teksam
- Division of Pediatric Emergency, Department of Pediatrics, Faculty of Medicine, Hacettepe University, Ankara, Turkey
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Kogan LR, Packman W, Erdman P, Currin-McCulloch J, Bussolari C. US Adults' Perceptions of Dog Breed Bans, Dog Aggression and Breed-Specific Laws. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10138. [PMID: 36011770 PMCID: PMC9408513 DOI: 10.3390/ijerph191610138] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 08/14/2022] [Accepted: 08/14/2022] [Indexed: 06/15/2023]
Abstract
Dog aggression directed towards people is a leading reason for relinquishment and a major public health hazard. In response to the threat of dog aggression and dog bites, breed-specific legislation has been introduced in numerous cities within the United States and countries throughout the world. There is limited evidence, however, to suggest that such laws are effective. This study explored, through an online, anonymous, cross-sectional survey, US residents' views about the bite risk of common dog breeds, breed-specific legislation, and alternative options for improved public safety. A total of 586 surveys were completed by adult US residents, 48.8% female and 48.6% male. Approximately half of the respondents reported feeling that dog bites are a serious public health issue. Although 70% of respondents were opposed to a breed ban, only 56% felt that banning specific breeds creates an animal welfare issue. Females were less likely to support a ban or agree that specific breed bans improve public safety. When participants were asked to indicate their support of several alternatives to breed-specific legislation, the most frequently endorsed options included public education about animal welfare and animal behavior, and stricter leash laws. Further research pertaining to the most effective public education dissemination methods is warranted.
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Affiliation(s)
- Lori R. Kogan
- Clinical Sciences, Colorado State University, Fort Collins, CO 80523, USA
| | - Wendy Packman
- Department of Psychology, Palo Alto University, Palo Alto, CA 94304, USA
| | - Phyllis Erdman
- College of Education, Washington State University, Pullman, WA 99163, USA
| | | | - Cori Bussolari
- Counseling Psychology, University of San Francisco, San Francisco, CA 94117, USA
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Stanbouly D, Selvi F. What factors influence the hospitalization outcomes of pediatric patients suffering facial dog bite wounds? Br J Oral Maxillofac Surg 2022. [DOI: 10.1016/j.bjoms.2022.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Kienesberger B, Arneitz C, Wolfschluckner V, Flucher C, Spitzer P, Singer G, Castellani C, Till H, Schalamon J. Child safety programs for primary school children decrease the injury severity of dog bites. Eur J Pediatr 2022; 181:709-714. [PMID: 34535830 PMCID: PMC8821379 DOI: 10.1007/s00431-021-04256-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 06/06/2021] [Accepted: 09/01/2021] [Indexed: 11/08/2022]
Abstract
This study focuses on the impact of a prevention program regarding dog bites in children. As a consequence of our previous investigation in 2005, we have initiated a child safety program for primary school children starting January 2008 until present to teach children how to avoid dog attacks and how to behave in case of an attack. In our retrospective study, we analyzed all patients younger than 15 years presenting with dog-related injuries between 2014 and 2018. As the main indicator for success of the prevention measures taken, we have defined the severity of injury in comparison to our previous study. Out of 296 children with dog-related injuries, 212 (71.6%) had sustained a dog bite. In the vast majority (n = 195; 92%), these patients presented with minor injuries; the extremities were most commonly affected (n = 100; 47%). Injuries to the head (n = 95; 45%) and trunk (n = 18; 8%) were less frequent. The proportion of severe injuries (8%) was significantly lower compared to our previous study, where 26% of children presented with severe injuries necessitating surgical intervention, while the number of patients requiring in-hospital treatment declined from 27.5% in the period 1994-2003 to 9.0% in the period between 2014 and 2018 (p < 0.05).Conclusion: Teaching of primary school children may effectively reduce the injury severity of dog bites. What is Known: • Dog bites are a substantial healthcare problem especially in children. What is New: • This study shows that a broad-based prevention program for primary school children can effectively decrease the severity but not the frequency of dog bite injuries in children.
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Affiliation(s)
- Bernhard Kienesberger
- grid.11598.340000 0000 8988 2476Department of Pediatric and Adolescent Surgery, Medical University of Graz, Auenbruggerplatz 34, 8036 Graz, Austria
| | - Christoph Arneitz
- grid.11598.340000 0000 8988 2476Department of Pediatric and Adolescent Surgery, Medical University of Graz, Auenbruggerplatz 34, 8036 Graz, Austria
| | - Vanessa Wolfschluckner
- grid.11598.340000 0000 8988 2476Department of Pediatric and Adolescent Surgery, Medical University of Graz, Auenbruggerplatz 34, 8036 Graz, Austria
| | - Christina Flucher
- grid.11598.340000 0000 8988 2476Department of Pediatric and Adolescent Surgery, Medical University of Graz, Auenbruggerplatz 34, 8036 Graz, Austria
| | - Peter Spitzer
- Research Center for Childhood Accidents, Safe Kids Austria, Graz, Austria
| | - Georg Singer
- grid.11598.340000 0000 8988 2476Department of Pediatric and Adolescent Surgery, Medical University of Graz, Auenbruggerplatz 34, 8036 Graz, Austria
| | - Christoph Castellani
- grid.11598.340000 0000 8988 2476Department of Pediatric and Adolescent Surgery, Medical University of Graz, Auenbruggerplatz 34, 8036 Graz, Austria
| | - Holger Till
- grid.11598.340000 0000 8988 2476Department of Pediatric and Adolescent Surgery, Medical University of Graz, Auenbruggerplatz 34, 8036 Graz, Austria
| | - Johannes Schalamon
- Department of Pediatric and Adolescent Surgery, Medical University of Graz, Auenbruggerplatz 34, 8036, Graz, Austria.
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13
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Ramgopal S, Macy ML. Pediatric patients with dog bites presenting to US children's hospitals. Inj Epidemiol 2021; 8:55. [PMID: 34517911 PMCID: PMC8436008 DOI: 10.1186/s40621-021-00349-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 08/19/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND To characterize pediatric dog bite injuries presenting to US children's hospitals and identify factors associated with clinically significant injuries. METHODS We performed a multicenter observational study from 26 pediatric hospitals between July 1, 2010, and June 30, 2020, including patients ≤ 18 years with dog bites, consolidating together encounters from patients with multiple encounters within 30 days as a single episode of care. We characterized diagnoses and procedures performed in these patients. We used generalized linear mixed models to identify factors associated with a composite outcome that we term clinically significant injuries (defined as admission, operating room charge, sedation, fractures/dislocations, intracranial/eye injury, skin/soft tissue infection, or in-hospital mortality). RESULTS 68,833 episodes were included (median age 6.6 years [interquartile range 3.5-10.4 years], 55.5% male) from 67,781 patients. We identified 16,502 patients (24.0%) with clinically significant injuries, including 6653 (9.7%) admitted, 5080 (7.4%) managed in the operating room, 11,685 (17.0%) requiring sedation, 493 (0.7%) with a skull fracture, 32 (0.0%) with a fracture in the neck or trunk, 389 (0.6%) with a fracture of the upper limb, 51 (0.1%) with a fracture in the lower limb, 15 (0.0%) with dislocations, 66 (0.1%) with an intracranial injury and 164 (0.2%) with an injury to the eyeball, 3708 (5.4%) with skin/soft tissue infections, and 5 (0.0%) with in-hospital mortality. In multivariable analysis, younger age (0-4 years, 5-9 years, and 10-14 years relative to 15-18 years), weekday injuries, and an income in the second and third quartiles (relative to the lowest quartile) had higher odds of clinically significant injuries. Black patients (relative to White), Hispanic/Latino ethnicity, and private insurance status (relative to public insurance) had lower odds of clinically important injuries. When evaluating individual components within the composite outcome, most followed broader trends. CONCLUSION Dog bites are an important mechanism of injury encountered in children's hospitals. Using a composite outcome measure, we identified younger, White, non-Hispanic children at higher risk of clinically significant injuries. Findings with respect to race and ethnicity and dog bite injuries warrant further investigation. Results can be used to identify populations for targeted prevention efforts to reduce severe dog bite injuries.
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Affiliation(s)
- Sriram Ramgopal
- Division of Pediatric Emergency Medicine, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, 225 E Chicago Ave, Box 62, Chicago, IL, 60611, USA.
- Mary Ann & J. Milburn Smith Child Health Outcomes, Research, and Evaluation Center, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
| | - Michelle L Macy
- Division of Pediatric Emergency Medicine, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, 225 E Chicago Ave, Box 62, Chicago, IL, 60611, USA
- Mary Ann & J. Milburn Smith Child Health Outcomes, Research, and Evaluation Center, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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Reuter Muñoz KD, Powell LE, Andersen ES, Nye AD, Powers JM, Rhodes J, Pozez AL. Analysis of Pediatric Dog Bite Injuries at a Level 1 Trauma Center Over 10 Years. Ann Plast Surg 2021; 86:S510-S516. [PMID: 34100808 DOI: 10.1097/sap.0000000000002928] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Dog bite injuries cause significant preventable patient morbidity and health care expenditure in children. This study aimed to characterize the patient and healthcare burden related to pediatric dog bite injuries at a level 1 trauma center. METHODS This is a retrospective review of 356 pediatric patients who presented to Virginia Commonwealth University Pediatric Emergency Department between July 2007 and August 2017 after sustaining dog bite injuries. Demographic information, injury details, management, outcomes, and financial information were analyzed. RESULTS Most pediatric dog bite injuries afflicted male children (55.6%), ages 6 to 12 years (45.7%), by a household dog (36.2%). The most common offending breed was a pit bull or pit bull mix (53.0%). Infants and grade schoolers were more likely to sustain bites to the head/face (P = 0.001). Usual management consisted of primary repair (75.9%), whereas approximately 25% of the patients required advanced reconstructive techniques. Most patients healed uneventfully, but prolonged antibiotics, additional wound care, or procedures were necessary in 8.4% of the patients. Hospital charges per patient averaged US $8830.70 and tended to be higher in the younger age groups. Insurance status was statistically associated with use of conscious sedation, surgical consult placement, and surgical repair. CONCLUSIONS Although most pediatric dog bite injuries in this study healed uneventfully from primary management in the emergency department, 25% required additional interventions. Furthermore, patient care for these injuries was associated with significant but potentially avoidable personal and financial burden to families. Our data reflect a need for safety education on animal care, behavior, and interaction.
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Affiliation(s)
| | - Lauren E Powell
- From the Virginia Commonwealth University School of Medicine
| | | | | | | | - Jennifer Rhodes
- Division of Plastic and Reconstructive Surgery, Children's Hospital of Richmond
| | - Andrea L Pozez
- Division of Plastic and Reconstructive Surgery, Virginia Commonwealth University Medical Center; Richmond, VA
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Saleem SM, Quansar R, Haq I, Salim Khan SM. Imposing COVID-19 lockdown and reported dog bite cases: An experience from a tertiary antirabies center of North India. J Vet Behav 2021; 42:48-52. [PMID: 36042750 PMCID: PMC9412179 DOI: 10.1016/j.jveb.2021.01.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 01/19/2021] [Accepted: 01/20/2021] [Indexed: 11/29/2022]
Abstract
The world was taken aback after the corona pandemic started from China and soon engulfed the whole of the world. Strict restrictions were in place since the beginning, and people were confined to their homes; only emergency services were allowed to work. The study's objectives were to see the effect of lockdown on the number of dog bite cases being reported to our antirabies clinic. The study was conducted in the antirabies clinic of the Department of Community Medicine, Government Medical College, Srinagar, Jammu & Kashmir. This study involved a dog bite victim who approached the said clinic during the lockdown, which was implemented in the wake of COVID-19 from March 21, 2020 to June 03, 2020. We included all the dog bite victims living in the Srinagar city and from the adjoining districts who had been bitten by the street dog during the lockdown phase. Over 5 years, 4,670 (73.6%) dog bites among males were reported. The proportion of dog bites among males varies from 72% to 81% in the 5 years. It can be observed that a maximum of 783 (81.1%) dog bites were reported from males during the lockdown period in 2020. Moreover, 2,847 (44.9%) bites were category II dog bites, while 3,392 (55.1%) were category III dog bites. There were fewer dog bites reported at the first, fourth, seventh, eighth, and ninth weeks while there was a little surge in cases on the 2nd, 3rd, 5th, 6th, and 10th week. Lockdown had indirectly reduced the number of dog bite cases reported to the clinic during different lockdown phases than the previous year's data.
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