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Analysis of Nonfatal Dog Bites in Children

Daniels, Dawn Marie DNS, RN; Ritzi, Rovane B. S. BS, MPH; O’Neil, Joseph MD, MPH, FAAP; “Tres Scherer, L R. MD, FACS

The Journal of Trauma: Injury, Infection, and Critical Care: March 2009 - Volume 66 - Issue 3 - p S17-S22
doi: 10.1097/TA.0b013e3181937925
Original Articles

Background: Dog bites are a significant public health problem among children. The purpose of this study was to examine the hospital incidence, hospital charges, and characteristics of dog bite injuries among children by age group and hospitalization status who were treated at our health care system to guide prevention programs and policies.

Methods: An electronic hospital database identified all patients younger than 18 years who were treated for dog bites from 1999 to 2006. Demographics, injury information, hospital admission status, length of stay, hospital charges, and payer source were collected. A further review of the narrative part of the inpatient electronic database was examined to identify owner of the dog, type of dog, and circumstances surrounding the incident.

Results: During 8 years, 1,347 children younger than 18 years were treated for dog bites. The majority were treated and released from the emergency department (91%). Of the 66 children (4.9%) requiring inpatient admission, the median length of stay was 2 days. Victims were frequently male (56.9%) and <8 years (55.2%). Children younger than 5 years represented 34% of all dog bite victims, but 50% of all children requiring hospitalization. Thirty-seven percent of all children admitted to the hospital were bitten by a family dog. The cost of direct medical care during the study was $2.15 million.

Conclusion: Dog bite visits comprised 1.5% of all pediatric injuries treated in our hospital system during the study period. The majority (91%) of all dog bite visits were treated and released from the emergency department. Injuries to the head/neck region increased the odds of requiring 23 hour observation (OR, 1.95) and age less than 5 years increased the odds of being admitted as an inpatient (OR, 3.3).

From the Departments of Public Health (R.B.S.R.), Pediatrics (J.O.N.), and Surgery (L.R.T.S.), Indiana University School of Medicine, Indianapolis, IN; and Injury Free Coalition for Kids (D.M.D.), Riley Hospital for Children, Indianapolis, IN.

Submitted for publication November 2, 2007.

Accepted for publication May 9, 2008.

This paper was presented at the IFCK Conference in December 2007.

Address for reprints: Dawn Marie Daniels, DNS, RN, Injury Free Coalition for Kids, Riley Hospital for Children, 702 Barnhill Drive, Suite 2500, Indianapolis, IN 46202; email:

© 2009 Lippincott Williams & Wilkins, Inc.