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Comparison of the epidemiology of human bites evaluated at three US pediatric emergency departments
Roland C Merchant1, Janene Fuerch, Bruce M Becker
1Department of Emergency Medicine, Brown Medical School, Rhode Island Hospital, Providence, RI 02903, USA. rmerchant@lifespan.org
Insights
Pediatric emergency department visits for human bites are infrequent and stable. While more males present with bites, the frequency may be similar between genders, with adolescents being more affected.
Area of Science:
- Pediatric Emergency Medicine
- Epidemiology
- Injury Prevention
Background:
- Human bites in children are a public health concern requiring epidemiological assessment.
- Understanding the frequency and characteristics of pediatric human bites is crucial for targeted interventions.
Purpose of the Study:
- To assess the current epidemiology of human bites in pediatric emergency departments (EDs).
- To compare current data with prior studies on pediatric human bites regarding frequency, demographics, and management.
- To determine if human bite injury frequency varies by year, gender, or body location.
Main Methods:
- Retrospective analysis of pediatric ED visits for human bites from 1995-2001.
- Identification of human bites using International Classification of Disease, Ninth Revision, Clinical Modification codes.
- Comparison with data from two previous ED studies on pediatric human bites.
Main Results:
- Human bites comprised 0.04% of pediatric ED visits, remaining stable over the study period.
- While males constituted the majority of patients, there was no statistically significant gender-based difference in visit frequency.
- Adolescents showed a higher frequency of human bites, with altercations and play being common causes.
Conclusions:
- Pediatric ED visits for human bites are infrequent and appear stable.
- Altercations and human bites may be associated with adolescence.
- Most pediatric human bite patients are male, but the actual incidence may not differ significantly between genders.
Objectives:
(1) Using clearly defined methods, provide a current assessment of the epidemiology of human bites sustained by pediatric patients evaluated at a pediatric ED; (2) Compare the frequency, demography, locations, and management of these injuries from the results of the current study to the 2 prior ED studies on pediatric human bites; and (3) Determine if the frequency of these injuries varies by year, gender, or body location.
Methods:
The current study involved a retrospective analysis of all visits to an urban, northeastern, United States pediatric ED from 1995 to 2001. Visits for human bites were identified by International Classification of Disease, Ninth Revision, Clinical Modification codes using 2 separate computerized billing databases. Data were extracted from 2 prior published studies for the comparative portion of the study. Frequency estimates and 95% confidence intervals were created using STATA7.
Results:
For the current study, there were 115 visits for human bites, which comprised 0.04% [0.03-0.05] of total visits to this pediatric ED. Bite visits as a percentage of pediatric ED visits remained the same during the 7 years of the current study. For all 3 pediatric EDs, human bites consisted of much less than 1% of the overall patient volume. The majority (65% [55.8-73.9]) of the patients in the current study were male. When adjusted for the frequency of all patient visits by gender, there was no statistically significant difference in percentage of visits for human bites between males and females (0.05% [0.039-0.063] vs. 0.03% [0.023-0.044]) in the current study. Prior studies did not reveal a statistically significant predominance of males presenting for human bites. As a percentage of visits by age group, human bites were more frequent among adolescents in the current study. Altercations and child play were reported approximately equally as the circumstances contributing to the bites in the current study, although altercations were reported more often in older age groups. In all 3 studies, fewer than 14% of patients were admitted and over 80% presented within 12 or 24 hours after the bite.
Conclusions:
Pediatric ED visits for human bites are infrequent and from the current study data, the frequency of visits for these injuries appears to be currently stable. Altercations may not be the main circumstances surrounding all pediatric human bites, yet altercations and human bites might be jointly associated with adolescence. The current study results suggest that most pediatric ED human bite patients are male, although males may not necessarily sustain human bites more frequently than females. Visits for human bite injuries may increase in frequency with age, in comparison to visits for other medical conditions.
