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Published on: October 13, 2017
Breed-specific Risk Factors and Clinical Outcomes in Pediatric Dog Bite Injuries: A 14-year Retrospective Analysis
Danny S Chamaa1, Liara S Ortiz-Ocasio1, Athena Zhang1
1From the Division of Plastic and Reconstructive Surgery, Children's National Hospital, Washington, DC.
Background:
Dog bites are a major cause of pediatric injury, resulting in serious physical and psychological effects. This study examines breed-specific injury patterns, management, and outcomes.
Methods:
A retrospective review of pediatric dog bite cases from 2010 to 2024 was conducted. Variables included demographics, injury characteristics, dog breed, management, and outcomes (eg, infection, scarring, revisions). Descriptive and statistical analyses were performed.
Results:
Among 430 patients, the median age was 8.0 years (interquartile range 4.0-11.0). Bite frequency decreased with age (Spearman rho = -0.67; P = 0.001). Head and neck injuries were the most common (184 of 430, 42.8%). Specialist consultation occurred in 125 of 430 (29.1%), and 41 of 430 (9.5%) required operating room (OR) intervention. Head and neck injuries had higher rates of complex reconstruction (15 of 184, 8.2% versus 6 of 246, 2.4%; P = 0.007), soft-tissue loss (15.8% versus 7.7%; P = 0.009), and avulsion (19.6% versus 4.9%; P < 0.001) compared with injuries elsewhere. Among known breeds (n = 169), pit bulls were the most frequently reported (81 of 169, 47.9%). Management patterns and outcomes did not differ significantly by breed. In multivariable regression analysis (n = 169), dermal (OR 25.48, 95% confidence interval 2.97-679.02; P = 0.013) and subcutaneous involvement (OR 6.85, 95% confidence interval 1.33-54.54; P = 0.037) were associated with higher odds of abnormal scars, whereas breed was not. Patients requiring specialist consultation had higher return-to-OR rates than emergency department-managed patients (8.0% versus 0.0%; P < 0.001), with similar infection rates (6.4% versus 4.9%).
Conclusions:
Objective wound characteristics were more informative than breed classification for predicting management needs and scar outcomes. Prevention should prioritize safer child-dog interactions in familiar settings. Improved structured documentation may strengthen future risk stratification.
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