390 - Retrospective Review Of Dog Bite Visits In A Pediatric ED

Poster Number: 390
Publication Number: 390.314

Kathy Monroe, University of Alabama School of Medicine, birmingham, AL, United States; Charli Cohen, University of Alabama- Birmingham, Birmingham, AL, United States; Michele Nichols, University of Alabama at Birmingham, Birmingham, AL, United States; William King, Children's Hospital, Birmingham, AL, United States; Ashley Bridgmon, Children's of Alabama, Birmingham, AL, United States

Background: Dog bites have been a common cause of pediatric emergency department (ED) visits. In June 2020 in the Journal of Pediatrics, “Dog Bites in Children Surge during Coronavirus Disease-2019: A Case for Enhanced Protection” discussed an almost three-fold increase in dog bites treated in the ED since the beginning of the COVID-19 pandemic at an urban Children’s Hospital in the Midwest.

Objective: This study aimed to describe the epidemiology of dog bite ED visits and to evaluate changes in dog bite visits over pre covid and peri covid time periods. Study objectives: 1) To describe the epidemiology of dog bite related ED visits and admissions; 2) To evaluate changes in the rate of dog bite ED visits during pre-Covid and Covid time frames.

Design/Methods: This study reviewed 2 years (2019 and 2020) of dog bite visit data. Descriptive statistical and epidemiologic analyses were conducted using Epi Info 7 (CDC). Statistical comparisons and analyses of continuous and categorical data were performed. Differences in proportions and T Test of means were reported with corresponding 95% Confidence Intervals (CI’s).

Results: During the 2 study period, 522 dog bite visits were treated representing 1.7% of all injury ED visits. Gender analyses indicated a higher proportion of males vs females (53.6% vs 46.4%), respectively. A higher proportion of white patients vs nonwhites was observed (62.8% vs 37.2%), respectively. Mean patient age was 6.1 yrs. Outcome metrics included patient disposition (3 categories): Admitted 57 (10.9%), Discharged 458 (87.7%), Other 7 (1.4%). Admitted patients were younger (statistically) 4.9 yrs vs 6.3 yrs, age difference -1.4 yrs 95% CI diff (-0.3, -2.5). Total length of stay for Admitted = 117 days (mean 2.1 days) and for Discharged mean hrs in the ED 3.7. Total charges were $2.6 million (mean = $4902, median $2043). The leading anatomic sites injured were head, face, and neck, all ages, (61.1%), but accounted for 79.8% for ages under 6 yrs.
An increase in the rate of dog bite visits was detected during the peri covid vs pre covid time frames, (20.4 per 1,000 injury visits vs 14.6 per 1,000 visits, rate difference = 5.8, 95% CI (3.4, 9.6).Conclusion(s): The peri covid time period was associated with a higher dog bite visit rate. Although the peri covid period had 20% fewer total injury visits than pre covid, it had a 39.7% higher rate of dog bite visits. Dog bites are a significant cause of injury in children and result in costly visits seen in the ED.