US estimates for dog bite injuries presenting to emergency departments

Objectives: Dog bites are a frequent source of injury requiring emergency department (ED) management. We sought to evaluate the longitudinal burden of dog bites presenting to US EDs.

Study design: Cross-sectional study of a complex survey.

Methods: We evaluated the National Hospital Ambulatory Medical Care Survey, a complex survey of non-federal US ED encounters between 2002 and 2017. Dog bites were identified via ICD-9-CM and ICD-10-CM codes. We report trends in dog bites (adjusted to US Census population data) overall and among patients younger than 18 years using the Spearman rank correlation test.

Results: Of 2.0 billion ED encounters, 6.6 million (0.3%, 95% confidence interval [CI] 0.3-0.4%) were for dog bites. There were 13.5 encounters per 10,000 population (all ages) and 20.8 per 10,000 among those younger than 18 years. Rates of bites increased over time for encounters younger than 18 years (rho = 0.54, 95% CI 0.08, 0.82), but not for those aged 18 years or older (rho = 0.44, 95% CI -0.08, 0.77). Among patients younger than 18 years, the rate of presentations increased from 17.7 to 22.3 per 10,000 encounters during the 16-year period. The highest rate of encounters was among patients aged 6-11 years, where 24.3 per 10,000 presented with dog bites and for which 59.3% (95% CI 49.1-69.6%) were boys. Overall, 75.3% (95% CI 72.3-89.3%) were provided with antibiotics and 4.1% (95% CI 2.5-5.7%) were diagnosed with skin/soft tissue infection.

Conclusion: Dog bite presentations demonstrated a small but significant increase in rates of presentation over time among children and youth. Continued efforts are needed to curb this common injury.