Citation

Uppuluri S, Nguyen J, Uppuluri A, Langer PD, Bhagat N. J. Pediatr. Ophthalmol. Strabismus 2024; 61(4): 296-297.

Copyright

(Copyright © 2024, Healio)

DOI

10.3928/01913913-20240620-04

PMID

39046120

Abstract

Dog-bite associated ocular trauma includes a diverse range of injuries, with acute and chronic complications requiring careful management.1 In school-aged children, dog bites have been identified as a cause of significant ophthalmic injury.1 Children bitten by dogs are more than four times more likely to suffer from ocular injuries than adults, and children are twice as likely as adults to suffer from a periorbital dog bite.2 Facial dog bites can also result in open globe injury without an eyelid laceration or contusion, thus warranting a complete ophthalmic evaluation in all pediatric periorbital dog bite injuries.3 Even in cases with early and appropriate surgical management, complications necessitating revision surgery are relatively common, having occurred at a rate of 14% at a single institution retrospective review at a large tertiary pediatric hospital.4 Understanding the epidemiology of dog bite-related ocular injuries occurring nationally can better inform guidelines and safety recommendations for vulnerable patient groups. Therefore, the purpose of this project was to use the National Trauma Data Bank (NTDB) to describe the epidemiological trends in pediatric (younger than 19 years) dog bite-associated ocular injuries occurring in the United States.

Cases were identified using the NTDB, a national database reporting information from participating institutions on emergency department visits resulting in admission, mortality during the encounter, or transfer to another hospital.5 This analysis describes trends in dog bite-associated pediatric cases spanning from 2007 to 2014. Ocular injuries were identified using ICD-9 CM codes. Multivariate logistic regression models were used to identify factors associated with ocular trauma secondary to dog bites. Statistical analysis was performed using IBM SPSS 23 software (IBM Corporation).

Overall, 6,231 cases of dog bite-associated ocular injury were documented by the NTDB during the 8-year period, for which the median (interquartile range) age was 5 years (range: 2 to 9 years). Further analysis of those cases occurring in children (n = 3,041) revealed that the majority occurred in boys (54.8%), Whites (68.9%), the younger (1 to 9 years) age group (88.6%), and at home (81.8%). The average length of stay was 2.29 days and 7.7% of cases required an intensive care unit stay, with an average intensive care unit stay being 4.47 days. When stratified by age into younger (1 to 9 years) and older (10 to 18 years) age groups, the average length of stay was significantly higher in the younger children (2.36 days vs 1.74 days; P =.028). Concerning the type of ocular injury in the pediatric population, the most common were open wound adnexal injury (89.3%), ocular adnexal contusion (4.9%), open globe injury (4.8%), optic pathway or cranial nerve injury (3.8%), and orbital floor fracture (3.0%). In addition, the overall number of cases significantly increased by calendar year (Figure 1). The most commonly reported disposition from the emergency department was the operating room (41.4%), and 9 cases of death were reported. ...

Language: en

Keywords

Humans; Child; Child, Preschool; Infant; Female; Male; Adolescent; Incidence; Animals; *Bites and Stings/epidemiology/complications; *Eye Injuries/epidemiology/diagnosis/etiology; Dogs