Age Matters: Predicting Outcomes After Dog Bite Injuries

Background Children are at a high risk for dog bite injuries with approximately 100 000 pediatric victims annually. Anatomical factors, including proportionally larger heads and compliant tissues, make children vulnerable to severe head and torso injuries. Methods A single center retrospective cohort study was performed including all patients with a mechanism of “dog bite” from 2016-2024. Demographics, injury patterns, surgical interventions, canine characteristics, and mortality were obtained. Patients were stratified into pediatric (<18 years old) and adult (≥18 years old) groups and a bivariate analysis was performed. Results A total of 276 patients were seen for dog bites, 80 (29%) of whom were less than 18 years old with a median age of 4. Pediatric patients were predominately bitten by known household pets (91.3%). They sustained a greater proportion of head and torso injuries (93.8% vs 41.8%, P < 0.0001) with a higher rate of facial surgery consultation (77.5% vs 28.1%, P < 0.0001). Despite that, adult patients had a higher median ISS (1.5 [1, 5] vs 1 [1, 2], P = 0.008) and were more likely to require an operation (57.1% vs 38.8%, P = 0.006), even when controlled for ISS. Discussion Pediatric dog bite victims have higher rates of cranial trauma requiring surgical subspecialist involvement. Larger studies are needed to refine risk stratification tools for this vulnerable population. Preventative strategies should emphasize responsible pet ownership and family education on dog behavior to reduce the incidence and severity of pediatric dog bite injuries.