Factors affecting length and complexity of hospital stay in pediatric dog bite patients

Author:

Alessio-Bilowus DominicORCID,Kumar Nishant,Donoghue Lydia,Ridelman Elika,Shanti Christina

Abstract

BackgroundDog bite injuries are a source of significant morbidity and expense in the USA, and rates of hospitalization have been rising. Children are at increased risk of dog bites compared with adults, yet there is a lack of published material on factors affecting hospital course. The objective of this study is to explore factors associated with increased length of stay (LOS), more complex course of care and post-discharge return rates in this population.MethodsA retrospective review was conducted of all patients presenting to our urban, academic children’s hospital for dog bite injuries between January 2016 and May 2021. Only those patients admitted for inpatient care were included, as identified through our institution’s trauma registry, and variables were examined prior to, during, and after hospital stay.Results739 pediatric patients in total were treated for dog bites during the study period, of which 349 were admitted. Analysis revealed two pre-admission predictors of increased LOS: bone fracture (mean LOS=5.3 days vs. 2.5 days, p=0.013) and prior medical comorbidity (4.3 days vs. 2.8 days, p=0.042). After admission, fractures were associated with a higher rate of postoperative complications (16% vs. 5.6%, p=0.014) and return (13% vs. 2.0%, p<0.001), primarily due to wound infection. Although the facial region represented the largest proportion of fractures, long bone fractures of the arm and leg were noted to have comparatively higher LOS and complication rates. Postoperative complications were not associated with any documented infection at admission.ConclusionsOur findings suggest that long bone fractures in pediatric dog bites can be an underappreciated source of latent wound infection associated with late-presenting negative outcomes. Increased awareness of these relationships could lead to earlier detection of infection in this vulnerable population.Level of evidenceLevel III, Prognostic / Epidemiological.

Publisher

BMJ

Subject

Critical Care and Intensive Care Medicine,Surgery

Reference23 articles.

1. An Epidemiological analysis of pediatric dog bite injuries over a decade;Cook;J Surg Res,2020

2. Holmquist L , Elixhauser A . Emergency Department visits and inpatient stays involving dog bites: statistical brief #101. In: Healthcare Cost and Utilization Project (HCUP) Statistical Briefs. Agency for Healthcare Research and Quality, 2010.

3. Dog-bite-related craniofacial fractures among pediatric patients: a case series and review of literature;Saadi;Craniomaxillofac Trauma Reconstr,2018

4. Pediatric patients with dog bites presenting to US children's hospitals;Ramgopal;Inj Epidemiol,2021

5. US estimates for dog bite injuries presenting to emergency departments;Ramgopal;Public Health,2021

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3