P3.F112: Shifting Trends in Dog Bite Injuries at a Level 1 Pediatric Trauma Center in Arizona

Background: The Center for Disease Control reports approximately 27,000 children suffer dog bite injuries (DBI) annually, resulting in a substantial financial burden to the healthcare system. Prior studies have characterized DBI and noted higher incidence during summer months, in younger school-aged males, and with pitbulls; DBI have also been associated with head injuries in toddlers and upper extremity injuries in teens. This study sought to further characterize demographic, socioeconomic, and environmental factors associated with DBI in children during the COVID pandemic.

Methods: A single center retrospective review was conducted among pediatric patients ( < 19 years) presenting to Phoenix Children’s Hospital (PCH), the only Pediatric Level 1 Trauma Center in Arizona, with DBI occurring between January 2018 and July 2022. March 31st, 2020 was defined as the COVID Inflection Point, with dates prior to 3/31 labeled as pre-COVID, and dates following 3/31 labeled as during COVID. Demographic data, DBI characteristics, national climatology data, and area development index (ADI) were abstracted. Data was sourced from the PCH Hospital EMR, National Centers for Environmental Information’s Global Historical Climatology Network Daily Database, and University of Wisconsin School of Medicine and Public Health’s ADI Database.

Results: 479 patients with DBI were included in this study, with a mean age of 5.9 ± 4.2 years. Overall there was an increased incidence of DBI treated at PCH over the study duration, with a higher incidence during COVID compared to pre-COVID times (Pre-COVID: 3.6%, 95% CI [3.1 – 4.1]; COVID: 4.8%, 95% CI [4.1 – 5.5]). There was an increase in DBI during the summer (p=.009) season and in the home (p=.017) or neighborhood (p=.046) setting during the COVID pandemic. DBI from pitbulls (p=.023) and rottweilers (p=.008) decreased during COVID, while bites from dogs of unknown breeds (p <.001) increased. In the SES analysis, patients from low-middle (26-50%) ADI experienced higher bites during the summer season (p=.009) and in the home (p=.017).

Conclusion: DBI treated at PCH increased during the COVID pandemic. Bite setting, dog breed, and season associated with DBI all significantly shifted during COVID, and setting and season influenced incidence based on SES. This study confirms trends in the literature regarding increased incidence of DBI during COVID, and an increase in at-home bites may reflect the heightened physical and social isolation of children during the pandemic. Furthermore, SES, expressed through ADI, may mediate trends in the DBI incidence, as seen in in lower-middle ADI patients with season and location.