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头颈部犬咬伤:常见儿科创伤及其相关治疗的评估

Dog bites of the head and neck: an evaluation of a common pediatric trauma and associated treatment.

作者信息

O'Brien Daniel C, Andre Tyler B, Robinson Aaron D, Squires Lane D, Tollefson Travis T

机构信息

Department of Medical Education, University of California, Davis Medical Center, Sacramento, CA, USA.

Department of Medical Education, University of California, Davis Medical Center, Sacramento, CA, USA; Department of Emergency Medicine, Western Michigan University, Kalamazoo, MI, USA.

出版信息

Am J Otolaryngol. 2015 Jan-Feb;36(1):32-8. doi: 10.1016/j.amjoto.2014.09.001. Epub 2014 Sep 28.

Abstract

PURPOSE

To identify which patients and canines are involved in dog bites of the head and neck, and how they impact health systems.

MATERIALS AND METHODS

This is a single center, retrospective cohort study conducted from January 2012 to June 2013 in an academic, tertiary care center situated between multiple suburban and urban communities. Patients were identified by queried search for all bite-related diagnoses codes.

RESULTS

334 unique dog bites were identified, of which 101 involved the head and neck. The mean patient age was 15.1±18.1years. Of the more than 8 different breeds identified, one-third were caused by pit bull terriers and resulted in the highest rate of consultation (94%) and had 5 times the relative rate of surgical intervention. Unlike all other breeds, pit bull terriers were relatively more likely to attack an unknown individual (+31%), and without provocation (+48%). Injuries of the head and neck had an average follow-up of 1.26±2.4 visits, and average specialty follow-up of 3.1±3.5 visits.

CONCLUSIONS

The patients most likely to suffer dog bite injuries of the head and neck are children. Although a number of dog breeds were identified, the largest group were pit bull terriers, whose resultant injuries were more severe and resulted from unprovoked, unknown dogs. More severe injuries required a greater number of interventions, a greater number of inpatient physicians, and more outpatient follow-up encounters. Healthcare utilization and costs associated with dog bites warrant further investigation.

摘要

目的

确定哪些患者和犬类涉及头颈部犬咬伤事件,以及这些事件如何影响卫生系统。

材料与方法

这是一项单中心回顾性队列研究,于2012年1月至2013年6月在一个位于多个郊区和城市社区之间的学术性三级护理中心进行。通过查询所有与咬伤相关的诊断代码来确定患者。

结果

共识别出334例独特的犬咬伤事件,其中101例涉及头颈部。患者的平均年龄为15.1±18.1岁。在识别出的8种以上不同犬种中,三分之一的咬伤由比特斗牛梗犬引起,其会诊率最高(94%),手术干预相对率是其他犬种的5倍。与所有其他犬种不同,比特斗牛梗犬相对更有可能攻击陌生人(增加31%),且无明显诱因(增加48%)。头颈部损伤的平均随访次数为1.26±2.4次,专科平均随访次数为3.1±3.5次。

结论

最容易遭受头颈部犬咬伤的患者是儿童。虽然识别出了多种犬种,但最大的一组是比特斗牛梗犬,其造成的损伤更严重,且多由无明显诱因、身份不明的犬只导致。更严重的损伤需要更多的干预措施、更多的住院医师以及更多的门诊随访。与犬咬伤相关的医疗资源利用和成本值得进一步研究。

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