Issues associated with dog bite injuries in children and adolescents assessed at the emergency department
Issues associated with dog bite injuries in children and adolescents assessed at the emergency department
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DOI：
10.1097/01.pec.0000280509.67795.a9
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发表时间：
2007-07-01
影响因子：
1.4
通讯作者：
Ng, Pak-cheung
中科院分区：
文献类型：
--
作者：
Hon, Kam-lun Ellis;Fu, Chun-cheung Antony;Ng, Pak-cheung
目的：本研究的目的是确定在大学医院急诊科看到的狗咬伤的模式。这些信息将用于规划预防和加强管理战略。方法：所有2003年1月至2004年12月在急诊科评估的出院诊断为动物咬伤的患者（年龄小于22岁）通过计算机化出院网络进行鉴定。结果：2年内共发生动物咬伤144例（男82例，女62例）。89%是被狗咬伤。犬咬伤患者平均年龄11.82岁（SD 6.39岁，范围0.06 ~ 21.83岁）。家庭犬只占15%的病例。五分之三的受害者认不出狗的种类，五分之二的受害者受到攻击。大多数咬伤（90%）只涉及单个解剖部位。通常累及四肢（右上肢[23%]，左上肢[16%]，右下肢[35%]，左下肢[20%]）。躯干（4%）和生殖器（0.8%）不常见。疼痛、红斑、出血和瘀伤是常见的症状，但60例患者在就诊时无症状。与老年患者相比，10岁以下儿童的面部损伤风险更高（25% vs. 2%, P = 0.0002；优势比为21.8,95%可信区间为2.9-455.9），更有可能被分类为紧急情况（P = 0.01）。大多数攻击都很轻微，不需要住院治疗。大约一半的人接受抗狂犬病治疗，五分之二的人接受止痛药治疗，四分之一的人接受抗生素治疗。结论：在哺乳动物的攻击中，犬科动物是最常见的。大多数伤害都很轻微，通常包括四肢。然而，年龄较小的儿童面部受伤的风险更高。疼痛程度和不良心理影响通常不记录在紧急评估中。
Objectives: The aim of this study was to determine the pattern of dog bites seen at the emergency department of a university hospital. The information will be used to plan prevention and enhance management strategies.Methods: All patients (younger than 22 years) assessed at the emergency department between January 2003 and December 2004 with a discharge diagnosis of animal bites were identified through the computerized discharge network.Results: One hundred forty-four incidents of animal bites (82 males and 62 females) occurred over the 2-year period. Eighty-nine percent was due to dog bites. Among the dog bite victims, the mean age was 11.82 years (SD, 6.39 years; range, 0.06-21.83 years). Family dogs were only involved in 15% of cases. The species of dogs were not recognized in three fifths, and attacks provoked in two fifths of victims. Most bites (90%) of bites involved only single anatomical sites. The extremities were commonly involved (right upper limb [23%], left upper limb [16%], right lower limb [35%], left lower limb [20%]). Torso (4%) and genitalia (0.8%) were uncommonly involved. Pain, erythema, bleeding, and bruising were common symptoms, but 60 patients were asymptomatic at presentation. Compared with older patients, children younger than 10 years had a much higher risk of facial injuries (25% vs. 2%, P = 0.0002; odds ratio, 21.8, 95% confidence interval, 2.9-455.9) and were more likely to be triaged as being urgent (P = 0.01). Most attacks were trivial and did not require hospitalization. Antirabies treatment was given in approximately half, analgesics in two fifths, and antibiotics in one fourth.Conclusions: In mammalian attacks, canines are most commonly involved. Most injuries are trivial, and the limbs are usually involved. However, younger children are at higher risk of facial injuries. Extent of pain and adverse psychological impacts are typically not documented in the emergency assessment.