Cited by 94Injury Epidemiology and PreventionTrauma and Emergency Care StudiesHuman-Animal Interaction Studies

The DOI matches its Crossref record; 37 of the 39 references it cites were found in a registry or an index; 2 of the 17 sources its claims cite were checked for support.

The demographics of dog bites in the United States

Open access
Loder, Randall T.·2019·Heliyon

Abstract

Dog bites are a significant public health issue. There is no comprehensive study of dog bite demographics. It was the purpose of this study to perform such an analysis across the US. The National Electronic Injury Surveillance System All Injury Program data for the years 2005 through 2013 was accessed; dog bite injuries were extracted and analyzed. Statistical analyses were performed with SUDAAN 11.0.01™ software to account for the weighted, stratified nature of the data. Incidence values were calculated using population data from the US Census Bureau. A P < 0.05 was considered significant. There was an average 337,103 ED visits each year for dog bites. The average age was 28.9 years; 52.6% were male and 47.4% female. The bites were located on the upper extremity in 47.3%, head/neck in 26.8%, lower extremity in 21.5%, and trunk in 4.4%. Younger patients had more bites involving the head/neck, while older patients the upper extremity. More occurred in the summer and on weekends and 80.2% occurred at home. Hospital admission occurred in 1.7%. Logistic regression analysis demonstrated that the odds of admission was solely dependent upon the age group. The OR for admission was 11.03 [4.68, 26.01] for those >85 years of age, 4.88 [2.89, 8.24] 75-84 years, and 2.79 [1.77, 4.39] those ≤4 years of age, with the 10-14 year age group the reference group. The average annual incidence was 1.1 per 1,000, and was slightly higher in males (1.18 vs 1.02 per 1,000). The estimated cost was at least 400 million US$ per year. Potential prevention strategies are educational programs directed at both children and parents/caretakers outlining the responsibilities of owning a dog. This information can be disseminated in health care facilities, radio/TV/Internet venues, and dog kennels/shelters.

Overview

AI snapshot

Written from the paper’s full text.

TL;DR

This study analyzed US emergency department visits for non-fatal dog bites from 2005–2013 using NEISS-AIP data, estimating about 337,103 ED visits per year and an annual incidence of 1.1 per 1,000. Bites were most common on the upper extremity, occurred mostly at home, and hospital admission was rare but strongly associated with age group.

Key findings

  • Dog bites accounted for 1.1% of ED injury visits, an estimated 3,033,931 visits over 9 years, or 337,103 per year; average age was 28.9 years, 52.6% male, and 80.2% occurred at home.
  • Anatomic distribution was upper extremity 47.3%, head/neck 26.8%, lower extremity 21.5%, and trunk 4.4%; younger patients had more head/neck bites, while older patients had more upper extremity bites.
  • Hospital admission occurred in 1.7%; the only significant predictor was age group, with OR 11.03 [4.68, 26.01] for >85 years, 4.88 [2.89, 8.24] for 75–84 years, and 2.79 [1.77, 4.39] for ≤4 years, using 10–14 years as reference.
  • The estimated cost was at least 400 million US$ per year, with a higher estimate of $795 million annually depending on cost assumptions.

Methods

  • Retrospective analysis of National Electronic Injury Surveillance System All Injury Program (NEISS-AIP) data for 2005–2013; dog bite injuries identified by NEISS AIP codes PCAUSE_C = 16 and/or ICAUSE_C = 16.
  • Data came from about 100 US hospitals with EDs, including about 65 hospitals reporting all injuries; analyses used SUDAAN 11.0.01 to account for weighted, stratified data, with incidence calculated from US Census Bureau population data.
  • Statistical testing used t-tests, ANOVA, χ² tests, and multivariate logistic regression; P < 0.05 was considered significant.

Limitations

  • The paper states NEISS only captures individuals who sought ED care, excluding urgent care, physician offices, and those who did not seek care, so the true number of dog bites is likely higher.
  • The paper notes limited detail on injury severity and diagnosis, with diagnosis coded as “other” in 33.8% of cases; NEISS data accuracy has been reported as over 90% in prior studies.
  • Evident from the text: this is a retrospective, cross-sectional database analysis, so associations such as age with admission or bite location cannot establish causation; race/ethnicity reporting was also restricted because of small numbers of Polynesian and Indo-Mediterranean peoples.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1016/j.heliyon.2019.e01360

Cites

37 of 37 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Figures

Fig. 1 Anatomic location of the estimated 3.03 million non-fatal dog bites.
Fig. 1 Anatomic location of the estimated 3.03 million non-fatal dog bites.CC BY-NC-ND · PubMed Central
Fig. 2 Temporal variation of dog bites. a. By month. b. By weekday.
Fig. 2 Temporal variation of dog bites. a. By month. b. By weekday.CC BY-NC-ND · PubMed Central
Fig. 3 Incidence of dog bite visits to US EDs in 1,000 per US population: differences by age and gender.
Fig. 3 Incidence of dog bite visits to US EDs in 1,000 per US population: differences by age and gender.CC BY-NC-ND · PubMed Central
Fig. 4 Differences in dog bites by anatomic location of injury (all P < 10−4). a. By age. b. By incident locale.
Fig. 4 Differences in dog bites by anatomic location of injury (all P < 10−4). a. By age. b. By incident locale.CC BY-NC-ND · PubMed Central
Fig. 5 Differences in dog bites by race (all P < 10−4). a. By age group. b. By anatomic location of injury. c. By incident locale. d. By gender.
Fig. 5 Differences in dog bites by race (all P < 10−4). a. By age group. b. By anatomic location of injury. c. By incident locale. d. By gender.CC BY-NC-ND · PubMed Central
Fig. 6 Number of ED visits for dog bites by gender and age group (P < 10−4).
Fig. 6 Number of ED visits for dog bites by gender and age group (P < 10−4).CC BY-NC-ND · PubMed Central
Fig. 7 Differences in incident locale by age group (P < 10−4).
Fig. 7 Differences in incident locale by age group (P < 10−4).CC BY-NC-ND · PubMed Central

Verification

Claims the paper makes

56 Own result · 9 Own interpretation · 5 No full text of the sources · 3 Not checked yet · 2 Own method · 1 Partly supported · 1 Couldn’t confirm · 1 Sources not found · accuracy not yet measured

Verify all 3 references — free account
  • It may state two separate claims as one. 31
  • The quote only partly states this claim. 2
  • Probably not a substantial claim. 6
37 of 37
  • The paper relies on this without support.

    There is no comprehensive or in-depth study of human dog bites encompassing the entire United States for all age groups, especially adults, studying anatomic location, gender, race, month/weekday, and other demographic variables.

    “There is no comprehensive study of dog bite demographics.”
    “There is no in depth study of human dog bites encompassing the entire United States for all age groups, especially adults, studying anatomic location of injury, gender, race, month/weekday of injury, and other demographic variables.”
  • The authors state this as an assumption.

    A hospital admission is a surrogate for a serious injury.

    “A hospital admission was used as a surrogate for a serious injury.”
  • The paper relies on this without support.

    The NEISS-AIP sample of approximately 100 hospitals is representative of US emergency departments, allowing nationwide estimates.

    “The NEISS is a dataset managed by the US Consumer Product Safety Commission (USCPSC) which collects emergency department (ED) injury data from ∼100 hospitals in the United States and its territories that have an ED.”
    “With appropriate statistical techniques, an estimated number of injuries is then calculated from this weighted, stratified data.”
  • The paper relies on this without support.

    The NEISS only identifies individuals who sought care in an ED and does not include those treated in urgent care centers, physician offices, or those who did not seek medical care.

    “First, the NEISS only identifies individuals who sought care in an ED. It does not include those who might have been treated in urgent care centers, physician offices, or those persons who did not seek medical care.”
  • The paper relies on this without support.

    The severity of the injury, aside from either the patient being treated and released or admitted, is unknown.

    “The severity of the injury, aside from either the patient being treated and released or admitted, is unknown.”
  • The authors state this as an assumption.

    Hospital admission is a proxy for severity.

    “Using hospital admission as a proxy for severity, logistic regression demonstrated analysis that the OR for admission was the age group.”
  • The authors state this as an assumption.

    The costs for those admitted with dog bites in this study was the average of the surgical and medical groups ($30,083.11).

    “Assuming that the costs for those admitted with dog bites in this study was the average of the surgical and medical groups ($30,083.11)”
  • The authors state this as an assumption.

    The median ED charge for an open wound of an extremity is likely similar to a dog bite.

    “In 2006–2008, the median ED charge for an open wound of an extremity (likely similar to a dog bite) was $979 [37].”
8 of 8

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

2 of 2

Citations

Cites

Show all 39 references

Research works printed but not linked: 1

  1. Springer, 2018

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Metadata

Authors
Loder, R. T.
Affiliations
Riley Hospital for Children (US)
Corresponding author
Loder, Randall T.
Venue
Heliyon
Publisher
Elsevier BV
Published
2019-03
Volume
5
Issue
3
Pages
e01360
ISSN
2405-8440 (ISSN-L)
OpenAlex
W2924793014
Cited by
92
References
39
Citations by year
2026: 14 · 2025: 14 · 2024: 10 · 2023: 9 · 2022: 10 · 2021: 20 · 2020: 12 · 2019: 3
FWCI
10.71
Type
journal article
Language
en
Open access
Locations
  • Heliyon (publishedVersion, cc-by-nc-nd)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by-nc-nd)
  • PubMed Central (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • IUScholarWorks (Indiana University) (submittedVersion, cc-by-nc-nd)
  • PMC
Funders
  • Garceau Professorship Fund
  • Rapp Pediatric Orthopaedic Research Fund
  • Riley Children's Foundation
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Injury Epidemiology and Prevention
  • Health Sciences › Medicine › Emergency Medicine › Trauma and Emergency Care Studies
  • Life Sciences › Agricultural and Biological Sciences › Animal Science and Zoology › Human-Animal Interaction Studies
Keywords
dog bites, demographics, injury incidence, emergency department visits, hospitalization, age differences, body site distribution, seasonal variation, dog bite prevention

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