title: Dog bites of the head and neck: an evaluation of a common pediatric trauma and associated treatment.
abstract: OBJECTIVE
  To identify which patients and canines are involved in dog bites of the head and neck, and how they impact health systems.
  
  
  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.
authors.affiliation: Department of Medical Education, University of California, Davis Medical Center, Sacramento, CA, USA. Electronic address: daniel.obrien@ucdmc.ucdavis.edu.
authors.forename: Daniel C
authors.initials: DC
authors.lastname: O'Brien
authors.affiliation: Department of Medical Education, University of California, Davis Medical Center, Sacramento, CA, USA; Department of Emergency Medicine, Western Michigan University, Kalamazoo, MI, USA. Electronic address: tylerbandre@gmail.com.
authors.forename: Tyler B
authors.initials: TB
authors.lastname: Andre
authors.affiliation: Department of Otolaryngology Head and Neck Surgery, University of California, Davis Medical Center, Sacramento, CA, USA. Electronic address: aaron.robinson@ucdmc.ucdavis.edu.
authors.forename: Aaron D
authors.initials: AD
authors.lastname: Robinson
authors.affiliation: Department of Otolaryngology Head and Neck Surgery, University of California, Davis Medical Center, Sacramento, CA, USA. Electronic address: lane.squires@ucdmc.ucdavis.edu.
authors.forename: Lane D
authors.initials: LD
authors.lastname: Squires
authors.affiliation: Department of Otolaryngology Head and Neck Surgery, University of California, Davis Medical Center, Sacramento, CA, USA. Electronic address: travis.tollefson@ucdmc.ucdavis.edu.
authors.forename: Travis T
authors.initials: TT
authors.lastname: Tollefson
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D001733:Bites and Stings / Q000601:surgery*; D002140:California; D002648:Child; D002675:Child, Preschool; D006259:Craniocerebral Trauma / Q000209:etiology* / Q000601:surgery*; D004285:Dogs; D005260:Female; D006801:Humans; D007223:Infant; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D019838:Neck Injuries / Q000209:etiology* / Q000601:surgery*; D012189:Retrospective Studies