Clinical Profile and Emergency Department Management of Dog Bite Injuries at a Regional Rabies Center: A Retrospective Cross-Sectional Study

Introduction: Dog bites are a preventable cause of injury whose frequency has been reported to be increasing in many countries, and they require both wound care and a rabies prophylaxis decision in the emergency department (ED).The prophylaxis decision is determined by the rabies exposure category and the observability of the biting dog.Studies comparing owned and stray dog bites in terms of clinical outcomes are few, and their findings are inconsistent; studies addressing ED management as a whole are also limited.This study primarily aimed to describe the clinical profile and ED management of dog bite cases; secondary aims were to compare owned and stray dog bites in an exploratory analysis and to describe rabies vaccine administration in Category II and III cases together with the documented recommendation for 10-day observation of the dog.Materials and methods: In this retrospective cross-sectional study, cases presenting with dog bites to the ED of a tertiary care hospital serving as a regional rabies center in Ankara, Türkiye, between April 1, 2018, and March 31, 2024, were identified by screening the hospital's electronic medical records for International Classification of Diseases, 10th Revision (ICD-10) codes W54 and W55.Demographic characteristics, injury site, clinical findings, rabies exposure category, surgical interventions, hospital admission, and medical treatments were evaluated.The chi-square test was used for comparisons, and Bonferroni correction was used for pairwise comparisons between age groups.Results: A total of 3,666 cases were included.The median age was 29 years (interquartile range 19-46), and 66.1% of cases were male.Among the 2,464 cases with a recorded injury site, the most frequently affected site was the lower extremity (56.1%); in the under-18-year group, the share of lower extremity injuries decreased (44.1%), while head and neck injuries became more prominent (7.1%).Among the 2,938 cases with known dog origin, the biting dog was a stray dog in 86.1%.Among the 1,709 cases with documented clinical findings, the injury was limited to isolated abrasion in 58.5%, and 71.4% of the 3,078 cases with a recorded rabies exposure category were classified as Category II.Surgical intervention was performed in 4.0% of cases, and only 10 cases (0.3%) required hospital admission.Rabies vaccine administration was documented in 94.9% of the 3,050 Category II and III cases with treatment records, and a recommendation for 10-day observation of the dog was documented in 73.7% of unvaccinated cases.Rates of skin laceration (49.3% vs. 38.9%;p=0.003) and surgical intervention (9.5% vs. 3.8%; p<0.001) were higher among owned dog bites than among stray dog bites.Conclusions: Among cases with documented clinical findings, most injuries were superficial; most cases were managed in the ED, and hospital admission was rare.Although stray dog bites predominated numerically, rates of skin laceration and surgical intervention were higher among owned dog bites; this unadjusted finding requires confirmation in studies that account for injury location and severity.The findings provide single-center baseline data from the period before the legislation on stray animals that came into force in Türkiye in 2024.