The epidemiology of dog attacks in an urban environment and the risk of vascular injury.

We performed this study to determine the associated injuries after dog attacks and determine the incidence of vascular injury (VI) and potential associated factors. The registry at our Level I center was queried for admissions after dog bites between January 1,1992 and June 30, 2008. Demographic, injury, and outcome data were studied. We examined associations with VI. There were 86 eligible patients. Most were male (57, 66.3%). Mean age was 34.1 (+/- 20.1). Mean injury severity score was 3.9 (+/- 4.3). The most common serious injury was upper extremity fracture and/or dislocation (26, 30.2%), followed by VI (10, 11.6%) to the extremities (8, 9.3%) and neck (2, 2.3%). There were 44 (51.2%) operative cases including 28 (32.6%) wound debridements and 22 (25.6%) orthopedic interventions. Nine (10.5%) VI patients required operation. Mean length of stay was 5.7 (+/- 5.9) days. There were two (2.3%) deaths. Both were unrelated to the attack. No studied variable reliably predicted VI. Many patients admitted after dog attacks will require an operative intervention and several will harbor a VI. The presence of VI is unpredictable, lacking reliable associated patient and admission factors. A high index of suspicion is required in the evaluation of patients involved in dog attacks.