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Posttraumatic Stress Disorder in Pediatric Dog Bite Victims
Yana Puckett MD, MPH, Faidah Badru MD, MPH, Perry Xu, Jaimi Ramsey, PhD, Jose Greenspon MD, Kaveer Chatoorgoon, MD, Gustavo Villalona, MD, Dennis Vane, MD, MBA, Colleen Fitzpatrick, MD. Cardinal Glennon Children Hospital, St Louis University School of Medicine, St Louis, MO USA.

Background: Dog bites in America affect approximately 2 million children every year. Little data exists on the rate of Posttraumatic Stress Disorder (PTSD) in children experiencing a dog bite. This study was used to identify the rate of PTSD in children with dog bites.

Methods: Level I pediatric trauma center database was used to identify all children sustaining dog bites between 2009-2015. Patient demographics, circumstances around the dog bite, and rate of PTSD were abstracted. Diagnostic Infant and Preschool Assessment (DIPA) was used to assess PTSD in children 1-6 years of age. UCLA PTSD Reaction Index for DSM-V was used to assess PTSD in children ages 7-18.

Results: A total of 713 dog bites were identified. Of those, 152 consented to complete an assessment over the phone. Males comprised 55.9%. Mean age of victims was 6.8 years. African-Americans (AA) comprised 47.5% of victims, Caucasians 42.9%, and Hispanics 3.1%. Overall PTSD rate was 35.5%. PTSD rate was 41.4% for children aged 3 and older. Children were found more likely to be diagnosed with PTSD if the dog bite occurred at an outside setting (p=.044) and if bitten on an extremity (p=.004).

Conclusions: Dog bites in children are associated with a high rate of PTSD (35.5%). Primary and secondary prevention strategies such as screening patients for acute stress disorder and providing patients with resources for PTSD counseling prior to discharge from the emergency department may potentially avoid long-term health consequences associated PTSD.

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