Between April 2018 and March 2024, emergency department physicians at Ankara Training and Research Hospital treated 3,666 patients for dog bite injuries. According to findings published in Cureus, stray dogs accounted for 86.1% of bites with a documented animal origin, though owned animals caused higher rates of skin lacerations and surgical interventions.
Superficial Injuries Dominate Dog Bite Cases Treated in Emergency Departments
- Superficial Injuries Dominate: Over 58% of documented clinical findings were isolated abrasions, meaning the outer layer of skin was scraped without deep structural trauma.
- Rapid Triage and Prophylaxis: Emergency department protocols prioritize rabies exposure categorization and wound irrigation, ensuring post-exposure prophylaxis is administered based on the biting animal’s health and observation status.
- Low Admission Rates: Only 0.3% of patients required formal hospital admission, demonstrating that the vast majority of dog bite trauma is successfully managed and discharged directly from the emergency setting.
Anatomy of Emergency Department Presentations at a Regional Rabies Center
Dog bites represent a significant, preventable public health challenge requiring immediate wound care and critical post-exposure prophylaxis decisions. Operating as a tertiary care hospital and regional rabies center in Ankara, Türkiye, the emergency department reviewed electronic medical records using International Classification of Diseases, 10th Revision (ICD-10) codes W54 and W55. Out of 12,849 screened records, investigators identified 3,666 confirmed dog bite presentations after filtering out inaccessible files and alternate animal exposures.
The patient demographic skewed predominantly male at 66.1%, with a median age of 29 years. Lower extremities bore the brunt of the trauma, accounting for 56.1% of recorded injury sites. However, pediatric patients under 18 years old presented a distinct anatomical risk profile. In the younger cohort, lower extremity injuries dropped to 44.1%, while head and neck injuries rose to 7.1%.
When clinicians assessed injury severity using Ministry of Health guidelines, 71.4% of cases fell into Category II. This classification indicates non-bleeding scratches and abrasions requiring prompt vaccination. Category III exposures, which involve transdermal bites or mucosal contact requiring rabies immunoglobulin (RIG) alongside the vaccine, constituted the remainder of significant presentations. Surgical interventions beyond standard wound irrigation and dressing were performed in just 4.0% of cases, and hospital admissions remained exceptionally rare at 0.3%.
| Clinical Metric | Documented Findings | Percentage / Value |
|---|---|---|
| Total Verified Dog Bite Cases | Emergency Department Presentations | 3,666 cases |
| Median Patient Age | Interquartile Range: 19–46 years | 29 years |
| Most Frequent Injury Site | Lower Extremity | 56.1% |
| Primary Rabies Exposure Category | Category II (Non-bleeding scratches/abrasions) | 71.4% |
| Stray vs. Owned Biting Dogs | Stray Dog Origin (among known cases) | 86.1% |
Evaluating the Divergence Between Stray and Owned Canine Injuries
An exploratory comparison between stray and owned biting dogs revealed counterintuitive clinical outcomes. Among cases with documented dog origins, stray dogs were responsible for 86.1% of the incidents. Despite this overwhelming numerical dominance by strays, owned dogs inflicted higher rates of skin lacerations (49.3% versus 38.9%, p=0.003) and required more surgical interventions (9.5% versus 3.8%, p<0.001).
Investigators noted that this unadjusted finding requires cautious interpretation. Factors such as anatomical location, dog breed size, and the circumstances of the interaction—such as perceived provocation versus unprovoked attacks—were not controlled in this initial comparative analysis. These data serve as a vital single-center baseline captured immediately prior to the implementation of Law No. 7527 on stray animals, which came into force in Türkiye in August 2024. Public health officials anticipate that future epidemiological evaluations will measure shifts in canine bite frequencies following the enforcement of this legislation.
Regarding prophylactic compliance, treatment records showed that rabies vaccines were administered in 94.9% of Category II and III cases. For unvaccinated individuals, a documented recommendation for a mandatory 10-day observation period of the biting animal was recorded in 73.7% of cases. National public health guidelines permit the deferral of vaccination or RIG if a healthy dog or cat can be successfully isolated and monitored for signs of rabies over this ten-day window.
References
- Cureus: Clinical Profile and Emergency Department Management of Dog Bite Injuries at a Regional Rabies Center: A Retrospective Cross-Sectional Study.
- Ministry of Health, Türkiye: National Rabies Prophylaxis Guidelines.
