Retrospective Analysis of Dog Bite Injuries in Children with Autism Spectrum Disorder

Purpose: Children with autism spectrum disorder (ASD) may suffer a dog bite injury, but the frequency and its clinical impact is unknown. We sought to evaluate the (1) subject characteristics; (2) injury type; (3) clinical care provided; and (4) mortality in children with ASD who suffer a dog bite injury. We hypothesized that children with ASD have higher mortality and require more clinical care than children without ASD.

Methods: This is a retrospective observational cohort study utilizing the TriNetX ^® EHR database of subjects aged 0 to 18 years with dog bite diagnostic codes. Data were analyzed for demographics, diagnostic, medication, procedural codes, and mortality.

Results: We analyzed 38,337 subjects (n, %) coded for a dog bite injury [619 (1.6%) with ASD and 37718 (98.4%) without ASD]. Children with ASD had a higher odds of a traumatic injury to the head [1.34 (1.15, 1.57), p < 0.0001] compared to those without. There was no difference in critical care services, hospitalization, mechanical ventilation, and rabies vaccine administration. All-cause mortality at 1 year was low with no deaths reported within the ASD cohort and 37 (0.1%) deaths reported within the no ASD cohort.

Conclusions: Children with ASD that suffer dog bite injuries have similar clinical needs to children without ASD but are more likely to suffer a traumatic injury to the head. Future studies are needed to better understand inciting factors for injuries in this population.