Objective. We evaluated children less than 16 years of age who had dog bite injuries that resulted in hospitalization or death to determine the typical characteristics of the children, the dogs, and the injuries suffered.

Design. Retrospective chart review.

Setting. Three large city hospitals including Harborview Medical Center, Seattle, Washington; Children's Mercy Hospital, Kansas City, Missouri; and Mary Bridge Hospital, Tacoma, Washington.

Methods. Charts were reviewed for patient demographic data and canine data. Hospitalization data included total length of stay, need for intensive care, Injury Severity Score, the nature and extent of the injuries, procedures performed, complications, and outcome.

Results. Forty cases were reviewed. Most children were boys (60%) and were white (87%). The median age was 50 months. There were three deaths. Most dogs were medium-sized or large breeds and were familiar to the victim. The average hospital stay was 6 days (SD = 5), and 12(30%) patients required a stay in the intensive care unit. Injuries to the face, head, and neck area were most common (82%). Major surgical procedures included craniotomy, exploration of the neck or abdomen, ocular procedures, and repair of fractures.

Conclusions. Severe dog bites in children occur most frequently in those younger than 5 years old and involve the head and neck. Large dogs that are familiar to the child are usually involved. Young children should be closely supervised when around any dog.

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