Between April 2018 and March 2024, medical staff at Ankara Training and Research Hospital treated 3,666 dog bite cases in the emergency department in a retrospective cross-sectional study from the regional rabies center.
Emergency physicians face complex treatment choices when patients arrive with animal bites. Doctors must balance immediate surgical wound care with strict post-exposure prophylaxis decisions based on rabies exposure categories. The capital hospital serves as a regional hub for these trauma cases, processing thousands of patient visits under national health guidelines.
Clinical Profiles and Injury Sites Across Age Groups
Patients ranged in age from infants to older adults, with a median age of 29 years. Men accounted for 66.1% of the total presentations. Lower extremities bore the brunt of the trauma, representing 56.1% of the 2,464 cases with documented injury locations.
Children under 18 experienced a different pattern of injuries compared to adults. Lower extremity bites dropped to 44.1% in the pediatric group, while head and neck injuries climbed to 7.1%.
Key pediatric pattern: In children under 18, lower extremity injuries were less frequent (44.1%) and head and neck injuries were more prominent (7.1%).
Stray Versus Owned Dog Bite Outcomes
Stray dogs accounted for 86.1% of the 2,938 cases where the animal’s origin was known. Owned dogs made up the remaining share of the biting animals. Yet, clinical findings revealed distinct differences between the two groups.
Skin lacerations appeared in 49.3% of owned dog bites compared to 38.9% of stray dog bites. Surgical interventions followed in 9.5% of owned dog encounters, contrasted with 3.8% for stray dog incidents.
Medical teams manage emergency department rabies prophylaxis
Medical teams performed surgical intervention in 4.0% of cases. Hospital admissions were exceptionally rare at 0.3%, with only 10 patients admitted. Most cases were managed in the emergency department.
Rabies exposure categorization dictated post-exposure treatment. Category II exposures, which involve non-bleeding scratches or abrasions, made up 71.4% of the 3,078 cases with a recorded rabies exposure category. Category III bites, covering skin-penetrating injuries, accounted for a portion of the cases. Rabies vaccination was documented in 94.9% of the 3,050 Category II and III cases with treatment records.
Did You Know? Turkish national guidelines allow doctors to defer the rabies vaccine in Category II exposures and rabies immunoglobulin in Category III exposures if a healthy biting dog can be kept under a 10-day observation period.
Baseline Data Before Law No. 7527
The study captures emergency department data from a period of six years leading up to the legislation on stray animals that came into force in Türkiye in 2024. That month marked the implementation of Law No. 7527 regarding stray animals in Türkiye. Researchers emphasized that single-center records from Ankara Training and Research Hospital establish a clear baseline for the period preceding the new legislation.
Single-center findings reflect the specific case mix of a regional capital hospital rather than nationwide incidence rates.
Ankara Hospital Dog Bite Statistics
| Clinical Variable | Owned Dog Bites | Stray Dog Bites | P-Value |
|---|---|---|---|
| Skin Laceration | 49.3% | 38.9% | 0.003 |
| Surgical Intervention | 9.5% | 3.8% | <0.001 |
Investigators exclude thousands of Ankara study records
Why were thousands of medical records excluded from the Ankara study?
Investigators excluded 6,272 out of 12,849 screened records because data were either inaccessible or incorrectly entered in the hospital system. The missing records lacked verifiable presentation notes or correct ICD-10 coding.
How many patients required hospital admission?
Only 10 patients required inpatient admission out of 3,666 total cases.
How many cases had a recorded dog origin?
Dog origin was known in 2,938 cases, and stray dogs accounted for 86.1% of them.
Was a 10-day observation of the biting dog recommended?
A recommendation for 10-day observation of the dog was documented in 73.7% of unvaccinated cases.
Can these single-center findings be applied across Türkiye?
Researchers caution that data collected from a single tertiary care center serving Ankara Province describe only that facility’s patient population. The figures cannot be generalized to estimate nationwide dog bite patterns.
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