Purpose
To assess the overall morbidity of cat bites to the hand and identify risk factors
for hospitalization after such an injury.
Methods
All patients recently treated at our institution for cat bite injuries to the hand
were retrospectively reviewed. We identified 193 patients in a 3-year period between
January 1, 2009, and December 31, 2011. Patient demographics, medical history, physical
examination findings, laboratory values, and long-term follow-up data were collected.
Univariate and multivariate statistical regression were used to analyze the data.
Results
Thirty percent (n = 57) of patients with cat bites to the hand were hospitalized.
The average length of stay for these patients was 3.2 days. Of the hospitalized patients,
67% (n = 38) underwent irrigation and debridement, with 8 patients requiring more
than 1 operation. Complications were common among these patients. Risk factors associated
with hospitalization included smoking, immunocompromised state, and location of bite
over a joint or tendon sheath. Physical examination findings of erythema and swelling
at presentation were also associated with increased risk of hospitalization. Time
from bite to presentation, white blood cell count, erythrocyte sedimentation rate,
and C-reactive protein values at presentation were not associated with hospitalization.
Conclusions
Cat bite injuries to the hand can progress to serious infection. The treatment of
such infections often requires hospitalization, intravenous antibiotic therapy, and
operative treatment. Clinical findings suggestive of the need for hospitalization
include location of the bite over a joint or tendon sheath, erythema, pain, and swelling.
These findings should increase concern for a severe infection and warrant hospitalization
and urgent consultation with a hand surgeon.
Type of study/level of evidence
Therapeutic III.
Key words
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Article info
Publication history
Accepted:
November 4,
2013
Received:
June 13,
2013
Footnotes
No benefits in any form have been received or will be received related directly or indirectly to the subject of this article.
Identification
Copyright
© 2014 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.