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Background <p>Cat bites constitute a significant and underrecognized source of upper extremity trauma, particularly in the domain of hand surgery. We aimed to characterize seasonal and demographic trends in feline-related upper extremity injuries presenting to the emergency department over 10 years, and to inform resource allocation, surgical workload, and injury prevention strategies.</p> Methods <p>We performed a retrospective observational cohort study of all emergency department visits for cat bites or scratches to the upper extremity within a large Midwestern health system from January 2014 to January 2024. Encounters were identified using ICD-10 diagnosis codes and merged with regional monthly climate data. Months were classified as warm (May–September) or cold (October–April). Hospital admission was used as a surrogate for clinically significant injury. Operative case data were extracted to characterize surgical burden, repeat washout rates, temporal trends, and sex-based differences in operative utilization.</p> Results <p>Cat bite presentations were significantly more frequent in warm months (74.6 ± 19.3) versus cold months (55.5 ± 14.3; <i>p</i> &lt; 0.0001), with temperature explaining 26.3% of variance in monthly bite counts. Admission probability per bite was unchanged across seasons. Among 6,748 ED encounters, 235 operative cases (3.5% overall) were identified across 164 unique patients; the operative rate among admitted patients was approximately 37%. Forty-six patients (28.0% of operative patients) required multiple washouts, accounting for 117 of 235 total OR cases (49.8%). Operative volume did not differ significantly between warm and cold months (<i>p</i> = 0.73). Annual operative volume increased from 10 cases in 2014 to 48 in 2023 (R² = 0.689, <i>p</i> = 0.003). Female patients comprised 73% of ED encounters but only 57.4% of operative cases (<i>p</i> &lt; 0.001).</p> Conclusions <p>Upper extremity cat bites peak in early summer correlating with warmer weather; injury severity and operative escalation rates remain stable across seasons. The high operative rate among admitted patients (~ 37%), concentration of operative burden among patients requiring multiple washouts, and a rising temporal trend in annual operative volume underscore the growing and disproportionate resource demands of complicated cat bite infections.</p> Level of evidence <p> Level III, risk / prognostic study.</p>

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Seasonal variation in upper extremity cat bite injuries: implications for hand surgery workload and resource utilization

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年8月3日

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  • Henry Marsh,
  • Aneesh Syal,
  • Abygail Andebrhan,
  • Scott N. Loewenstein

摘要

Background

Cat bites constitute a significant and underrecognized source of upper extremity trauma, particularly in the domain of hand surgery. We aimed to characterize seasonal and demographic trends in feline-related upper extremity injuries presenting to the emergency department over 10 years, and to inform resource allocation, surgical workload, and injury prevention strategies.

Methods

We performed a retrospective observational cohort study of all emergency department visits for cat bites or scratches to the upper extremity within a large Midwestern health system from January 2014 to January 2024. Encounters were identified using ICD-10 diagnosis codes and merged with regional monthly climate data. Months were classified as warm (May–September) or cold (October–April). Hospital admission was used as a surrogate for clinically significant injury. Operative case data were extracted to characterize surgical burden, repeat washout rates, temporal trends, and sex-based differences in operative utilization.

Results

Cat bite presentations were significantly more frequent in warm months (74.6 ± 19.3) versus cold months (55.5 ± 14.3; p < 0.0001), with temperature explaining 26.3% of variance in monthly bite counts. Admission probability per bite was unchanged across seasons. Among 6,748 ED encounters, 235 operative cases (3.5% overall) were identified across 164 unique patients; the operative rate among admitted patients was approximately 37%. Forty-six patients (28.0% of operative patients) required multiple washouts, accounting for 117 of 235 total OR cases (49.8%). Operative volume did not differ significantly between warm and cold months (p = 0.73). Annual operative volume increased from 10 cases in 2014 to 48 in 2023 (R² = 0.689, p = 0.003). Female patients comprised 73% of ED encounters but only 57.4% of operative cases (p < 0.001).

Conclusions

Upper extremity cat bites peak in early summer correlating with warmer weather; injury severity and operative escalation rates remain stable across seasons. The high operative rate among admitted patients (~ 37%), concentration of operative burden among patients requiring multiple washouts, and a rising temporal trend in annual operative volume underscore the growing and disproportionate resource demands of complicated cat bite infections.

Level of evidence

Level III, risk / prognostic study.