Clinic-based characteristics of animal-related injury presentations in Hangzhou, China: a 10-year retrospective analysis

Background: Animal-related injuries are a significant public health concern, particularly in urban settings with high population density and widespread pet ownership. Methods: This retrospective descriptive study was based on a clinic-based case series of animal-related injury presentations at a high-volume rabies vaccination clinic in Hangzhou, China, from 2015 to 2024. Demographic characteristics, injury site, exposure category, animal species, and time to presentation were extracted from outpatient records. Delayed presentation was defined as seeking care more than 3 days after injury. Descriptive analyses were performed to summarize clinic-based patterns. Multivariable logistic regression was used to identify factors associated with delayed presentation and to examine differences between dog- and cat-related injuries. Results: A total of 193,849 cases were included. Injuries exhibited significant seasonality, with the highest incidence in summer (30.16%) and the lowest in winter (20.22%). Females accounted for 55.9% of cases, and the 16-30 age group was the most affected (36.2%). Upper extremities were the predominant injury site (61.1%), and most cases were WHO Category II exposures (83.8%). Domestic animals caused 82.5% of injuries, with dogs (65.85%) and cats (27.64%) being the main offending animals. The rate of delayed presentation (>3 days) increased from 10.48% in 2015 to a peak of 20.67% in 2019 and then stabilized at approximately 16%. Multivariable logistic regression analysis showed that both Category I and Category III exposures (compared with Category II), injuries caused by non-dog species, and injuries caused by non-domestic animals were associated with higher odds of delayed presentation, while younger individuals and those with head and face injuries were less likely to delay care-seeking. For cat-related injuries (vs. dog-related injuries), independent predictors included increasing age, female sex, head and face injuries, and Category III exposure. Conclusion: This study provides a comprehensive description of animal-related injury presentations at a major urban rabies vaccination clinic. The findings highlight variation in healthcare-seeking behavior and injury patterns across demographic and exposure characteristics. These results may inform future hypothesis-driven research and support the development of targeted public health education strategies.