Seasonal Trends in Sinusitis-related Cerebral Abscess

Abstract

Introduction

Sinus infections, if left untreated, can spread to the brain, leading to life-threatening complications such as cerebral abscesses. While previous research has established a correlation between seasonality and the incidence, presentation, and clinical course of sinusitis, as well as its progression to conditions like orbital cellulitis, the relationship between seasonality and the development of sinusitis- related cerebral abscesses remains inadequately explored. Understanding potential seasonal variations in disease progression is critical, as it may have implications for early diagnosis, risk stratification, and targeted public health interventions. This study leverages data from the National Emergency Department Sample (NEDS) to investigate whether a seasonal association exists between sinusitis-related cerebral abscesses and to identify key factors that may influence this relationship. By analyzing large-scale national data, this research aims to provide new insights into the temporal patterns and risk factors associated with this severe complication, ultimately contributing to improved clinical decision-making and preventive strategies.

Methods

Patients diagnosed with sinusitis-related cerebral abscesses between 2018 and 2021 were identified using the National Emergency Department Sample (NEDS) database. To assess potential seasonal and demographic variations, patients were categorized based on age groups, geographic region, and month of presentation. Statistical analyses were conducted to evaluate differences across these groups. Chi-square tests were utilized to compare categorical variables, and a significance threshold of p ≤ 0.05 was applied to determine statistical significance.

Results

A total of 645 cases met the inclusion criteria for this study. Statistical analysis demonstrated a significant correlation between the overall number of sinusitis-related cerebral abscess cases and the month of presentation (p = 0.02). Further subgroup analysis revealed notable seasonal patterns in specific demographics. A significant association was observed in adult cases overall by month (p = 0.005), as well as in regional analyses, with adult cases in the Northeast showing a significant seasonal trend (p = 0.014) and adult cases in the South also exhibiting a significant monthly variation (p = 0.007).

Conclusions

Despite advancements in antibiotic therapy and imaging modalities that have contributed to a decline in the overall incidence of sinusitis-related cerebral abscesses, this condition remains a serious medical concern, particularly in regions with limited healthcare access and diagnostic capabilities. The findings of this study indicate a significant correlation between seasonality and the incidence of sinusitis-related cerebral abscesses, suggesting that environmental or seasonal factors may play a role in disease progression.

Additionally, the observed differences based on patient age and geographic region highlight potential disparities in risk factors or healthcare-seeking behaviors across populations. However, as this is an observational study, causality cannot be definitively established, and the precise mechanisms underlying these seasonal variations remain unclear. Future research should focus on identifying the contributing factors—such as climate variations, seasonal patterns of viral upper respiratory infections, or delays in medical intervention—that may influence the progression of sinusitis to cerebral abscess. Understanding these dynamics could help inform targeted prevention strategies and optimize patient outcomes.