Abstract
BACKGROUND: The incidence of fascial space infections of the head and neck has long been suggested to correlate with weather patterns, though objective evidence is inconsistent, and a causative effect is difficult to prove. One issue in the existing literature is that correlations between space infections and weather patterns have been assessed in only a few climates, so data from additional regions is needed. The purpose of this study is to understand whether head and neck infection rates correlate with weather patterns in a humid subtropical climate, adding to the current literature derived largely from temperate environments. METHODS: In this retrospective observational study, we investigate potential associations between weather variables and fascial space infections of the head and neck treated by oral and maxillofacial surgery (OMFS) at Augusta University Medical Center, an urban tertiary care center in the Southeastern United States, over a 7-year period. The study sample included all patients presenting between October 2012 and September 2019 for head and neck infections identified by ICD10 code. Those with pre-existing oral or maxillofacial disease, including recent infection, were excluded. Daily weather reports from this period were obtained from the National Oceanic and Atmospheric Administration online database. The primary outcome variable, "infection rate" was stratified according to the day, month, year, and season of diagnosis. Spearman correlation coefficients were calculated for infection rate with each weather variable in each time grouping, with needle plots constructed to visualize trends. Statistical significance was determined with p-value < 0.05. RESULTS: 199 patients were included. Only when infection rates were stratified by year did Spearman correlations reach statistical significance. Correlations that reached statistical significance included daily departure from normal average temperature, cooling degree days, daily maximum dry bulb temperature, average dry bulb temperature, average wet bulb temperature, and daily minimum dry bulb temperature. Using the null hypothesis that there was no correlation between weather variables and infection rates, all other correlation coefficients failed to reach statistical significance. CONCLUSIONS: The results of this study do not support an association between weather and head and neck fascial space infections in the southeastern United States.