Skip to main content
AAO-HNSF 2026 Annual Meeting & OTO EXPO Main banner
Icon Legend
This session is not in your schedule.
This session is in your schedule. Click again to remove it.

Scientific Oral Presentation

Care Equity, Quality, and Safety

Where Patients Live Matters: The Effect of Neighborhood Disadvantage upon Skull Base Osteomyelitis

Sunday, October 18, 2026
11:54 AM - 12:00 PM PT
Location: 406A

    Presenting Author(s)

  • SJ

    Shreya Jain, BA

    Medical Student
    Baylor College of Medicine
    Houston, Texas, United States

    • Co-Author(s)

  • Marco A. Campioli, BA

    Medical Student
    Baylor College of Medicine
    Houston, Texas, United States

  • KB

    Kaitlyn A. Brooks, MD

    Assistant Professor
    University of Texas Health Science Center - San Antonio, United States

  • Nathan R. Lindquist, MD

    Assistant Professor
    Baylor College of Medicine
    Houston, TX, United States

  • Alex D. Sweeney, MD

    Brown Foundation Associate Professor, Vice-Chair of Clinical Affairs
    Baylor College of Medicine, Department of Otolaryngology
    Houston, TX, United States

    • Senior Author(s)

  • Angela S. Peng, MD

    Assistant Professor
    Baylor College of Medicine
    Houston, TX, United States

Disclosure(s):
Angela S. Peng, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Skull base osteomyelitis (SBO) is a dangerous infection, which more commonly affects immunocompromised patients. We compared distinct patient populations (public vs. private institution) within the same metropolitan area and hypothesized that socioeconomic disadvantage portends a higher risk to SBO diagnosis.

Methods: A retrospective study was conducted from 2000 to 2025 with aggregated data at private and public hospitals. Adult patients with SBO ICD-10 codes (cases) were compared to controls without ICD-10 codes. Area deprivation index (ADI) is a validated metric that ranks neighborhoods by relative socioeconomic disadvantage, with higher values indicating more disadvantage. The most prevalent ZIP codes for cases and controls at each institution were collected along with corresponding ADI state deciles and national percentiles for comparison with t-test and logistic regression. Effect sizes were measured by mean difference (MD) and odds ratio (OR) with 95% confidence interval (CI) reported.

Results: The private institution (A) yielded 351 cases and 4,309,144 controls versus 539 cases and 4,067,562 controls at the public hospital (B). Patients with SBO at hospital B faced greater area deprivation by state decile (MD 1.32, 95% CI 0.24 – 2.41, p = 0.018) and national percentile (MD 11.25, 95% CI 2.1 – 20.41, p = 0.017) compared to patients at hospital A. Unadjusted odds of SBO diagnosis between institutions is higher at hospital B (OR 1.63, 95% CI 1.42 to 1.86, p< 0.001). When adjusted for ADI, however, at the state (OR 0.94, p = 0.56) and national level (OR 0.93, p = 0.53), this odds difference vanished between institutions. For each one-unit increase in ADI national percentile and state decile, there is a 1.7% (p < 0.001) and 15% (p < 0.001) increase in odds of SBO diagnosis overall, respectively.

Conclusions: Our study indicates that living in a higher deprivation neighborhood affects the risk of SBO diagnosis, regardless of healthcare institution type. This result indicates that neighborhood deprivation plays a significant role in developing SBO.