Objective Current data suggest that a history of traumatic open skin wounds may be a risk factor for infectious endocarditis, with limited evidence. We tested the hypothesis that traumatic skin wound is a risk factor for infectious endocarditis.
Methods Using the Japan Medical Data Center (JMDC) database (4 650 927 people aged 20–64 years, 2012–2018) and the Kumamoto database (493 414 people aged ≥65 years, 2012–2017), we conducted nested case–control and self-controlled case series (SCCS) analyses.
Results In the JMDC database, 544 cases hospitalised for infective endocarditis (IE) were matched with 2091 controls; 2.8% of cases and 0.5% of controls were exposed to traumatic skin wounds in the previous 1–4 weeks, with an adjusted OR of 4.31 (95% CI 1.74 to 10.7). In the Kumamoto database, 4.0% (27/670) of cases and 1.1% (29/2581) of controls were exposed to traumatic skin wounds in the previous 1–4 weeks, with an adjusted OR of 4.15 (95% CI 2.04 to 8.46). In the SCCS, the incidence rate ratios for IE were 2.61 (95% CI 1.67 to 4.09), 1.73 (95% CI 1.01 to 2.94), 1.19 (95% CI 0.63 to 2.27) and 1.52 (95% CI 0.82 to 2.74) for the Kumamoto database and 3.78 (95% CI 2.07 to 6.92), 1.58 (95% CI 0.64 to 3.89), 1.60 (95% CI 0.65 to 3.94) and 1.29 (95% CI 0.47 to 3.53) for the JMDC database at 1–4, 5–8, 9–12 and 13–16 weeks after traumatic skin wound, respectively, compared with the baseline period.
Conclusions This study suggests that traumatic skin wound is a risk factor for IE 1–4 weeks after the wound.
Data availability statement
Data may be obtained from a third party and are not publicly available. The datasets analysed during the current study are not publicly available due to contracts with the hospitals providing data to the database.
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Presented at This work was performed at The University of Tokyo and Jichi Medical University.
Contributors HO designed the research; YS and HY conducted the research; HO and MI analysed the data; HO, MI and HY wrote the paper; HO is the guarantor of this research. All authors read and approved the final manuscript.
Funding This work was supported by grants from the Ministry of Health, Labour and Welfare, Japan (grant numbers 19AA2007 and H30-Policy-Designated-004) and the Ministry of Education, Culture, Sports, Science and Technology, Japan (grant numbers 17H04141 and JP19K19394).
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
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