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 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.

中文翻译：

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外伤性皮肤伤口后感染性心内膜炎的风险增加

目的 目前的数据表明，外伤性开放性皮肤伤口史可能是感染性心内膜炎的危险因素，但证据有限。我们检验了外伤性皮肤伤口是感染性心内膜炎的危险因素的假设。方法利用日本医疗数据中心（JMDC）数据库（4 650 927人，2012-2018年）和熊本数据库（493 414人，≥65岁，2012-2017年），我们进行嵌套病例对照和自控病例系列 (SCCS) 分析。结果在JMDC数据库中，544例感染性心内膜炎（IE）住院病例与2091例对照者匹配；在过去的 1-4 周内，2.8% 的病例和 0.5% 的对照组暴露于外伤性皮肤伤口，调整后的 OR 为 4.31（95% CI 1.74 至 10.7）。在熊本数据库中，4.0% (27/670) 的病例和 1. 1% (29/2581) 的对照组在过去 1-4 周内暴露于外伤性皮肤伤口，调整后的 OR 为 4.15（95% CI 2.04 至 8.46）。在 SCCS 中，IE 的发生率为 2.61（95% CI 1.67 至 4.09）、1.73（95% CI 1.01 至 2.94）、1.19（95% CI 0.63 至 2.27）和 1.52（95% CI 2.74）对于 Kumamoto 数据库和 3.78（95% CI 2.07 到 6.92）、1.58（95% CI 0.64 到 3.89）、1.60（95% CI 0.65 到 3.94）和 1.29（95% CI 0.47 到 3.53）和 1.29（95% CI 0.47 到 3.53）数据库与基线期相比，分别在皮肤外伤后 –4、5–8、9–12 和 13–16 周。结论 本研究表明外伤性皮肤伤口是伤口后 1-4 周 IE 的危险因素。数据可能从第三方获得并且不公开可用。