创伤性皮肤伤口后感染性心内膜炎风险增加。

Increased risk of infective endocarditis after traumatic skin wound.

机构信息

Department of Clinical Epidemiology and Health Economics, The University of Tokyo, Tokyo, Japan

Department of Health Services Research, University of Tsukuba, Tsukuba, Ibaraki, Japan.

出版信息

Heart. 2021 Dec;107(23):1868-1874. doi: 10.1136/heartjnl-2020-318632. Epub 2021 Feb 25.

DOI:10.1136/heartjnl-2020-318632

PMID:33632746

Abstract

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.

摘要

目的

目前的数据表明，创伤性开放性皮肤伤口史可能是感染性心内膜炎的一个危险因素，但证据有限。我们检验了创伤性皮肤伤口是感染性心内膜炎的危险因素这一假说。

方法

我们使用日本医疗数据中心（JMDC）数据库（2012-2018 年，4650927 名 20-64 岁人群）和熊本数据库（2012-2017 年，493414 名≥65 岁人群），进行了嵌套病例对照和自身对照病例系列（SCCS）分析。

结果

在 JMDC 数据库中，544 例因感染性心内膜炎（IE）住院的患者与 2091 例对照进行了匹配；2.8%的病例和 0.5%的对照在过去 1-4 周内有创伤性皮肤伤口暴露史，调整后的 OR 为 4.31（95%CI 1.74-10.7）。在熊本数据库中，4.0%（27/670）的病例和 1.1%（29/2581）的对照在过去 1-4 周内有创伤性皮肤伤口暴露史，调整后的 OR 为 4.15（95%CI 2.04-8.46）。在 SCCS 中，IE 的发病率比值在熊本数据库中分别为 2.61（95%CI 1.67-4.09）、1.73（95%CI 1.01-2.94）、1.19（95%CI 0.63-2.27）和 1.52（95%CI 0.82-2.74），在 JMDC 数据库中分别为 3.78（95%CI 2.07-6.92）、1.58（95%CI 0.64-3.89）、1.60（95%CI 0.65-3.94）和 1.29（95%CI 0.47-3.53），分别为创伤性皮肤伤口后 1-4、5-8、9-12 和 13-16 周与基线期相比。