Liu Peter Pin-Sung, Chang Huai-Ren, Huang Huei-Kai, Hsu Jin-Yi, Peng Carol Chiung-Hui, Chang Kai-Ming, Loh Ching-Hui, Yeh Jih-I
Center for Healthy Longevity, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan.
School of Medicine, Tzu Chi University, Hualien, Taiwan.
Korean Circ J. 2025 Jul;55(7):640-652. doi: 10.4070/kcj.2024.0306. Epub 2025 Mar 25.
We aim to investigate whether disruption of the skin defense in the form of cutaneous wounds may increase the incidence rate (IR) of infective endocarditis (IE) in the general population.
We performed a retrospective population-based study using Taiwan's National Health Insurance Database from 2013 to 2022. Self-controlled case series (SCCS) was used to investigate the time-sequential association between cutaneous wounds and IE. Adult patients with both cutaneous wounds (exposure) and IE (outcome) in the database were included in the study. Conditional Poisson regression was used to calculate the adjusted IR ratios (aIRRs) of IE during the 4 weeks following wounds to that of the baseline period within the same individuals.
We enrolled 3,241 eligible patients for SCCS analysis. The risks of IE were elevated in the second week (aIRR, 2.16; 95% confidence interval [CI], 1.07-4.35; p value=0.032) after a treated traumatic wound. The risks of IE were elevated in the first (aIRR, 1.56; 95% CI, 1.17-2.09; p value=0.002) and second (aIRR, 1.58; 95% CI, 1.19-2.10; p value=0.002) after a treated non-traumatic wound.
Both traumatic and non-traumatic cutaneous wounds are associated with an increased risk of IE within the first 2 weeks after treatments among the general population in Taiwan. Clinicians should be vigilant for symptoms or signs associated with IE in these patients to avoid delays in diagnosis and treatment.
我们旨在研究皮肤伤口形式的皮肤防御破坏是否会增加普通人群感染性心内膜炎（IE）的发病率（IR）。
我们使用2013年至2022年台湾国民健康保险数据库进行了一项基于人群的回顾性研究。自我对照病例系列（SCCS）用于研究皮肤伤口与IE之间的时间顺序关联。数据库中同时患有皮肤伤口（暴露）和IE（结局）的成年患者被纳入研究。使用条件泊松回归计算伤口后4周内IE与同一患者基线期IE的调整发病率比（aIRRs）。
我们纳入了3241例符合条件的患者进行SCCS分析。治疗性创伤伤口后第二周IE风险升高（aIRR，2.16；9５％置信区间[CI]，1.07 - 4.35；p值 = 0.032）。治疗性非创伤伤口后第一周（aIRR，1.56；95％CI，1.17 - 2.09；p值 = 0.002）和第二周（aIRR，1.58；95％CI，1.19 - 2.10；p值 = 0.002）IE风险升高。
在台湾普通人群中，创伤性和非创伤性皮肤伤口在治疗后的前2周内均与IE风险增加相关。临床医生应警惕这些患者中与IE相关的症状或体征，以避免诊断和治疗延迟。
