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The Association Between Cutaneous Wounds and Infective Endocarditis: A Nationwide Self-Controlled Case Series Study
Peter Pin-Sung Liu1, Huai-Ren Chang2,3, Huei-Kai Huang2,4,5
1Center for Healthy Longevity, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan.
Korean Circulation Journal
|April 10, 2025
Summary
Cutaneous wounds, both traumatic and non-traumatic, elevate the risk of infective endocarditis (IE) within two weeks post-treatment. This highlights the importance of monitoring patients with skin injuries for IE symptoms.
Area of Science:
- Infectious Diseases
- Dermatology
- Cardiology
Background:
- Skin integrity is crucial for preventing pathogen entry.
- Cutaneous wounds may serve as a portal for bacteria leading to systemic infections.
- The association between skin barrier disruption and infective endocarditis (IE) requires further investigation.
Purpose of the Study:
- To determine if cutaneous wounds increase the incidence rate of infective endocarditis (IE) in the general population.
- To investigate the temporal relationship between treated cutaneous wounds and the subsequent risk of IE.
Main Methods:
- Retrospective population-based study utilizing Taiwan's National Health Insurance Database (2013-2022).
- Self-controlled case series (SCCS) design to assess the association between cutaneous wounds and IE.
- Conditional Poisson regression to calculate adjusted incidence rate ratios (aIRRs) of IE post-wounding.
Main Results:
- 3,241 patients were included in the SCCS analysis.
- Traumatic wounds showed an elevated IE risk in the second week (aIRR: 2.16).
- Non-traumatic wounds elevated IE risk in the first (aIRR: 1.56) and second (aIRR: 1.58) weeks post-treatment.
Conclusions:
- Both traumatic and non-traumatic cutaneous wounds are linked to a heightened risk of IE.
- The increased IE risk is observed within the first two weeks following wound treatment.
- Clinicians should maintain vigilance for IE symptoms in patients with recent cutaneous wounds.
