Abstract:
Objective: Acupuncture, a widely employed traditional therapeutic modality known for its efficacy in pain alleviation and diverse condition management, may inadvertently result in mechanical nerve injury due to its invasive nature. This research aimed to ascertain the incidence of nerve injuries post-acupuncture, identify associated risk factors, and map the distribution of nerve injury sites. Methods: A case-control study nested in the National Health Insurance Research Database (NHIRD) 2000-2018 two million cohort was conducted. Patients previously diagnosed with nerve injury, surgery, or degeneration before acupuncture were excluded. Cases were defined as patients receiving acupuncture and seeking medical attention for nerve injury (ICD9-CM code 950-957) within 14 days post-procedure, while control groups comprised patients undergoing acupuncture without subsequent adverse events. Invasive treatments prior to adverse events and adverse events occurring more than 14 days post-acupuncture were excluded. To ensure case-control comparability, factors such as age, gender, socioeconomic status, and medical facility environment were controlled using propensity score matching. Results: The study encompassed 14,507,847 acupuncture treatments administered to 886,753 patients, with 8361 instances of post-acupuncture nerve injury identified, representing an incidence rate of approximately 5.76 per 10,000 procedures. Age emerged as a significant risk factor, with the adjusted odds ratios escalating with age. Several comorbidities including diabetes, hypothyroidism, liver cirrhosis, chronic kidney disease, herpes zoster, hepatitis virus, rheumatoid arthritis, systemic lupus erythematosus, dementia, and cerebrovascular accidents were associated with an elevated risk of nerve injury post-acupuncture. Conclusion: This study underscores the importance of meticulous patient profiling and cautious therapeutic approach in acupuncture, considering the evident influence of various demographic, systemic, and treatment-related factors on the incidence of nerve injuries.
Biography:
Chia-Lin Lin is a traditional Chinese physician who currently practices at the Renai Branch of the Taipei city hospital, where she completed her medical training after earning her degree at the Post-baccalaureate School of Chinese Medicine, Tzu-Chi university. Dr. Lin specializes in all forms acupuncture, management of osteoarthritis and tendinopathy and management of patients with metabolic syndrome. Dr. Lin is particularly adept at facial acupuncture, for which she received intensive training and is certified by the Taiwan facial acupuncture society. Facial acupuncture can be applied to patients with various neurological facial disorders including Bell’s palsy, post stroke facial asymmetry, trigeminal neuropathy and other similar diseases for symptom relief. Dr. Lin often collaborates with numerous neurologists, whom regularly refer patients following resolution of acute neurological episodes for long term symptom relief. Dr. Lin has also cooperated with neurologists to treat numerous patients seeking her advice due to nerve injury following acupuncture at various clinics. Dr. Lin’s numerous encounters with such patients prompted her to investigate and identify the most vulnerable patients, which resulted in this study.
Chia-Lin Lin
