Acupuncture for inpatients with ischemic stroke in Southern Taiwan: real-world data

Traditional Chinese Medicine (TCM) interventions have shown efficacy in aiding the outpatient treatment of patients with ischemic stroke, particularly in functional recovery and mortality reduction. Despite being covered by Taiwan National Health Insurance (NHI), TCM utilization among inpatients remains low. This study investigated the use of acupuncture, a key TCM modality, among hospitalized patients with ischemic stroke in a medical center in southern Taiwan from 2017 to 2020. Newly hospitalized ischemic stroke patients diagnosed between January 1, 2017, and December 31, 2020, were enrolled. This study assessed acupuncture interventions in hospitalized patients with stroke and evaluated whether acupuncture reduced patient mortality. Differences in demographic and clinical variables between the acupuncture and non-acupuncture groups were analyzed using independent sample t-tests or chi-square tests. Hazard ratios (HR) were used to compare the mortality risk between the acupuncture and non-acupuncture groups using Cox proportional hazards models employed for univariate and multivariate regressions. Between 2017 and 2020, 23.9% of the 1,455 inpatients with ischemic stroke at Kaohsiung Veterans General Hospital received acupuncture interventions. The demographic characteristics were similar between the two groups, except for age and renal failure. The acupuncture group showed a higher proportion of patients receiving recombinant tissue plasminogen activator, lipid-modifying agents, and endovascular thrombectomy, as well as a higher proportion of patients with baseline modified Rankin Scale scores of 3–6. Adjusted HRs for 12-month mortality in the acupuncture group were 0.45 (0.22–0.93, 95% CI) compared to the control group. This study provides real-world data on inpatients with ischemic stroke receiving acupuncture treatment during hospitalization. Patients with ischemic stroke who received acupuncture during hospitalization exhibited a lower 12-month mortality risk, even among those who were older or had severe physical disabilities at admission. This study was approved by the Institutional Review Board of Kaohsiung Veterans General Hospital (IRB No. KSVGH23-CT8-12).