Jen-Lin Yang1,2, Ta-Liang Chen3,4, Chun-Chieh Yeh5,6, Chaur-Jong Hu7, Chien-Chang Liao4,8,9,10,11, Hsin-Long Lane12, Chun-Chuan Shih12,13. 1. 1 Center for Traditional Medicine, Taipei Veterans General Hospital, Taipei, Taiwan. 2. 2 Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan. 3. 3 Department of Anesthesiology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan. 4. 4 Department of Anesthesiology, School of Medicine, Taipei Medical University, Taipei, Taiwan. 5. 5 Department of Surgery, China Medical University Hospital, Taichung, Taiwan. 6. 6 Department of Surgery, University of Illinois, Chicago, IL, USA. 7. 7 Department of Neurology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan. 8. 8 Department of Anesthesiology, Taipei Medical University Hospital, Taipei, Taiwan. 9. 9 Anesthesiology and Health Policy Research Center, Taipei Medical University Hospital, Taipei, Taiwan. 10. 10 School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan. 11. 11 Department of Anesthesiology, Shuan Ho Hospital, Taipei Medical University, Taipei, Taiwan. 12. 12 School of Chinese Medicine for Post-Baccalaureate, I-Shou University, Kaohsiung, Taiwan. 13. 13 Ph.D. Program in Clinical Drug Development of Herbal Medicine, College of Pharmacy, Taipei Medical University, Taipei, Taiwan.
Abstract
BACKGROUND: The association between acupuncture treatment and post-stroke urinary tract infection (UTI) remains incompletely understood. OBJECTIVE: To compare the long-term risks of UTI among stroke patients treated with or without acupuncture treatment. METHODS: This retrospective cohort study was based on data from the National Health Insurance Research Database in Taiwan that included hospitalized stroke patients. We identified 19,286 patients aged 30 years and older who were hospitalized for newly diagnosed stroke between 1 January 2000 and 31 December 2004. Considering immortal time bias, we compared the incidence of UTI during the follow-up period until the end of 2009 in patients with stroke who did and did not receive acupuncture. The adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) of UTI associated with acupuncture were calculated using multivariate Cox proportional hazard regression analysis. RESULTS: Stroke patients who received acupuncture treatment experienced a lower incidence of UTI than those who were not treated with acupuncture (95.4 vs 110.0 per 1000 person-years) with an HR of 0.76 (95% CI: 0.73-0.80). The association between acupuncture treatment and UTI was significant for both sexes and for patients older than 40 years of age, particularly for patients who had no history of medical conditions. CONCLUSIONS: In this nationwide retrospective cohort study, we raised the possibility that acupuncture treatment may be associated with a reduced risk of UTI among stroke patients. However, the protective effect associated with acupuncture treatment requires further validation using randomized clinical trials.
BACKGROUND: The association between acupuncture treatment and post-stroke urinary tract infection (UTI) remains incompletely understood. OBJECTIVE: To compare the long-term risks of UTI among strokepatients treated with or without acupuncture treatment. METHODS: This retrospective cohort study was based on data from the National Health Insurance Research Database in Taiwan that included hospitalized strokepatients. We identified 19,286 patients aged 30 years and older who were hospitalized for newly diagnosed stroke between 1 January 2000 and 31 December 2004. Considering immortal time bias, we compared the incidence of UTI during the follow-up period until the end of 2009 in patients with stroke who did and did not receive acupuncture. The adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) of UTI associated with acupuncture were calculated using multivariate Cox proportional hazard regression analysis. RESULTS:Strokepatients who received acupuncture treatment experienced a lower incidence of UTI than those who were not treated with acupuncture (95.4 vs 110.0 per 1000 person-years) with an HR of 0.76 (95% CI: 0.73-0.80). The association between acupuncture treatment and UTI was significant for both sexes and for patients older than 40 years of age, particularly for patients who had no history of medical conditions. CONCLUSIONS: In this nationwide retrospective cohort study, we raised the possibility that acupuncture treatment may be associated with a reduced risk of UTI among strokepatients. However, the protective effect associated with acupuncture treatment requires further validation using randomized clinical trials.