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

This retrospective cohort study analyzed real-world data on the use of acupuncture in inpatients with ischemic stroke in Taiwan, providing important evidence on the efficacy of this complementary therapy in the acute phase of stroke. The research was conducted at Kaohsiung Veterans General Hospital between 2017 and 2020, including 1,455 patients with recently diagnosed ischemic stroke. The methodology involved retrospective analysis of medical records, comparing patients who received acupuncture during hospitalization with those who received conventional care only. The primary outcome was 12-month mortality, analyzed using Cox regression models to adjust for confounding variables such as age, sex, comorbidities, and treatments received.

The results showed that 23.9% of hospitalized patients received acupuncture, a relatively high proportion compared with previous studies. Interestingly, the group that received acupuncture had greater baseline severity, with 84.5% of patients having modified Rankin scores between 3-6, compared with 65.8% in the control group. Despite the greater severity, the acupuncture group showed superior survival outcomes. The multivariate analysis demonstrated that patients treated with acupuncture had an adjusted hazard ratio of 0.45 for 12-month mortality, representing a 55% reduction in the risk of death.

This reduction was statistically significant even after adjustment for age, stroke severity, comorbidities, and other treatments. The acupuncture group also showed greater use of advanced therapies such as thrombolysis, endovascular thrombectomy, and rehabilitation, suggesting a more integrated approach to care. The proposed mechanisms for the benefits of acupuncture include reduction of complications such as pneumonia, urinary tract infections, and recurrent cardiovascular events, which are major causes of death after stroke. Acupuncture may also improve neurological function and physical capacity, contributing to a better overall prognosis.

The study suggests that early integration of acupuncture with conventional care during hospitalization may optimize outcomes, especially considering that the optimal window for acupuncture intervention is within 24-48 hours after stroke. The clinical implications are significant, supporting health policies that promote integration between traditional Chinese medicine and Western medicine in the inpatient management of stroke. Taiwan represents a unique model with national health system coverage for acupuncture, which made this real-world data analysis possible. The study has important limitations, including an observational design that does not allow definitive causality to be established, single-center setting that limits generalizability, and the inability to evaluate the optimal frequency or total number of acupuncture sessions due to multiple confounding factors.