Incidence of nerve injury following acupuncture treatments in Taiwan

Chia-Lin Lin; Andy Chern; Ming-Jen Wang; Shun-Ku Lin

doi:10.1016/j.ctim.2023.103007

Incidence of nerve injury following acupuncture treatments in Taiwan

Complement Ther Med. 2024 Mar:80:103007. doi: 10.1016/j.ctim.2023.103007. Epub 2023 Nov 30.

Authors

Chia-Lin Lin¹, Andy Chern², Ming-Jen Wang³, Shun-Ku Lin⁴

Affiliations

¹ Department of Chinese medicine, Taipei City Hospital, Renai Branch, Taipei, Taiwan, ROC; Institute of Traditional Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC. Electronic address: 103318121@gms.tcu.edu.tw.
² Department of Chinese medicine, Taipei City Hospital, Renai Branch, Taipei, Taiwan, ROC; Institute of Traditional Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC.
³ Department of Chinese medicine, Taipei City Hospital, Renai Branch, Taipei, Taiwan, ROC; Institute of Public Health, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC; Institute of Traditional Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC.
⁴ Department of Chinese medicine, Taipei City Hospital, Renai Branch, Taipei, Taiwan, ROC; Institute of Public Health, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC; Institute of Traditional Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC; University of Taipei, Taipei, Taiwan, ROC.

PMID: 38040097
DOI: 10.1016/j.ctim.2023.103007

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.

Keywords: Acupuncture; Distribution of nerve injury, sites; Incidence rate; Nerve injury; Risk factors.

MeSH terms

Acupuncture Therapy* / adverse effects
Acupuncture Therapy* / methods
Case-Control Studies
Cohort Studies
Humans
Incidence
Taiwan / epidemiology