Highlights
- •The use of adjuvant therapy with different forms of traditional Chinese medicine after stroke was associated with reduced mortality.
- •The most commonly used form of traditional Chinese medicine in this cohort was acupuncture.
- •The use of acupuncture alone was associated with reduced mortality.
Abstract
Objectives
We investigated whether the use of adjuvant traditional Chinese medicine (TCM) therapy,
a form of complementary and alternative medicine, is associated with long-term mortality
after stroke.
Study design
We conducted a retrospective cohort study and used claims data from Taiwan's National
Health Insurance program linked to the National Registry of Death. The cohort included
patients aged ≥18 years who were hospitalized for their first stroke event between
January 1, 2006, and December 31, 2013. Adjuvant TCM therapy was defined as additional
treatments with TCM, which included acupuncture, Chinese herbal medicine, and Tuina,
during hospitalization for up to six months.
Main outcome measure
The mortality rate was measured through to December 31, 2014.
Results
Of 321,157 patients with stroke, 14,579 received adjuvant TCM therapy. Propensity
score matching resulted in 13,918 matched pairs of patients who did and did not receive
adjuvant TCM care. Both multivariable-adjusted Cox proportional hazards models (hazard
ratio [HR] 0.67, 95% confidence interval [CI] 0.64–0.69) and propensity score-matching
analysis (HR, 0.65; 95% CI, 0.60–0.66) revealed a reduced mortality risk associated
with the use of adjuvant TCM therapy, as compared with routine inpatient care only.
Acupuncture was the most commonly used TCM therapy. Patients treated with acupuncture
only, which accounted for 41.3% of TCM users, had a reduced risk of mortality compared
with those treated with routine inpatient care.
Conclusions
The use of TCM therapy adjuvant to Western inpatient care in the acute and subacute
stages of stroke recovery is associated with a reduced risk of long-term mortality.
Keywords
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Article info
Publication history
Published online: December 10, 2021
Accepted:
December 8,
2021
Received in revised form:
October 1,
2021
Received:
June 12,
2021
Identification
Copyright
© 2021 Elsevier B.V. All rights reserved.
