Outcomes after stroke in patients receiving adjuvant therapy with traditional Chinese medicine: A nationwide matched interventional cohort study

Chuen-Chau Chang, Ta-Liang Chen, Hsienhsueh Elley Chiu, Chaur-Jong Hu, Chun Chieh Yeh, Chin Chuan Tsai, Hsin Long Lane, Mao Feng Sun, Fung Chang Sung, Chien-Chang Liao, Jaung Geng Lin, Chun Chuan Shih

Research output: Contribution to journalArticle

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Abstract

Ethnopharmacological relevance The use of traditional Chinese medicine (TCM) was high in stroke patients but limited information was available on whether TCM is effective on post-stroke outcomes. The aim of this study is to compare the outcomes of stroke patients with and without receiving adjuvant TCM therapy. Materials and methods Using Taiwan's National Health Insurance Research Database, we conducted a nationwide cohort study and selected hospitalized stroke patients receiving routine care with (n=1734) and without (n=1734) in-hospital adjuvant TCM therapy by propensity score matching procedures. The adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) of poststroke complications and mortality associated with in-hospital adjuvant TCM therapy were calculated. The use of medical resource was also compared between stroke patients with and without adjuvant TCM therapy. Results Compared with hospitalized stroke patients receiving routine care alone, hospitalized stroke patients receiving routine care and adjuvant TCM therapy exhibited decreased risks of urinary tract infection (HR 0.82, 95% CI 0.68-1.00), pneumonia (HR 0.60, 95% CI 0.47-0.76), epilepsy (HR 0.67, 95% CI 0.49-0.96), gastrointestinal hemorrhage (HR 0.68, 95% CI 0.47-0.98), and mortality (HR 0.37, 95% CI 0.19-0.70) within 3 months after stroke admission. The corresponding 6-month HRs for urinary tract infection, pneumonia, gastrointestinal hemorrhage, and mortality were 0.83, 0.63, 0.64, and 0.40, respectively. Less use and expenditure of hospitalization were found in those received adjuvant TCM therapy. Conclusions Hospitalized stroke patients who received routine care and adjuvant TCM therapy exhibited reduced adverse outcomes after admission within a 6-month follow-up period.

Original languageEnglish
Pages (from-to)46-52
Number of pages7
JournalJournal of Ethnopharmacology
Volume177
DOIs
Publication statusPublished - Jan 11 2016

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Chinese Traditional Medicine
Cohort Studies
Stroke
Confidence Intervals
Gastrointestinal Hemorrhage
Therapeutics
Urinary Tract Infections
Mortality
Pneumonia
Propensity Score
National Health Programs
Health Expenditures
Taiwan
Epilepsy
Hospitalization
Databases

Keywords

  • Cohort study
  • Outcomes
  • Stroke
  • Traditional Chinese medicine

ASJC Scopus subject areas

  • Pharmacology
  • Drug Discovery

Cite this

Outcomes after stroke in patients receiving adjuvant therapy with traditional Chinese medicine : A nationwide matched interventional cohort study. / Chang, Chuen-Chau; Chen, Ta-Liang; Elley Chiu, Hsienhsueh; Hu, Chaur-Jong; Yeh, Chun Chieh; Tsai, Chin Chuan; Lane, Hsin Long; Sun, Mao Feng; Sung, Fung Chang; Liao, Chien-Chang; Lin, Jaung Geng; Shih, Chun Chuan.

In: Journal of Ethnopharmacology, Vol. 177, 11.01.2016, p. 46-52.

Research output: Contribution to journalArticle

Chang, Chuen-Chau ; Chen, Ta-Liang ; Elley Chiu, Hsienhsueh ; Hu, Chaur-Jong ; Yeh, Chun Chieh ; Tsai, Chin Chuan ; Lane, Hsin Long ; Sun, Mao Feng ; Sung, Fung Chang ; Liao, Chien-Chang ; Lin, Jaung Geng ; Shih, Chun Chuan. / Outcomes after stroke in patients receiving adjuvant therapy with traditional Chinese medicine : A nationwide matched interventional cohort study. In: Journal of Ethnopharmacology. 2016 ; Vol. 177. pp. 46-52.
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abstract = "Ethnopharmacological relevance The use of traditional Chinese medicine (TCM) was high in stroke patients but limited information was available on whether TCM is effective on post-stroke outcomes. The aim of this study is to compare the outcomes of stroke patients with and without receiving adjuvant TCM therapy. Materials and methods Using Taiwan's National Health Insurance Research Database, we conducted a nationwide cohort study and selected hospitalized stroke patients receiving routine care with (n=1734) and without (n=1734) in-hospital adjuvant TCM therapy by propensity score matching procedures. The adjusted hazard ratios (HRs) and 95{\%} confidence intervals (CIs) of poststroke complications and mortality associated with in-hospital adjuvant TCM therapy were calculated. The use of medical resource was also compared between stroke patients with and without adjuvant TCM therapy. Results Compared with hospitalized stroke patients receiving routine care alone, hospitalized stroke patients receiving routine care and adjuvant TCM therapy exhibited decreased risks of urinary tract infection (HR 0.82, 95{\%} CI 0.68-1.00), pneumonia (HR 0.60, 95{\%} CI 0.47-0.76), epilepsy (HR 0.67, 95{\%} CI 0.49-0.96), gastrointestinal hemorrhage (HR 0.68, 95{\%} CI 0.47-0.98), and mortality (HR 0.37, 95{\%} CI 0.19-0.70) within 3 months after stroke admission. The corresponding 6-month HRs for urinary tract infection, pneumonia, gastrointestinal hemorrhage, and mortality were 0.83, 0.63, 0.64, and 0.40, respectively. Less use and expenditure of hospitalization were found in those received adjuvant TCM therapy. Conclusions Hospitalized stroke patients who received routine care and adjuvant TCM therapy exhibited reduced adverse outcomes after admission within a 6-month follow-up period.",
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AU - Chang, Chuen-Chau

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AU - Hu, Chaur-Jong

AU - Yeh, Chun Chieh

AU - Tsai, Chin Chuan

AU - Lane, Hsin Long

AU - Sun, Mao Feng

AU - Sung, Fung Chang

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AU - Lin, Jaung Geng

AU - Shih, Chun Chuan

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AB - Ethnopharmacological relevance The use of traditional Chinese medicine (TCM) was high in stroke patients but limited information was available on whether TCM is effective on post-stroke outcomes. The aim of this study is to compare the outcomes of stroke patients with and without receiving adjuvant TCM therapy. Materials and methods Using Taiwan's National Health Insurance Research Database, we conducted a nationwide cohort study and selected hospitalized stroke patients receiving routine care with (n=1734) and without (n=1734) in-hospital adjuvant TCM therapy by propensity score matching procedures. The adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) of poststroke complications and mortality associated with in-hospital adjuvant TCM therapy were calculated. The use of medical resource was also compared between stroke patients with and without adjuvant TCM therapy. Results Compared with hospitalized stroke patients receiving routine care alone, hospitalized stroke patients receiving routine care and adjuvant TCM therapy exhibited decreased risks of urinary tract infection (HR 0.82, 95% CI 0.68-1.00), pneumonia (HR 0.60, 95% CI 0.47-0.76), epilepsy (HR 0.67, 95% CI 0.49-0.96), gastrointestinal hemorrhage (HR 0.68, 95% CI 0.47-0.98), and mortality (HR 0.37, 95% CI 0.19-0.70) within 3 months after stroke admission. The corresponding 6-month HRs for urinary tract infection, pneumonia, gastrointestinal hemorrhage, and mortality were 0.83, 0.63, 0.64, and 0.40, respectively. Less use and expenditure of hospitalization were found in those received adjuvant TCM therapy. Conclusions Hospitalized stroke patients who received routine care and adjuvant TCM therapy exhibited reduced adverse outcomes after admission within a 6-month follow-up period.

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